Cardiovascular Training with a Chronic Respiratory Condition

Cardio, short for cardiovascular, is physical training aimed to strengthen your heart and increase your lung capacity. Cardio is foundational to any well-balanced program of physical activity and comes in many different forms. Generally, cardio involves an activity that uses the large muscle groups in a rhythmic fashion and increases the heart and respiration rates. Examples of cardio include walking, cycling, boxing, and swimming.

Adaptations to Regular Cardiovascular Training

Over a period of time, an individual’s engagement in regular physical activity will produce a number of important long-term physiological adaptations. 

  • The cardiovascular and respiratory systems will become more efficient at delivering oxygen to the working muscles.
  • More red blood cells will be produced to carry more oxygen in the blood.
  • Blood pressure will lower as our arteries widen and become more elastic.
  • The heart will grow stronger so it can pump more blood with each beat.
  • Resting heart rate may decrease.
  • Respiratory muscles (e.g., diaphragm and intercostal muscles) may become stronger and better able to move the chest for breathing.

The F.I.T.T Principles

The F.I.T.T principles are an exercise prescription guide to help individuals understand how long and how hard they should exercise for. F.I.T.T is an acronym that stands for Frequency, Intensity, Time and Type. 

Frequency refers to the number of training sessions to be undertaken each week. 

Intensity is the level of effort involved in each exercise session.

Time refers to the duration of a training session and is expressed in minutes.

Type is the mode of activity being performed (e.g., walking or cycling).

How To Gauge Intensity

A way of measuring the level of effort you are exerting during exercise is with the Borg Rating of Perceived Exertion (RPE) Scale and the Borg Dyspnea (Breathlessness) Scale.

The Borg Rating of Perceived Exertion (RPE) Scale

Perceived exertion is how hard you feel like your body is working based on physical sensations, such as increased heart rate, breathing rate, sweating and muscle fatigue. The scale ranges from 6 to 20. A rating of 6 perceived “no exertion at all” to 20 that describes “maximal exertion”.

The Borg Dyspnea (Breathlessness) Scale

The dyspnea or breathlessness scale asks you to rate the difficulty of your breathing from 0 to 10. A rating of 0 means your breathing is causing you no difficulty at all. Breathing difficulty can progress up to 10 where breathlessness is maximal.

During activity, you can self-monitor how hard your body is working or the difficulty of your breathing and adjust the intensity of the activity by speeding up or slowing down your movements.

Cardio F.I.T.T Guidelines for People with Chronic Respiratory Conditions

Frequency: Cardiovascular physical activity should be performed 3-5 days each week with an aim of accumulating at least 150 minutes a week.

Intensity: Low to moderate intensity (10-12 on the RPE scale or 2-3 on the Borg Dyspnea scale) effort is recommended for clients new to exercise. Better conditioned clients may work at higher intensities (i.e., moderate to vigorous intensity (13-15 on the RPE scale or 4-6 on the Borg Dyspnea scale) as their condition permits). 

Time: Exercise ranging from 20-60 minutes a day can be beneficial, with durations as short as 10 minutes.

Type: Rhythmic activities that incorporate major muscle groups such as walking, running, cycling, swimming, or pool exercise (ideally non-chlorinated) are appropriate for better conditioned individuals. Walking, stationary cycling, and upper body exercises are great for individuals new to exercise and for those who have a more severe lung condition.

Designing a Cardiovascular Training Session


The warm-up is usually 5-10 minutes long and includes large rhythmical movements that mimic the exercises that will be performed during the work-out, but at a lower level of intensity. A warm-up is intended to prepare the cardiovascular system by raising body temperature and increasing blood flow to working muscles. It will also help reduce the likelihood of sore muscles and will lessen the risk of injury. 


The work-out usually ranges from 10 – 60 minutes (or longer), during which you are working in the prescribed intensity zone.


The cool down is usually 5-10 minutes and involves slowly easing back on the intensity to allow your heart rate and blood pressure to gradually recover back to their pre-exercise levels. Stopping exercise abruptly can make your blood pressure drop dramatically and make you feel faint.

Post exercise stretching can be done after the cool-down is complete.

Exercise Prescription Principles

Regular physical activity will improve health and fitness as a result of physiological adaptation. These physiological adaptations (e.g. greater aerobic capacity) are the result of following exercise prescription principles. The primary prescription principles include:

  • Overload. Your training stimulus must be greater than what your body is used to.
  • Progression. As your training capacities expand, your initial workload must increase (progress) to ensure continued improvement in health and fitness.  
  • Specificity. The demand placed on your body during physical activity dictates the type of adaptation that will occur.  
  • Reversibility. Discontinuing or lowering the intensity or volume of your training will have a detraining effect. Resuming your exercise program will regain those losses. 
  • Individuality. Everyone responds differently to training. It is important to do exercises that meet your needs, interests, ability, and goals.

Safety Considerations for Individuals Exercising with a Chronic Respiratory Condition

It is important to consider safety strategies to maximize health benefits and minimize risk with cardio training.

  • If you have asthma, it is important to consider asthmatic triggers. For example, you may want to avoid outdoor exercise at certain times of the year due to seasonal allergies and other air pollutants. You may also need to avoid some indoor exercise spaces or swimming pools because of allergies to dust and chlorine. 
  • If you have COPD, cardiovascular risks may be present, it is important to not overexert yourself during exercise.
  • If your symptoms are not well-controlled, or if you have a cold or respiratory infection, you should postpone exercise.
  • It is important to perform a warm-up and cool-down, which can reduce the changes or severity of exercise-induced problems.

Try to implement cardio training into your lifestyle. The exercise programs provided with the online pulmonary rehabilitation program at iMaster Health are specific to chronic respiratory conditions and are a great resource to help kickstart or maintain your fitness journey. You can also get creative and create your own exercises or try new activities. Remember to listen to your body and ask your doctor or health care provider if a certain activity is right for you. 

Receive exercise training,  breathing techniques, and educational tools tailored to your respiratory condition and fitness level on the iMaster Health Online Pulmonary Rehabilitation Program. Sign up today and enjoy a 7 DAY FREE TRIAL!

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Pulmonary rehabilitation helps ease respiratory symptoms, improve physical and psychological well-being, and increase disease management. Please discuss your decision to begin online pulmonary rehabilitation with a doctor or health care provider.

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