Exercise

During the assessment, the lung transplant physiotherapist will give you an exercise programme to follow. You will need access to an exercise bike (stationary bike) and some weights. If this is an issue for you, talk to the physiotherapist about other options.

Your exercise programme will include aerobic and strengthening exercises.

Aerobic exercise (daily)

Aerobic exercise gets your heart and lungs working. Your exercise programme will include walking and stationary cycling (on an exercise bike). You will feel somewhat out of breath, a bit sweaty and your heart will be beating faster. However, if you begin to feel unwell (severe shortness of breath, dizzy, lightheaded, chest pain, your oxygen levels drop very low or your heart is racing), you should stop. The aim is that as you get fitter, you will be able to do more without getting too out of breath.

Strengthening exercises (3 times per week)

Strengthening exercises help you develop stronger muscles. Building muscles in your legs and core can also help with balance, which is important for staying independent. Always stretch after these exercises to avoid any muscle soreness.

The physiotherapist will also give you an exercise diary with your personalised exercise programme. Record your activity every day and bring the diary with you to all your physiotherapy appointments.

Pulmonary rehabilitation

Pulmonary rehabilitation is a programme to help people with lung disease manage feelings of breathlessness. We encourage all patients to enrol in a pulmonary rehabilitation class locally. Ask your GP or local respiratory consultant for a referral.

Feeling out of breath

Everyone experiences breathlessness duringphysical activity, including trained athletes. You too should expect to be more breathless when exercising but you should never feel more than ‘moderately breathless’. If you are on oxygen, increase your oxygen to whatever level the medical team advises for exercise. This will allow you to exercise comfortably and to stick with your planned programme.

Don’t hold your breath when exercising. If you feel any symptoms of light-headedness, dizziness, uncontrolled shortness of breath or pain, stop and rest. If these symptoms continue, you should go to your GP or local respiratory consultant for review.

The BORG scale

Knowing how breathless you should be when you exercise will give you the confidence to remain active. Physiotherapists use the BORG scale with patients, to gauge how breathless you should be when exercising.

This scale goes from 0 to 10, 0 meaning no breathlessness, and 10 meaning extremely breathless. When active and exercising, you should be aiming for a level of 3 to 4 on the BORG scale. This can best be described as being able to speak but not gasping. Remember, every day is unique and your level on this scale may vary depending on how you are feeling.

Breathing tips

Align your breathing with the exercise. Breathe out during the hardest part (for example, lifting a weight) and breathe in as you relax and return to your starting position.

Keep your hands loose and relaxed. There are some positions that make it easier to catch your breath. Ask your physiotherapist for more information. If none of these positions feel comfortable, try sitting more upright with your arms supported.

• Start slowly and gradually build up momentum.
• Stick to a level that is safe and right for you, as advised by your physiotherapist.
• Warm up before and cool down after exercising.
• Carry your reliever inhaler (if you have been prescribed one) and use it when you need it.
• Wear loose, comfortable clothing and supportive non-slip shoes, such as trainers.
• Make sure you're hydrated.
• Use oxygen at the setting prescribed for exercise by your physiotherapist.
• If you're using a portable cylinder for exercise, make sure there's enough oxygen in it.
• Talk to your physiotherapist if exercise makes your chest feel tight or wheezy. They may advise you to take a reliever inhaler 5 to 20 minutes before your exercise session.
• Stop any exercise that feels painful (beyond your normal aches).
• Some patients find it hard to exercise for prolonged periods. In this case, it is better to do shorter exercise routines more frequently, rather than longer sessions.

Stop your exercise if you feel:

• Chest pain or tightness that is new for you
• Dizzy, nauseous, clammy or cold
• Increasingly wheezy
• Weakness in an arm or leg that is more than just a tired muscle
• Lightheaded or heart racing (palpitations)
• Low oxygen levels

Contact your GP or local respiratory team for advice. In an emergency, go straight to the nearest Emergency Department.

If you need extra support to help you stick to your exercise programme, your physiotherapist may recommend some of the following:


• Irish Lung Fibrosis Association (ILFA)
• COPD Support Ireland
• Exwell Medical
• CF Ireland