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Suzanne Rutkowski

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How people age is greatly influencedby their lifestyle decisions. One ofthe factors that contributes to suc-cessful aging is being physicallyactive. Regular exercise is importantbecause it can help prevent diseases,improve the physical condition andquality of life of those who alreadyhave diseases, prevent falls, improveone’s quality of sleep, and even helpreduce cognitive decline. The onsetof physical limitations and the loss ofindependence that so often accompa-ny our later years can be delayed oravoided altogether with the help ofregular exercise.

Many people with asthma, espe-cially older adults, tend to exercisefar less than they should. Many, infact, deliberately avoid exercisebecause exercise triggers their asthmasymptoms. Asthma may also makephysical exertion difficult. Years ago,doctors told people with asthma thatthey shouldn’t exercise, and thismyth still lingers. But doctors nowknow that exercise has great benefitsfor people with asthma, and there areeffective medications that can helpthem exercise safely and comfortably.

When a person is physically fit,his heart and lungs don’t have towork as hard. As the lungs become

stronger withregular exertion,staminaimproves andlung functioncan improve aswell. Regularexercise can helpa person main-tain a physicalcondition inwhich asthmasymptoms areless likely tointerfere withdaily activitiesand quality oflife. Olderadults with asth-ma, when physi-cally fit, gain allthe benefits that

exercise provides for general healthand well being, as well as the poten-tial for improved respiratory health.

Exercise for GeneralHealth

Although exercise is a key factorin remaining healthy and indepen-dent in one’s later years, as many as75% of older Americans are notactive enough to achieve these bene-fits. Regular exercise can help pre-vent diseases such as coronary heartdisease, osteoporosis, high bloodpressure, and high cholesterol. Therisk of cardiovascular disease inwomen who do not exercise is 1.9%compared to 2.5% in women whosmoke. However, the risk to the pop-ulation of not exercising may begreater: in the over-75 age group,only 10% of women smoke, while70% are not sufficiently active.1

Without regular exercise, musclestrength declines by 15% every 10years after the age of 50, and this

increases to 30% after the age of 70.Resistance training, using differentmuscle groups to lift weights, canhelp prevent this deterioration.Furthermore, even after such a loss,beginning an exercise program canresult in significant strength gains inolder individuals. Strength isextremely important to daily func-tion and quality of life. It can meanthe difference between being housebound or even bedridden and lead-ing an active and productive life!

Frederick Flach, MD, KCHS, ofthe NY Presbyterian Hospital, is aspokesperson for the book entitled“Fitness Over Fifty” published by theNational Institute on Aging. Dr.Flach explains that exercise is impor-tant as we age as “our body experi-ences wear and tear. We have to gothe extra mile. Exercise will increaselongevity and help us recover quick-ly.” The book describes four types ofexercise to help older adults improvetheir health.• Endurance exercises increase your

breathing and heart rate. The sim-plest form of this kind of exerciseis a brisk walk two to three timesa week.

• Strength exercises increase yourmetabolism, keep your bloodsugar in check, and may even helpprevent osteoporosis.

• Balance exercises help improve bal-ance and therefore prevent falls.Falling can cause disabling injuriesin older adults, from which theyoften have difficulty recovering.

• Flexibility exercises help keep yourbody limber. This type of exercisehelps increase and maintainmobility.

Exercising for LungHealth

If you have asthma, exercise isextremely important—not some-thing you should avoid or fear. Thisis true for people of all ages, includ-ing older adults. According to MarcMcMorris, MD, of the Division ofAllergy at University of MichiganHealth System, “exercising can help

1 Jones, DA, Ainsworth EB , Croft JB,Macera CA, Lloyd EE, Yusuf HR. Moderateleisure-time physical activity: who is meetingthe public health recommendations? Anational cross-sectional study. Arch FamMed 1998;7:285-9.

Beginning an exerciseprogram can result in asignificant gain in strengthin older adults.

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improve heart and lung function. Itcan also reduce your need for med-ication and your risk of hospitaliza-tion. Building up lung endurance hasthe potential to improve lung andcardiac function. Losing weight byexercising can also increase lungfunction in those who are over-weight.” Many adults with asthmawho are physically fit are less affectedby their asthma and feel better.Adults with asthma, in most cases,can exercise safely by simply taking afew simple precautions.

Exercising Safely withAsthma

Exercise, especially vigorous exer-cise, can trigger asthma symptomsfor many people. To exercise safely,be sure to plan ahead. Discuss yourexercise plan with your health careprovider. He or she may recommenda change in your medication regimenbefore or during exercise. You mayneed to take a short-acting bron-chodilator, like albuterol, 15 to 30minutes before exertion. It may alsobe helpful to monitor your peak flowmeasurements before, during, andafter exercise to note any change inyour breathing status. This will helpyou recognize the onset of asthmasymptoms and help you and yourhealth care provider tailor an exerciseprogram to fit your needs.

Some types of exercise are betterfor adults with asthma. Exercise thathas stop-and-go activity or includesperiods of rest is less likely to triggerasthma symptoms. Golf, bowling,and doubles tennis are good exam-ples of such activities. Swimmingmay be particularly well tolerated bypeople with asthma, and water aero-bics may also be a good choice.Yoga, which uses stretching, breath-ing, and chest expansion techniques,offers benefits that may includestress reduction (stress itself can bean asthma trigger) and improvedbreathing. Walking is an excellentexercise for people with asthmabecause it builds cardiovascular sta-mina without causing you to exert

yourself to the point of being out ofbreath. It is also an activity you cando with a friend or partner, whichmay help you to stick with it as aregular regimen.

It is important to be aware ofasthma triggers. For people withallergies, it may be better to takewalks in an air-conditioned indoortrack or shopping mall rather thanoutside during peak pollen seasons.Cold air can also trigger asthma, soif you are going to exercise outsideduring cold weather, it is best towear a facemask or a scarf over yournose and mouth to warm the airyou breathe. Avoid exercising out-doors on days when pollution levelsare high because ground-level ozoneis a well-established and potentasthma trigger. Be sure to warm upwith stretching or light exercisebefore you exert yourself. This hasbeen shown to help decrease therisk of exercise-induced asthmasymptoms.

Breathing through your nose isimportant in helping to reduceasthma symptoms during exercise.The nasal passages contain a naturalfiltering and humidifying system.Breathing through your nasal pas-sages will help keep the air at prop-er temperature and humidity. If youbreathe through your mouth, this

humidifying and filtering process isbypassed, introducing irritants intoyour airways.

When exercising, be aware ofyour breathing and heart rate. Payattention to warning signs of asth-ma worsening, such as cough, chesttightness, or wheezing. If you devel-op difficulty breathing, stop, rest,and follow your asthma action plan.

Having asthma should not keepyou from staying fit and vital as youage and enjoying life to its fullest.Talk to your health care providerabout beginning an exercise program.Find out what he or she recommendsgiven your health history. There is notime like the present to get started.The lifestyle changes you make todaymay greatly influence your well beingtomorrow. Remember—exercise isbeneficial for people with asthmawhen done under the guidance of ahealth care provider. Let your asthmabe an inspiration rather than abarrier to including regular exercisein your life.

Suzanne Rutkowski, CMA, works as apatient educator, advocate and consul-tant in the fields of asthma and allergy.

Reprint orders: Elsevier Inc., 11830 WestlineIndustrial Dr., St. Louis, MO 63146-3318;phone (314) 453-4350.doi:10.1016/j.asthmamag.2004.03.003

For people with asthma, exercise that has stop-and-goactivity or includes periods of rest is less likely to triggerasthma symptoms.