Exercise Improves Small Airway Function in Chronic Obstructive Pulmonary Disease
Physical exercise can improve the function of the tiny airways in the lungs of people with chronic obstructive pulmonary disease (COPD), according to a study published in Respiratory Research. Researchers at Lund University and Uppsala University found that a 12-week structured training program produced measurable mechanical improvements in peripheral lung regions that standard spirometry largely fails to detect. Over 400 million people worldwide live with COPD, a progressive condition with irreversible lung damage where treatment focuses on relieving symptoms and slowing disease progression.
Twelve-Week Training Program Designed for Peripheral Lungs
The study evaluated 62 participants with stable COPD ranging from mild to severe severity. Over a 12-week period, participants exercised three times a week both at home and alongside a physiotherapist, combining endurance and strength exercises tailored to their individual capacity. The program aimed to engage the peripheral parts of the lungs where blood oxygenation takes place. In COPD, small airway changes often cause uneven ventilation, leaving certain lung zones with restricted airflow. Deeper and faster breathing during exercise helps air reach more areas of the lung tissue while introducing mechanical stress that influences small airway function.
Impulsoscillometri Detects Changes Missed by Spirometry
Participants underwent lung function testing before and after the 12-week intervention using both conventional spirometry and impulsoscillometri (IOS), a method that examines the mechanical properties of the lungs during normal, calm breathing. While spirometry measures how much and how quickly air can be expelled, IOS assesses airway resistance and lung elasticity. Following the training period, IOS measurements revealed clear improvements in several indicators of peripheral airway function. Conventional spirometry did not capture these changes with the same clarity.
It surprised us that the improvement was so clear with IOS while we saw no or only moderate changes with spirometry,
said Linda Elowsson, researcher and associate professor in cell and matrix biology at Lund University, as reported by forskning.se. If we had only used that measurement method, we would not have seen the same clear change, but now we could see a clinically significant improvement.
Physical Capacity and Symptom Relief
Participants also increased their overall physical fitness during the study. After 12 weeks, individuals could walk an average of 28 meters farther in six minutes and complete 2.5 more sit-to-stand repetitions in one minute. Symptom relief proved greatest among participants who experienced more severe limitations at the start of the intervention.
For many with COPD, shortness of breath can lead to a vicious circle,
said Margareta Emtner, physiotherapist and professor at Uppsala University, according to forskning.se. You become afraid to move because you become short of breath, and when you move less, your physical capacity deteriorates further. Therefore, it is important to be able to show that training not only makes you stronger, but also gives measurable changes in lung function.
Future Research Into Biological Repair Processes
Researchers are currently analyzing blood samples to determine which biological processes respond to exercise and why individual results vary. The team also plans to study the findings using a bioreactor designed to simulate lung breathing. Future investigations aim to identify molecular pathways activated by physical activity that could eventually serve as targets for new pharmaceutical treatments combined with exercise.
Frequently Asked Questions
What is the main difference between spirometry and impulsoscillometri?
Spirometry measures the volume and speed of forced exhalation, whereas impulsoscillometri (IOS) measures airway resistance and lung elasticity during calm, normal breathing without requiring forceful maneuvers.
How many people participated in the Lund and Uppsala University study?
The study included 62 participants diagnosed with stable COPD, covering conditions from mild to severe stages.
What specific physical gains did participants achieve after 12 weeks?
Participants increased their six-minute walking distance by an average of 28 meters and completed 2.5 more chair-rise repetitions in one minute.
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