context: Exercise -- especially exercise that works your lungs and heart -- has many benefits for those with chronic obstructive pulmonary disease ( COPD). Exercise can: Improve how well your body uses oxygen. That's important because people with COPD use more energy to breathe than other people do. Decrease your symptoms and improve your breathing Strengthen your heart, lower your blood pressure, and improve your circulation Improve your energy, making it possible to stay more active Improve your sleep and make you feel more relaxed Help you maintain a healthy weight Enhance your mental and emotional outlook Reduce your social isolation, if you exercise with others Strengthen your bones These four types of exercise can help you if you have COPD. How much you focus on each type depends on the COPD exercise program your health care provider suggests for you. Stretching exercises lengthen your muscles, increasing your flexibility. Aerobic exercises use large muscle groups to move at a steady, rhythmic pace. This type of exercise works your heart and lungs, improving their endurance. This helps your body use oxygen more efficiently and, with time, can improve your breathing. Walking and using a stationary bike are two good aerobic exercises if you have COPD. Strengthening exercises involve tightening muscles until they begin to tire. When you do this for the upper body, it can help increase the strength of your breathing muscles. Breathing exercises for COPD help you strengthen breathing muscles, get more oxygen, and breathe with less effort. Here are two examples of breathing exercises you can begin practicing. Work up to 5 to 10 minutes, three to four times a day. Pursed-lip breathing: Relax your neck and shoulder muscles. Breathe in for 2 seconds through your nose, keeping your mouth closed. Breathe out for 4 seconds through pursed lips. If this is too long for you, simply breathe out twice as long as you breathe in. Use pursed-lip breathing while exercising. If you experience shortness of breath, first try slowing your rate of breathing and focus on breathing out through pursed lips. Diaphragmatic breathing: Lie on your back with knees bent. You can put a pillow under your knees for support. Place one hand on your belly below your rib cage. Place the other hand on your chest. Inhale deeply through your nose for a count of three. Your belly and lower ribs should rise, but your chest should remain still. Tighten your stomach muscles and exhale for a count of six through slightly puckered lips. Set realistic goals. Gradually increase the number of minutes and days you exercise. A good goal is to exercise 20 to 40 minutes, 2 to 4 times a week. Start out slow. Warm up for a few minutes. Choose activities you enjoy, and vary them to help you stay motivated. Find an exercise partner. Keep a record of your exercise to help you stay on track. As you end your exercise, cool down by moving more slowly. It's good to take precautions when exercising with COPD, but remember that shortness of breath doesn't always mean you should stop altogether. Ask your doctor about when you should stop exercising and rest. Here are other exercise precautions: Always consult a doctor or other health care provider before starting a COPD exercise program. If you have a change in any medications, talk to your doctor before continuing your exercise routine. Balance exercise with rest. If you feel tired, start at a lower level. If you feel very tired, rest, and try again the next day. Wait at least an hour and a half after eating before beginning to exercise. When you drink fluids while exercising, remember any fluid restrictions you have. Avoid hot or cold showers after exercising. If you've been away from exercise for several days, start up slowly, and gradually return to your regular routine. Exercises to avoid when you have COPD: Heavy lifting or pushing Chores such as shoveling, mowing, or raking Pushups, sit-ups, or isometric exercises, which involve pushing against immovable objects Outdoor exercises when the weather is very cold, hot, or humid Walking up steep hills Ask your doctor whether exercises like weightlifting, jogging, and swimming are OK for you to do. If you experience any of these signs or symptoms, stop your COPD exercise program right away. Sit down, and keep your feet raised while resting. If you don't feel better right away, call 911. Even if you do feel better, make sure you tell your doctor right away about any of these symptoms. Nausea Dizziness Weakness Rapid or irregular heartbeat Severe shortness of breath Pain Pressure or pain in your chest, arm, neck, jaw, or shoulder