Exercise is good for your health – this fundamental rule also applies to people with chronic obstructive pulmonary disease (COPD), a group of inflammatory lung conditions that cause worsening trouble breathing if not treated.

But many avoid exercise for fear of shortness of breath.

They shouldn't though, particularly because their breathing difficulties aren't due solely to their narrowed airways, but also to poor physical fitness. To keep from getting winded when performing everyday activities such as going shopping, they should do exercises that strengthen their heart, lungs and respiratory muscles.

"It's important that you first get individualized instruction from professionals," says lung specialist Dr. Heinrich Worth, chairman of the Pulmonary Sports Working Group in Germany, an association of people and institutions promoting exercise therapy and physical training for patients with respiratory and lung disorders.

The special training is aimed at improving the coordination of muscles, ligaments and joints. One of the things that patients practice is adapting their breathing to their physicalexertion.

"You learn how to breathe properly when you're climbing stairs or carrying loads, for instance," Worth says, adding that the training is also aimed at maintaining strength and mobility of your rib cage so that you can cough up phlegm more easily.

"The focus is on physical conditioning," remarks Dr. Adrian Gillissen, deputy chairman of the German Lung Foundation and head of the Department of Internal Medicine and Pulmonology at Ermstal Clinic in Bad Urach, Germany.

Lung exercise benefits not only COPD sufferers, but also people with bronchial asthma, pulmonary fibrosis, cystic fibrosis or lung cancer. Lung exercise groups typically meet once a week.

"If they want and their condition allows it, patients can also do the exercises at home," says Gillissen.

Continuity is important. "It's not a matter of delivering one top performance after another, but of engaging in regular physical activity," Worth says.

When you're in a group, rather than at home by yourself, the motivation is often greater and the instructor can step in if problems arise.

Asthma or COPD patients who do the exercises alone should always have a "rescue" inhaler at hand to expand their airways if needed. It can also be helpful to carry an up-to-date medical report with you, or at least a list of your medications, so that a doctor can get a quick idea of your medical history in the event of an emergency.

Gillissen discourages COPD patients who score less than 50% on a spirometry (pulmonary function) test from exercising alone. They're better off in an outpatient rehab exercise group with a specially trained instructor, he says. But before you can join such a group, a doctor must attest that you're healthy enough.

"The training definitely improves patients' quality of life," Worth says.