Chronic obstructive pulmonary disease (COPD) – Key Facts

COPD is a lung disease caused by a persistent blockage of airflow from the lungs. COPD is a life threatening disease that interferes with normal breathing.


COPD has one prevalent symptom – breathlessness. Other symptoms include abnormal sputum (a mix of saliva and mucus in the airway) and a chronic cough. Every day activities such as climbing stairs or carrying a heavy bag an become difficult over time as the condition worsens.

Diagnosis and treatment

A simple test called a ‘spirometry’ will confirm if you have COPD. This test measures how much a person can inhale and exhale, and how fast air can travel into and out of the lungs.  COPD is a condition that develops slowly. People over the age of 40 frequently have it diagnosed.

The condition is not curable. However, treatment can help control the symptoms and also increase the quality of life of sufferers.

Risk factors

COPD is preventable. The primary cause of COPD is tobacco smoke (including second-hand or passive exposure). Other risk factors include:

  • indoor air pollution (such as solid fuel used for cooking and heating);
  • outdoor air pollution;
  • occupational dusts and chemicals (vapours, irritants, and fumes);
  • frequent lower respiratory infections during childhood.

Key Facts

  • Chronic obstructive pulmonary disease (COPD) is a life-threatening lung disease that interferes with normal breathing – it is more than a “smoker’s cough”.
  • An estimated 64 million(*) people had COPD worldwide in 2004.
  • More than 3 million people died of COPD in 2005, which is equal to 5% of all deaths globally that year.
  • Almost 90% of COPD deaths occur in low- and middle-income countries.
  • The number of deaths from COPD has increased more than 60% over the last 20 years.

POWERbreathe is drug-free and has no side-effects or drug interactions, POWERbreathe inspiratory muscle training will complement your prescribed COPD medicine, but we would recommend you speak to your medical practitioner before starting any exercise training plan.

Read more about COPD and managing your shortness of breath with breathing training.


What Is COPD? by Stephen Trevathan, Achieve Clinical Patient Education

Achieve Clinical Research What Is COPD?

Did you know that COPD is the third leading cause of death in the United States and causes about 25,000 deaths a year in the UK? In fact, according to the World Health Organization (WHO), COPD is the fifth leading cause of death worldwide! Millions of people around the world have been diagnosed with COPD, but perhaps even more frightening is the number of people who have gone undiagnosed. Doctors estimate that there could be millions of people who have this disease, but are not even aware of it. You may be asking yourself, “Exactly how could someone have this disease and not know it?” In order to understand this problem, we need to understand the disease itself.

So, what exactly is this deadly lung disease? In order to fully understand COPD, it is helpful to start out by realizing that this is actually not one single disease. Chronic Obstructive Pulmonary Disease (COPD) refers to a group of lung diseases that start to inhibit a patient’s airflow as they exhale. COPD is primarily made up of three related conditions: emphysema, chronic bronchitis, and chronic asthma.

Over time, these conditions make it increasingly more and more difficult to breathe. As any doctor would note, COPD can be a progressive disease, so it is very important to catch it at an early stage. In fact, this is exactly why this disease can be so deadly. Many patients are not diagnosed until they have reached a more advanced stage of the disease, and any damage to the lungs is irreversible.

Common Symptoms of COPD
There are a number of symptoms that have been associated with COPD. Some people may develop a chronic cough, frequent respiratory infections, and shortness of breath (this is also referred to as dyspnea). In fact, breathlessness, or dyspnea, tends to be one of the biggest red flags for COPD. It will be the major symptom if the patient is predominantly affected by emphysema. Initially, the shortness of breath will be more apparent during physical activity, but as the disease progresses to a more advanced stage, dyspnea can even occur while at rest.

For those COPD patients that have been affected primarily by chronic bronchitis, their major symptoms will be excess sputum production and a chronic cough. One should keep an eye out for sputum that appears to be clear and thick. Patients that experience periodic chest infections should also be wary of purulent (meaning discolored or cloudy) sputum, fever, breathlessness, or wheezing. As the chronic bronchitis starts to get worse, these chest infections will become more frequent.

Symptoms of Advanced Stage COPD
As COPD progresses, the symptoms will become more severe, and hospitalization may be required. Patients could develop morning headaches, which can occur if their body is not able to remove the carbon dioxide from the blood. If the disease has advanced far enough, patients may develop cyanosis (their lips and nail beds may turn bluish) from the overall lack of oxygen in available in the blood.

During the more advanced stages of COPD, the small blood vessels in the lungs are gradually destroyed. As they go, the flow of blood through the patient’s lungs gets blocked, which causes the heart to pump with more force and pressure in order to send blood through the lungs. In some cases, the patient’s heart is not able to cope with the additional strain. This can cause Cor pulmonale, or failure of the right side of the heart, resulting in swollen ankles and feet. Additionally, if the damage done to the inner lining of the airways is bad enough, it can cause some COPD patients to cough up blood. In any case, immediate medical attention should be sought if any of these advanced symptoms are experienced.

What Causes COPD? 

Cigarette Smoke: The number one cause of COPD around the world is smoking. Simply put, smoking causes ninety percent of the COPD cases identified in the United States and at least four out of five people in the UK who develop COPD are or have been smokers. According to current estimates, about fifteen percent of all cigarette smokers will eventually develop COPD. Additionally, the death toll among COPD patients that were (or still are) smokers is much higher than for COPD patients who were not smokers. COPD patients who smoke will experience a much faster rate of deterioration in their lungs. However, doctors have noted that if they quit, their rate of deterioration will slow down to about the same rate as a non-smoker with COPD.

Air Pollution: According to recent studies, in the non-industrialized world, the most common cause of COPD is actually indoor air pollution. Things like indoor stoves, dust, household chemical products, and poor ventilation can all be contributing factors. Outdoor air pollution can trigger the symptoms of COPD; however, it is still unclear whether it contributes to the development of COPD.

Workplace Exposure: Some jobs put people in contact with a variety of occupational pollutants. Over a long period of time, this sustained exposure can increase their risk of COPD. People who work as coal miners, metal workers, construction workers, or cotton workers need to take extra precautions while on the job.

Alpha-1 Antitrypsin (AAT) Deficiency: Despite only accounting for less than one percent of the COPD in the United States, the deficiency of alpha -1 antitrypsin (AAT) has become a well-established cause of COPD. AAT helps to block the damaging effect of elastase (this is an enzyme found in the lungs, which can cause damage to the airways and the alveoli). If a person is AAT deficient, they could develop emphysema by the time they are in their 40’s. Additionally, smoking will actually increase the amount of elastase in the lungs.

Medical Research on COPD
Unfortunately, there is no cure for COPD. However, medical researchers have been making excellent strides forward in recent years. For the better part of the last four decades, clinical research for COPD focused on learning more about the pathogenesis of the disease. This has led to a number of very promising discoveries. In particular, medical researchers have been learning incredible things about the primary cellular pathways which are involved in the development of COPD. Data that supports a number of new and innovative procedures and therapies has been presented, and could prove to be very beneficial for COPD patients all over the world. A comprehensive cure is still far from being discovered, but we can certainly expect to see the development and utilization of more effective diagnostic tests for COPD in the near future.

Stephen Trevathan,
Achieve Clinical Patient Education


Exercises for COPD

copd-sphereCOPD is the short definitions for Chronic Obstructive Pulmonary Disease. In the United States alone COPD is the fourth leading cause of death.  This respiratory illness is primarily caused by smoking, genetics, air pollution and asthma. Secondary smoke and respiratory infections can also occur in COPD.  This disease affects your quality of life as it makes breathing incredibly difficult. However, a regular exercise program can help you manage the disease better as well as increase the quality of life.

Importance of Exercise

Pulmonary rehabilitation and exercise go hand in hand as it improves the overall strength and endurance of the respiratory muscles. during exercise the muscles in the body learn to use oxygen more efficiently which means the lungs don’t have to work so hard.  Another benefit of exercise is that it boosts mental health and help you maintain a healthy lifestyle – healthy weight and blood pressure. exercise also improves blood circulation round your body which helps with your breathing

Begin an Exercise Routine

Anyone who is a COPD sufferer should practice two types of exercise – regular aerobic exercise for general strength and conditioning and exercises to help control and manage breathing. However, it is imperative you talk to your GP before undertaking any form of exercise program. Always start off slow and rest immediately if you experience shortness of breath, chest pain or feel dizzy.

Exercises to Control Breathing

Pursed lip and diaphragmatic breathing help improve your airflow and decrease shortness of breath. Pursed lip exercises are done by breathing in through your nose, pursing your lips as though you’re going to whistle, and then exhaling slowing through your mouth. It should take you 2-4 times longer to exhale than it took to inhale. Separating the chest from the abdomen, the diaphragm muscle is essential for breathing. Learning to properly use and strengthen this muscle can be accomplished by following this exercise: Lay down, put one hand on your abdomen and the other on your chest, and inhale through your nose while concentrating on making your stomach move while keeping your chest still. Then exhale through pursed lips, letting your stomach fall inward while continuing to keep the upper chest as still as possible. Regular exercise can help aid you in your COPD treatment and make your quality of life better.



Breathing exercises that can help with COPD treatment

What-is-COPDChronic obstructive pulmonary disease also known as COPD is the term that is given to a group of lung diseases. these lung diseases block your airflow as you exhale, making it very difficult for you to breathe.  Practising regular breathing exercises can help you cope with COPD and also aid your COPD treatment.  Worldwide COPD is a major cause of death.

Relax and breathe

If you have COPD then the most effective way to overcome breathlessness is to relax and breathe. Find a quiet spot and lay down in a comfortable position completely focus on your breathing.  With each breathe that you take you should try and slow down the pace and relax your body each more and more.  Eventually you will be able to control your breath. Anytime you are feeling breathless you should use this technique.

Counting Breath

Try counting silently in your head while breathing. Doing this automatically slows and relaxes the breathing. To start with count to two on your inhale and two on your exhale. Then gradually increase to three then four. Become comfortable with counting to four on your inhales and exhales before you take the next step and increase exhales to a count of five while keeping the inhales to a count of four. Eventually you want to increase your exhales to a count of six.

Ujjayi Pranayama

Ujjayi pranayama can be performed while laying flat on your back or with your head and chest slightly elevated. It is important that you get the correct position and that your head is sits higher than your chest. Always start with a few cycles of normal breathing, then inhale naturally and exhale fully keeping your chest elevated.  This should be repeated for 15-20 cycles, then you should return to your normal breathing pattern. This method of breathing helps to improve the function of the lungs.

Viloma Pranayama

Anyone who suffers from a breathing order should practice this breathing exercise. Start by inhaling three-fourths of a breath and then exhale fully. Continue this breathing pattern for a few breaths. Next, inhale only two-thirds of a breath and exhale fully. Continue this pattern for a few breaths. Go back to breathing three-fourths in and fully exhaling for a few rounds. Then slowly return to normal, relaxed breathing.

If you suffer from breathing difficulties you will know just how difficult it is to breathe. Inspiratory muscle training helps to strengthen and condition your breathing muscles. Practicing any of the above breathing methods can aid you with your COPD treatment as well as increase the quality of your life as a COPD sufferer.


Training a client with COPD (Chronic Obstructive Pulmonary Disease)

Within each edition of Fitpro Network, the magazine for personal trainers, they ask an expert to answer a training-related query, and in the April/May 2012 edition they examined training a client with COPD.

We thought we’d share the question and answer with you.

Q: A new client has chronic obstructive pulmonary disease (COPD). What do I need to  be aware of when training them and how much impact can exercise have on their condition?

A: According to the NHS, COPD is the name for a collection of lung diseases including chronic bronhistis, emphysema and chronic obstructive airways disease. People with COPD have trouble breathing in and out, with these breathing difficulties being due to varying degrees of damage to the lungs, usually caused by smoking.1

COPD can progress to become a life-threatening respiratory condition. According to the World Health Organization,2 COPD is the fourth leading cause of death worldwide. There are approximately 900,000 people in the England and Wales with COPD, of which more than 250,000 die each year. The consequences of COPD may be quite serious – daily activities can become very difficult as the condition gradually worsens over time.

Symptoms can include a chronic cough, dyspnoea (breathlessness with even the slightest exertion), wheezing, muscle weakness (muscle wasting occurs in about 30% of those with COPD), plus high and low blood pressure.

Even though physical activity will have no effect on the life expectancy of the individual, according to the 2008 GOLD report,3 there are many reported benefits of exercise on the overall quality of life. These include a reduction in symptoms improved muscular capacity, lower risk of hospital admission and mortality, and improved ability for functional tasks. These benefits highlight the importance that those with COPD perform some form of physical activity. It is also important that you inform the client’s GP as anyone with more than mild COPD will be under direct specialist supervision. One form of activity that is generally recommended is that of ventilatory training (e.g.,PowerBreathe).

It is thought that including this type of training as well as cardio training benefits the individual more than just performing ventilator training in its own.

As can be seen in the guidelines, the use of a dyspnoea scale is recommended. This particular scale gets the individual to rate their own level of discomfort. The scale is a sliding one; zero indicates a discomfort level of nothing at all, three is moderate, five is severe and 10 is maximal.

Those with more severe COPD generally have limited aerobic capacity and poor posture, therefore several very short periods of activity with rest in between and upper-body strength exercises should be encouraged. The primary goal is usually to begin with aerobic-type activities and then gradually introduce resistance-type activities. Trainers should be familiar with warning signs of any cardio respiratory problem such as worsening dyspnoea, swollen ankles and high resting heart rate. If in any doubt, cease all physical activity and seek medical advice. FN

Morc Coulson

Morc is senior lecturer in health-related exercise and programme leader of sports and exercise sciences at the University of Sunderland. His book Exercise for Special Populations is out now.



2. World Health Organization (2009), WHO Disease and injury country estimates, Retrieved 11 June 2010.

3. GOLD (2008), Global initiative for chronic obstructive lung disease, Pocket guide to COPD diagnosis, management and prevention: A guide for health care professionals, Medical Communications Resources Inc.

4. American College of Sports Medicine (2009), Exercise management for persons with chronic diseases and disabilities (3rd edition), Human Kinetics, Champaign, IL.

END….Fitpro Network | April May 2012

Analysis from controlled trials reported improvements following the use of inspiratory muscle training (IMT), and guidelines such as those issued by NICE for the management of COPD, acknowledge that this form of breathing training has a part to play in the treatment of COPD. Read more about IMT and COPD or view which model of POWERbreathe for COPD is available.

Penny Harris – 3 weeks of using my POWERbreathe Medic

Penny Harris in Turkey 2011I have now been using my Powerbreathe Medic for 3 weeks.  The day I started using it I also reduced my inhaler dosage. This was done with the full approval of the nurse at the asthmas clinic!

I have been tracking my peak flows twice a day to give me an objective picture of what is happening.

The first couple of days my peak flow stayed the same, then on day 3 it dropped slightly, only by 15-20 points.  After two days it popped back up again, and has been trundling along since then.  The only time I have had any symptoms was after a tough track session, but I always have coughed after those!

Getting into a routine with the twice daily use of the Powerbreathe has been a case of trial and error.  In the morning I try and use it before I use my inhaler, in the evening the same.

It did take a few days to get the tension right, but I got there! I am now increasing the resistance quite quickly, especially when I realise that I have done 30 breaths and not noticed! I am intrigued to see how I go over the next few weeks, as I increase the resistance higher.

I am going to see the asthma nurse again and go through the Powerbreathe with her. We are going to discuss my asthma medication again as well as I am on such a low dose of my current inhaler it is not technically therapeutic!


If you too use POWERbreathe breathing exercises for asthma, we’d love to hear from you. Please sign up to the Blog or leave a comment here.

Penny Harris – How I got hold of my POWERbreathe Medic

I follow a lot of triathletes on Twitter, and Mel Ryding was mentioning POWERbreathe and how it was reducing her asthma inhaler usage at track running sessions.  I am an asthmatic who uses Seretide inhalers twice a day and have been talking to the nurse at the asthma clinic about trying to reduce my usage.  I had got down to three puffs a day and I want to see how low I can go so I swapped a few messages with POWERbreathe and discovered that a version is available as a medical device on prescription!

On my next visit to my doctor, I mentioned the POWERBreathe Medic.  She had never heard of  it and suggested I spoke to the nurse at the asthma clinic on my next visit.  This I did last week but she was not aware of it either!  Luckily for me she is keen to improve the service she can offer her respiratory patients in the rural area we live in.  She could not find it on the computer, which we later discovered was because POWERbreathe is one word, not two.  She persisted and called me at home to say she had written a prescription for me.  In return, I am going to be her guinea pig, going back in a month with my POWERbreathe Medic to show her how it works and if there has been any improvement.  At the same time I am going to reduce my inhaler dose to one puff twice a day!  The nurse was impressed to find research evidence on the device, and is keen to look at it for her COPD patients.

It has been a little frustrating to get my hands on the POWERbreathe Medic, but having finally picked it up from the chemists today, after they had to order it, I am looking forward to seeing what happens over the next few weeks.  I will use my peak flow meter and my subjective opinion to track any benefits.  Hopefully it will help my breathing during my triathlon training as well!

I’ll keep you updated with my progress.


If you too use POWERbreathe breathing exercises for asthma, we’d love to hear from you. Please sign up to the Blog or leave a comment here.

Breathing difficulty, symptoms and treatment

Respiratory SymptomIf you are someone who suffers from shortness of breath, have trouble breathing or find you have to put in more effort to breathe, then you probably have a respiratory illness or some form of lung disease such as emphysema, COPD or asthma.  Whether you are resting, exercising or simply lying flat, you can suffer breathing difficulty symptoms.  If you can pinpoint the triggers that cause these breathing problems then you can find out what the underlying cause is.

Symptoms contributing to breathing difficulty

So what are the symptoms? If you have severe breathing problems then the most common symptoms are rapid respiratory rate, continuous wheezing and nasal flaring. Anyone who suffers from severe breathing problems will place extra strain on the neck and chest muscles to breathe.  For example, an asthma sufferer will experience breathing difficulty with wheezing while someone who suffers from a heart condition will find they experience breathing problems when they exercise.

Treatment for breathing difficulties

Breathing conditions are treated differently. It all depends on what the underlying cause is for the breathing problem you have. Many treatments are available – some medications and some drug-free treatments.  An inspiratory muscle trainer can help with any breathing problems you may have and is a suitable aid for COPD treatment as it exercises and strengthens the muscles you use to breathe. Inspiratory Muscle Training (IMT) is scientifically proven to benefit patients with respiratory illness.


Five COPD treatment tips to control the quality of your indoor air

copd-sphereIndoor air can be just as polluted as outdoor air. Even more so. For those who suffer from COPD and other respiratory illnesses, spending time indoors is not by choice. This is why it is important that the quality of the indoor air is as pollution free as possible.

To help improve the quality of air indoors, here are some top tips which will help anyone who suffers from COPD, asthma or any other respiratory illness.


#1 You need to take charge of the air you breathe inside

Over anything else you need to take charge of your home if you want to improve the quality of the indoor air you breathe.  What this means is identifying the three main categories of substances that reduce the quality of your indoor air.  These are:


Substances that cause your body’s immune system to have an allergic response. These include dust mites and pollen.


These are substances that irritate your respiratory system. Common sources of irritants include paint, tobacco smoke and chemicals in cleaning products.

Dangerous chemicals

These are less common but cause greater harm on our health. These would include chemicals containing carbon monoxide which is highly  poisonous and if detected in the home should be immediately eliminated.

#2 Talk to Your Doctor

Most health care specialists are very knowledgeable regarding issues surrounding air pollution – indoor and outdoor. Talk to your healthcare official or GP and they will help you with a plan to help you manage indoor pollution. Your GP knows you best so is the best person to advise you.

#3 Ensure your home is properly ventilated

According to the Environmental Protection Agency (EPA), one of the most important ways that you can reduce the build-up of indoor air pollution is to properly ventilate your home.  Properly ventilating your home is easy. All you need to do is make sure you open windows, use exhaust fans and use window fans. Having exhaust fans fitted also benefit any home as they help to reduce moisture.

#4 Tell the smokers to smoke outside

The worst irritant of all for someone who suffers from   a respiratory condition is tobacco smoke. Breathing in second hand smoke is dangerous to your health. Anyone who is a smoker and is visiting your home, why not ask them politely to go outside and smoke.

#5 Say goodbye to the house guests known as dust mites

If you did not know, dust mites survive by eating dead skin cells from humans and animals. Although invisible to the human eye these little mites are a  major contributor of indoor pollution and are found in all homes. Dust mites have brittle shells that create dried particles. People can actually inhale these particles and cause damage to their lungs. You can reduce the dust mite population within your home with these few simple steps:

  • Try and wash your bed linen on a weekly basis.
  • Lower your indoor humidity level to below 50% (with a dehumidifier or air-conditioner)
  • If you have pets, keep them off the furniture.

Following these simple steps can ensure your COPD treatment will be effective as well as help improve the quality of your indoor air. Some healthcare professionals may recommend you use a breathing trainer which will help you with your respiratory conditions.

Love your lungs and breathe for life

Love Your LungsLung disease is a condition or disease in which the lung function is impaired.  Without lungs, humans will not be able to breathe correctly. Our lungs open the doors to life as they provide us with oxygen and remove the carbon dioxide from our bodies.

Our lungs are constantly in contact with the outside air and the internal body environment which means they are susceptible to disease. In the USA alone COPD is the fourth leading cause of death. It has been predicted that by 2020 COPD will become the leading cause of death in the USA. Lung disease affects many people but it is also the number one killer in babies less than a year old.

With the cold weather upon us many of us try and keep indoors to stay warm and illness free. However the cold weather is a nightmare for anyone that suffers from respiratory illness such as chronic lung illness, COPD and asthma. The cold weather can be the cause of severe asthma attacksand can also aggravate existing lung conditions.

Image Source

These problems can be avoided by keeping our lungs nice and healthy. Here is some useful advice to keep your lungs disease free:

If you are a smoker, get some help in quitting

If you don’t smoke then be grateful and don’t be tempted to start.  Anyone who smokes a pipe, cigarette or cigar is inhaling more than 4,000 chemicals from the smoke.

Second hand smoke should be avoided

Smoking is harmless on its own, but breathing in second hand smoke is just as bad as smoking yourself.

Make sure you wash your hands to reduce the risk of infection

You may not know but around 80 percent of common respiratory illnesses such as common colds and flu are spread by our hands.

Get vaccinated regularly

Over recent years the flu vaccination has been recommended for anyone that wants it. It is also recommended you have the pneumonia vaccination if you are 65 or over. The pneumonia vaccination should also be given to those with chronic health conditions such as COPD.

Avoid anything that will trigger your lung disorder

People who suffer from asthma, COPD or emphysema should avoid anything that can trigger the illness. This can be anything that causes the chest to tighten, causes you to wheeze or suffer shortness of breath symptoms or coughing attacks.

Adhere to your diagnosis guidelines

If your diagnosis tells you that you have COPD, asthma or emphysema then it is important you understand how important breathing medication is and how often you need to take your medication.

Understand your symptoms and talk to your Doctor

It is very common for people to ignore symptoms such as shortness of breath, wheezing, constant coughing and chest tightness. If you experience any of these then speak to your Doctor immediately.

We only get one set of lungs so it is extremely important we know how to look after them. Following these tips can help us cope if we have respiratory conditions such as COPD and asthma. If you do suffer from COPD then your doctor can recommend COPD treatment advice which will help you with your condition as well as improve the quality of your life. This treatment may involve the use of a breathing trainer.