Welcome!
All journeys start with a single step.
Thank you for deciding to take this step with the Canadian Lung Association.
How to use this program
The BREATHE Better | Stay STRONG Virtual Pulmonary Rehabilitation program contains an Introduction module and eight learning modules. Each module is divided into five sections: Overview, Education, Exercise, Take Action and Feedback. Using this program properly is the key to your success.
Please read through the information below to learn how the modules are structured and what kind of information you'll find in each section.
Each module begins with an Overview. The Overview introduces the topic and lists the goals that you will meet as you complete the module.
To the left of the overview is a sidebar menu that lists the other sections in the module. The sidebar menu appears on every page to make it easy for you to navigate through the module.
The Education section of each module features important information about your lung health and overall wellness.
Some of the information is more general and applies to anyone taking part in this program, while other information is specific to your lung disease, whether you have COPD, asthma, bronchiectasis, cystic fibrosis, pulmonary fibrosis, sarcoidosis or other interstitial lung disease.
Having lung disease does not mean you can't stay active. In fact, staying active is an important part of living with chronic lung disease.
The Exercise section offers tools that will help you safely and gradually build your strength and endurance during the next eight-weeks. We have created a video exercise program, a deep breathing meditation and have included a home walking program to help you be and stay active.
Make sure to watch the Introduction to Exercise video that will help you stay safe while exercising with lung disease.
The Take Action section is where you'll find helpful tools, links to other trusted websites and downloadable resources that you can print or save on your device. These resources offer more information on how to Take Action and manage your disease, your mood and your quality of life.
The Take Action Section in the Introduction includes self-assessments for health and well-being, self-management and exercise tolerance. Doing these now and again at the end of the program will help you see how far you've come in just eight weeks.
The Feedback section gives you a chance to tell us what you think. Has the module been helpful to you? Do you have any suggestions on how to improve the module or program in general?
We'd love to hear from you.
Exercising with lung disease
Exercise is an important part of managing your lung disease. Avoiding activity does more harm than good. The less you do, the weaker you become and the more you try to avoid activities that increase your shortness of breath. This leads to more deconditioning of your muscles, increased shortness of breath and even more inactivity.
By adding exercise to your day, you are breaking the cycle of inactivity. This will help you to do more without feeling as breathless.
Exercising will also help build strength and endurance to help you feel more confident in your abilities. That confidence can improve your mood and your quality of life.
Exercising with COPD
If you use oxygen, follow your prescription for increasing the oxygen flow rate with exercise or exertion. Maintain an oxygen saturation level above 90%. Take your controller breathing medication regularly (at the same time every day). Reliever medications can be taken 15 to 20 minutes before exercise to reduce shortness of breath (dyspnea). Take breaks for breathing exercises as needed. Increase the number of times (repetitions) you perform an exercise before increasing the weight.
Exercising with asthma
If you usually wheeze or feel chest tightness with exertion, take your reliever medications 15-20 minutes before exercising. A longer warm up and cool down will reduce symptoms of breathlessness. Exercise in areas where you won't be exposed to triggers for your asthma; avoid or adjust for cold, dry, dusty or polluted air.
Exercising with bronchiectasis or cystic fibrosis
Lower-limb exercises may increase lung secretion movement. You may want to take additional pauses in the exercise videos to perform airway clearance with huff coughing. Some people may find it helpful to use airway clearance techniques before starting endurance exercise.
Exercising with pulmonary fibrosis or sarcoidosis
Your body’s response to shortness of breath while exercising is to breathe faster because it’s difficult to breathe deeper. Take breaks as needed to use breathing techniques to regain your breath. Increase your intensity more slowly throughout the program, perhaps increasing intensity by one repetition rather than two, or by half as much weight.
Pace yourself, as you keep moving forward, to safely reach your highest level of activity and to maintain it.
EXERCISE
Below you will find key concepts, questions and reminders that reinforce self-management before you begin to exercise.
Your steps to success
- If you have a pulse oximeter, check your oxygen saturation and heart rate. If they are normal for you, plan to exercise with us.
- If you use home oxygen, follow your provider’s order regarding if and how you should increase your oxygen flow for exercise or exertion.
- Did you take you long-acting controller medications this morning?
- If you are diabetic, monitor your blood glucose (sugar) levels before and after exercising.
- If you smoke, do you BELIEVE that smoking is dangerous to your health?
- Did you smile at yourself in the mirror today? You made a great choice to start this program today.
A circulating fan helps many people with chronic lung disease exercise more comfortably.
How do you know if you're working hard enough? Too hard?
Consider the sentence, “I know this exercise is doing me good.”
- Your intensity level is too low if you do not need to pause mid-sentence.
- Your intensity level is too high if you cannot start or finish the sentence.
- Your intensity level is just right if you have to pause mid-sentence to take one breath. Consider your intensity level just right if you are able to say your phone number in one breath.
You will rate your level of intensity several times during your exercise workout using the Rate of Perceived Exertion Scale. The exertion goal that you should strive for while exercising is a level 3 to 5 on this scale. This level of intensity will let you experience the benefits of the exercise without overdoing it.
Increase your strength safely
Everyone starts from their own starting point. As instructors, we will start by doing 8 reps of strength exercises, then work our way up to 15 reps. Find the amount of weight that works for you. Some people may start without weights, using only their body as resistance; others may start with light or moderate weights.
If you find that you can easily perform 15 reps with a certain amount of weight, it's time to increase that weight by 0.5 to 1.0 kg and repeat the reps at 8.
The goal is for you to keep moving forward and reach your highest level safely and maintain it. Only you know the limits of your ability and your range of motion. You should not feel pain when you are exercising.
Some shortness of breath or muscle fatigue is normal during exercise. Feel free to take a break to do some breathing techniques to regain your breath or to clear secretions.
If you develop chest pain, dizziness, or uncontrolled shortness of breath, stop exercising.
Home walking program
Below is a home walking guide to help you increase your cardiovascular fitness and personal endurance. If your endurance is low, start slow on the cardio. Gradually increase how long your walk, cycle or swim. The goal is to enjoy 30 minutes of cardio 5 to 7 days per week.
Home Walking Program
Week 1
5 minutes, 5 times per day
Weeks 2 & 3
10 minutes, 3 times per day
Weeks 4 & 5
15 minutes, 2 times per day
Week 6
20 minutes, 1 time per day
Week 7
25 minutes, 1 time per day
Week 8
30 minutes, 1 time per day
Other forms of exercise
Regular aerobic activity, helps you to build endurance, maintain a healthy weight, regulate blood sugar, reduce stress and decrease the risk of cardiovascular disease.
Cycling and stationary fitness pedals can increase your heart and lung fitness as well as increasing your strength and endurance. It can be a part of your exercise program. You can begin at your own pace and increase your speed and distance as you are able. Stationary pedals can be used for upper and lower body fitness.
Swimming and water fitness is a great aerobic exercise that works your whole body. It improves aerobic conditioning, muscle strength, endurance and flexibility all at the same time. Advantages include lower risk of injury and improved posture.
Stair climbing is another option for cardiovascular exercise. Use pursed-lip breathing while stair climbing. Inhale at rest and exhale as you climb one, two or three steps, based on your ability. Repeat. As your endurance improves, inhale at rest, exhale as you climb two or three steps, inhale while climbing two of three more steps. Continue taking breaks as needed.
Using technology can be fun!
Purchasing a simple pedometer can help you track the number of steps you take in a day.
If you have a smart phone, you can download a free app to track your steps and/or activity level. Devices such as Fitbits, Garmin watches or Smartwatches can also be used.
Relaxation, Meditation and Better Breathing
Following the exercise program, BREATHE Better|Stay STRONG offers a 10-minute body sensing and breath sensing meditation that helps to reinforce relaxation and diaphragmatic breathing.
Youtube supports many free Mindful Meditation and Better Breathing videos to promote effective breathing techniques, as well as mood, motivation, relaxation, stability, clarity and sleep enhancement. The Canadian Lung Association does not endorse the use of any particular or specific website or channel for meditation and relaxation. Sites listed are suggestions only.
- Goodful | 10-Minute Meditation to Start Your Day
- The Daily Calm | 10-Minute Mindfulness Meditation
- Better Breathing Coach | Janice Brown
Modules
Introduction · Module 1 · Module 2 · Module 3 · Module 4
Module 5 · Module 6 · Module 7 · Module 8 · Conclusion
Speak to a certified respiratory educator
Call our Health Information Line at 1-866-717-2673 to speak to a certified respiratory educator. You can also email info@lung.ca.