February 18, 2016

Managing day-to-day activities with shortness of breath

Corinne French, Program Manager – Pulmonary Rehabilitation, Lung Foundation Australia

Our body needs oxygen to function. The more we move, and the faster we move, the more oxygen our body needs. Our body’s response to this increased demand is to increase our breathing and heart rate. If our lungs are affected by lung disease, any activity can lead to shortness of breath (dyspnoea) and this may result in a reluctance to do day-to-day activities like walking or mowing the lawn. However, when we move less, our muscles become weaker which makes them less efficient in oxygen usage, leading to a downward spiral of inactivity and increased shortness of breath. To assist you to maintain your activity level and continue your daily tasks, these are the main points to consider:

1. Efficient breathing pattern

Be aware of your breathing because you can get into habits that can hinder the function of the lungs. It is important to use your diaphragm and rib cage, avoid raising your shoulders and holding your breath. Instead, try to breathe out with effort and you may find using pursed lip breathing assists. It is also important to make your breath out slightly longer than your breath in as this will assist in a more efficient breathing pattern.

2. Pacing

The faster you move the more oxygen your body needs,
so it is important to work at a pace where your breathing is under your control. For most people with a lung condition, this means slowing down. This can be hard to accept as you may feel that you are not doing an activity “correctly” or as quickly as you used to. However, if by slowing down or taking regular rests you are able to complete the task and not be completely out of breath, you have succeeded.

3. Coordination of breathing with movement and posture

When you are bending forward to do an activity like putting on your shoes, you will find it helps to breathe out during the movement. Due to your position, your ability to breathe in is compromised as your lungs are squashed. It is important not to hold your breath because when you return to the upright position you will need to exhale the air you have held in your lungs before taking a new breath in. The same rule applies when you are doing activities with your arms raised above your head like washing your hair or hanging out your washing, as this position raises the rib cage and changes your body dynamics. This restricts the size of the breath that you are able to take in. So, the rule of thumb is to breathe out when bending forward or when raising your arms overhead.

4. Breaking tasks into manageable segments

Sometimes daily tasks can be long and exhausting, and breaking the task into manageable segments with short rests to recover is a good way to assist you to cope. For example, after showering, sitting and resting with a bathrobe on allows you to recover. Another example is housework, which can be broken up by doing a little bit or one room at a time.

5. Energy conservation 

With all tasks, the more movement and muscle groups involved, the more energy and oxygen required. Not meeting the energy and oxygen demands of the muscles which are trying to work can cause an increased breathing rate. To conserve energy, “work smarter” by trying to simplify the task or reduce some of the effort involved.

Examples of how you can reduce the energy used to complete a task include:

  • Sitting to perform tasks like cutting your vegetables or folding your washing
  • Having someone help you perform the task such as making the bed with your partner
  • Using lighter or smaller items to perform the task such as lighter cooking pots
  • Adapting the task by using equipment like pushing a laundry trolley rather than carrying a heavy basket

To avoid attempting to do too much on one day, plan ahead. Try to prioritise the tasks that are most important to you.

6.  Muscle strengthening

Weak muscles have been shown to be less efficient at utilising oxygen so it is important to maintain or improve the strength of your muscles through regular movement and exercise. Simple exercises such as moving from sitting to standing and step ups at a controlled pace are some of the exercises that will help strengthen your larger leg muscles. To gain maximum benefit from exercise, it is recommended you attend a pulmonary rehabilitation program or seek guidance from a health professional to provide exercises at a level suitable for you.

7. Pulmonary rehabilitation and maintenance exercise 

Pulmonary rehabilitation is a comprehensive program of education and exercise designed to optimise your physical and social wellbeing. Evidence shows the programs can assist you to manage breathlessness, improve quality of life, help you to stay out of hospital and resume activities you may have given up. Lungs in Action is Lung Foundation Australia’s community-based maintenance exercise program for people with stable chronic lung conditions who have previously completed pulmonary rehabilitation. Studies show that people who continue regular exercise are more likely to maintain the improvements gained from pulmonary rehabilitation. Unless you continue to attend a regular maintenance exercise program, the benefits of pulmonary rehabilitation can decline over a 6 – 12 month period.

Some of the benefits from attending a Lungs in Action program include:

  • Maintaining or improving fitness
  • Exercising with people who have had similar experiences
  • Making daily life activities like gardening, self-care and housework easier
  • Exposure to a social environment that is fun and supportive
  • Being instructed by an exercise professional who understands your specific needs, and has been trained by Lung Foundation Australia

For information about your local pulmonary rehabilitation program or Lungs in Action class, call Lung Foundation Australia on 1800 654 301 or visit the website here.