Exercise and Cystic Fibrosis

Benefits of Physical Activity for People wtih Cystic Fibrosis

Girl swimming, underwater view
What are the benefits of exercise for people with cystic fibrosis?. Zena Holloway / Getty Images

Exercise used to be discouraged among people with cystic fibrosis (CF) because it was thought that overexertion would increase breathing problems. Now we know that the opposite is actually true. Studies have shown that regular physical activity provides many benefits to people with cystic fibrosis.

Let's talk about what those specific benefits are, what activities are best, how much and how often you should exercise, and most importantly, how it's important to work with your doctor to design an exercise program that is right for you.

Why Exercise If You Have Cystic Fibrosis?

The health benefits of an active lifestyle are widely recognized for all people. However, exercise is especially important for people with cystic fibrosis because it can:

  • Increase lung capacity
  • Increase strength and endurance
  • Increase energy
  • Increase life expectancy
  • Improve airway clearance, which helps prevent respiratory infections
  • Increase bone density and prevent bone loss
  • Have a positive effect on well-being
  • Be the most effective method of addressing peripheral muscle dysfunction
  • Benefit you in ways beyond cystic fibrosis

Work with Your Doctor to Design an Ideal Exercise Program Just for You

We will address some of the common questions about exercise for people with cystic fibrosis below, but it's important to note that everyone is different. Studies tell us what may work statistically, but people aren't statistics. There may be a reason that something good for the majority of people would not be good for you personally, and vice versa.

In fact, the most important reason to discuss exercise for people with cystic fibrosis is to make sure everyone with the disease takes the time to have a thorough discussion with their doctor. In medicine we tend to put more energy into discussing medications and procedures—things we do as physicians, instead of things like exercise which you can do yourself.

Yet the lack of time spent discussing physical activity does not mean it is any less important than the medications you take and procedures you do to stay healthy with your disease.

That said, medical schools and residency programs put far more emphasis on specific treatment which can help with cystic fibrosis. Until medicine catches up with the benefits being found from exercise, this may be a discussion you need to initiate yourself as an empowered patient.

What Type of Exercise Should People With Cystic Fibrosis Do?

While most people with cystic fibrosis can tolerate some form of physical activity, the amount and type of exercise that you can tolerate will vary based on the severity of your illness. For those who can tolerate it, aerobic exercise appears to provide the most benefit overall. Aerobic exercise includes activities such as swimming, cycling, running, or any other vigorous activity that raises your heart rate and makes you breathe harder. It's important to note that walking can be an excellent form of exercise.

If running sounds out of the question, don't fret. A good walking program can provide just as much benefit.

What's often ignored when discussing exercise, is that you need to find a form of exercise which you enjoy. Your physical activity should be something which you consider fun. We all know what happens for most people when they make resolutions of any form. Some people are able to push through and honor their good intentions, but for most of us, those intentions don't become a reality unless we like what we are doing.

How Much and How Often Should People with CF Exercise?

The general rule of thumb is that to receive the most benefit, exercise routines should include 20 to 30 minutes of aerobic activity three times per week at a minimum. However, any amount of exercise is better than no exercise at all and exercise routines should be adjusted according to each person’s level of tolerance.

In general, frequency is more important that length. For example, if you choose to walk 10 to 15 minutes a day every day you will probably notice more improvement in your well being than if you try to work out for 45 minutes twice a week.

Exercise Precautions for People with Cystic Fibrosis

To get the most out of your workouts and prevent potential setbacks, people with cystic fibrosis should take a few extra precautions when participating in the exercise.

Avoid Dehydration: Sweat and salt loss during exercise can cause anybody to become dehydrated, especially in hot weather. People with cystic fibrosis lose more salt through sweat than people without cystic fibrosis, which can put you at a greater risk of complications from dehydration. Dehydration can be avoided by replacing fluids and salt lost by drinking sports drinks or water and eating salty snacks.

Avoid Weight Loss: Exercise increases the body’s energy requirements, which are already quite high for people with cystic fibrosis. To prevent weight loss, it is important to eat enough calories to replace the calories burned in exercise. It can be very helpful to discuss your exercise plans with a cystic fibrosis nutritionist who can recommend appropriate dietary additions. Learn more about malnutrition with cystic fibrosis.

Airway Clearance: Many people with cystic fibrosis find that doing airway clearance treatments prior to physical activity helps to increase their exercise tolerance. As an added bonus, the exercise itself could loosen more secretions so it might be necessary to do another airway clearance treatment after the workout.

Exercise Challenges Posed by Cystic Fibrosis

Certainly, cystic fibrosis can impose some limitations on exercise, but what exactly are these? A study looking at this precise question found that most concerns related to:

  • Cardiac output - The amount of blood your heart pumps with each beat
  • Ventilatory limitation - The ability to increase the volume of your breaths or the frequency of those breaths
  • Physical deconditioning - If you haven't been exercising routinely, it can take a while to get in shape

Your doctor can work with any of these limitations to help you choose the types of exercise most likely to be effective, as well as help you know how rapidly you can increase your exercise.

Finding The Motivation to Exercise

As a final note, studies tell us that people with cystic fibrosis, especially children and teens, fall away from their exercise programs far too commonly. It may be worthwhile to look into ways that people without cystic fibrosis have stuck with their activity programs. Here are some ideas:

Bottom Line on Exercising with Cystic Fibrosis

It's clear that exercise can provide abundant benefits for people living with cystic fibrosis. At the same time, however, exercise needs to be continued on a regular basis in order to be effective.

Take a moment to think about the types of physical activity you enjoy the most. What types of exercise make you happy? Are there certain types of activity that can kill the two proverbial birds with one stone? For example, is there an activity which gets you out and allows you to socialize with others? Is there an activity which can fill some creative desire you have, such as gardening? (Yes, gardening counts as physical activity.)

Once you've considered the activities you most enjoy, sit down with your doctor and talk about how to safely do that activity within the constraints of your disease.

Exercise is only one way to improve your well being with cystic fibrosis. Take a moment to check out these tips on living a full life with cystic fibrosis.

Sources:

Carbonera, R., Vendrusculo, F., and M. Donadio. Physiological Responses During Exercise with Video Games in Patients with Cystic Fibrosis: A Systematic Review. Respiratory Medicine. 2016. 119:63-69.

Cox, N., Alison, J., and A. Holland. Interventions for Promoting Physical Activity in People with Cystic Fibrosis. Cochrane Database of Systematic Reviews. 2013. (12):CD009448.

Gruet, M., Troosters, T., and S. Verges. Peripheral Muscle Abnormalities in Cystic Fibrosis: Etiology, Clinical Implications and Response to Therapeutic Interventions. Journal of Cystic Fibrosis. 2017 Mar 2. (Epub ahead of print).

Urquhart, D., ad F. Vendrusculo. Clinical Interpretation of Cardiopulmonary Exercise Testing in Cystic Fibrosis and Implications for Exercise Counselling. Paediatric Respiratory Reviews. 2015 Oct 13. (Epub ahead of print).

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