COPD stands for chronic obstructive pulmonary disease. COPD affects hundreds of thousands of New Zealanders, yet most have never even heard of it. Around 15% of adults aged over 45 years live with COPD and it is the fourth leading cause of death in NZ.


What is COPD?

COPD is an umbrella term for the conditions emphysema, chronic bronchitis and long-standing asthma. When we breathe, air travels from our nose and mouth down through our airways to our lungs. In people with COPD, the airways are permanently damaged, making it hard to breathe. COPD affects hundreds of thousands of New Zealanders, yet most have never even heard of it.

What causes COPD?

Smoking, including second-hand smoking, is the main cause of COPD. This means that for most people COPD is a preventable disease. However, there are a small number of people who develop COPD who have never smoked. These people may have long-standing asthma or have been exposed to other inhaled pollutants such as industrial dusts in their workplace or air pollution.

What are the symptoms of COPD?

As COPD is a condition that gets worse over time, the initial stages of the condition may be mild and almost unnoticeable. Once more lung damage has occurred, your COPD will be classed as ‘moderate’ and you may begin to notice symptoms.

Moderate COPD symptoms include:

Severe COPD symptoms include:

How can I manage COPD?

by Zöe Manderson

We tend to think of chronic obstructive lung disease (COPD) as something that just affects our lungs and breathing - you get puffed more easily and that is why physical activity becomes more difficult. However, research has shown that COPD also has an impact on your musculoskeletal system (your muscles and bones) which contributes to reduced exercise capacity.

Sarcopenia is a medical term used to describe the gradual loss of muscle mass and strength. People with COPD are more susceptible to sarcopenia. It typically affects their lower limb muscles the most, especially the big front thigh muscles called the quadriceps.

Deterioration in bone quality is known as osteoporosis. The bone becomes more fragile and is at risk of fractures (getting broken). Hip fractures and spinal fractures are the most common. Unfortunately, osteoporosis is also more common in people with COPD.

There are several factors which contribute to the increased incidence of osteoporosis and sarcopenia in COPD. These include cigarette smoking, physical inactivity, poor nutrition, corticosteroid (e.g. prednisone) use and inflammation.

One of the most important things you can do to help minimise the musculoskeletal impacts of COPD is exercise. Why not start right now, with this simple exercise:


This exercise targets your quadriceps. Sit comfortably in your chair, lift one leg, lower and then repeat with the other leg. Aim for ten repetitions on each leg, or until your muscles start feel tired. A good time to do this exercise is during an ad-break on TV. You can make the exercise more difficult by wearing strap on leg weights if you have them.

Another simple exercise which focuses on lower limb strength and also balance is this:


Do this exercise near the kitchen bench so you can hold it for support, or if you want to challenge your balance, try it without holding on. Gently bend your hips and knees, like you are preparing to sit down, then push up tall again. A good time to do this exercise is while you are waiting for the kettle to boil. Try and do these exercises three or four times per week.

With the warmer weather approaching (hopefully!) it is also a good time to get outside. Walking is an excellent, easy and free exercise option which can help strengthen your muscles and bones and improve your overall exercise capacity.


Zöe Manderson is a respiratory physiotherapist in Taranaki for Te Whatu Ora and a member of the Asthma and Respiratory Foundation’s Scientific Advisory Board.

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