Lung Health Newsletter March, 2026
A monthly collection of research, patient wisdom, and lived experience from people navigating life with lung disease. Pulmonary Success Circles
Topics:
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+Myths vs Facts of supplemental oxygen portable concentrators and tanks
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+The health benefits of a rebounder or vibration plate.
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+Stopping a negative thought loop quickly
A Note Before We Begin (disclaimer)
This newsletter is for educational purposes only. It is not medical advice, diagnosis, or treatment and should never replace guidance from your physician.
Most physicians must follow strict guidelines based on approved diagnostic tests and FDA-approved medications. Approaches outside of that regulated universe — including exercise, nutrition, and non-pharmaceutical strategies — may fall outside their scope of practice.
Here, we share patient experiences, insights from research, and practical strategies people with chronic lung disease have tried with varying degrees of success. These are not recommendations, but they may offer ideas to discuss with your care team.
This newsletter has no commercial affiliation with any product or service and receives zero financial support or revenue of any kind, nor do we need or want it.
And now back to our show with No commercial interruptions….
From the author of this newsletter: As a patient with a diagnosis of advanced pulmonary fibrosis, I have been on supplemental oxygen for 5 1/2 years. I have used all of the delivery methods described in this research report below, and I have had 52 million breaths on supplemental oxygen. Of that, 45 million breaths were delivered by a large Home Concentrator, 7 million breaths were from portable oxygen tanks, and 1 million from a portable concentrator which I realized was insufficient for my needs.
1)Supplemental Oxygen for Activity
For patients who are prescribed oxygen, they are universally prescribed a home concentrator which runs off of electricity and most devices provide 1 to 5 Liters of continuous flow oxygen. For many patients who desire to exercise, but don’t want to leave home to do so, the home concentrator can provide sufficient oxygen to allow for fairly vigorous exercise, depending upon a person’s flow require requirements. (My oxygen prescription is 3 Liters at rest and 5 Liters with exertion—which is often the prescribed amount for moderate to severe lung restriction. ) Always refer to your Pulmonologist’s recommended flow rate while at rest and under exertion.
For patients who want to be active and mobile with outdoor walking, hiking, or gym exercises they need a portable option which is either Portable Battery Powered Concentrators (POC) or small portable oxygen tanks/ cylinders. Understanding the differences in these is important.
Myths vs. Facts About Portable Concentrators and Oxygen Tanks
Many people with lung disease receive portable oxygen concentrators (POCs) because they are convenient and lightweight when compared to the large oxygen tank on a cart. However, there are several common misunderstandings about how these POC devices compare with compressed oxygen tanks, especially when it comes to exercise and physical activity.
Below is a simple Myths vs. Facts summary that can help patients better understand how these systems differ.
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Myth #1
“If my concentrator is set on 5, I’m getting 5 liters per minute of oxygen.”❌
Fact
Most portable oxygen concentrators do not deliver liters per minute. Their settings represent pulse-dose levels, not continuous flow rates.
Almost all POCs deliver a maximum oxygen output roughly equivalent to about 1.0–1.3 liters per minute depending on the device and breathing pattern.
This means that turning the dial from 2 to 5 increases the pulse size, but it does not equal 5 LPM.
If your Oxygen prescription states that you should have 3 Liters at rest and 5 Liters with exertion, then you should know immediately that a POC is not capable of providing sufficient oxygen for you.
Sources
• American Thoracic Society – Home Oxygen Therapy for Adults with Chronic Lung Disease (2020)
• McCoy R. “Oxygen Conserving Devices.” Respiratory Care Journal, 2013.
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Myth #2
“Portable oxygen concentrators provide the same oxygen support as tanks.”❌
Fact
Compressed oxygen tanks can deliver much higher oxygen volumes, especially when using continuous flow regulators. Pulse dose regulators are also available for oxygen tanks. They only release oxygen when you breathe in and they release a very strong pulse of oxygen, unlike a weaker POC pulse. This conserves your tank and helps it last three times as long. In the gym when exercising I do most of my exercise with 5 L pulse flow and then for the more intense exercises, I will switch to 5 L continuous flow. With this method a D tank lasts me for 2 one-hour gym sessions and two 16 mile round trips to the gym.
Typical capabilities:
• Portable concentrator: ~1.0–1.3 LPM equivalent
• Oxygen tank regulator: 1-15 LPM continuous flow
During exercise, oxygen demand rises significantly, and tanks are able to meet that demand better than pulse-dose concentrators.
Sources
American Association of Cardiovascular and Pulmonary Rehabilitation Guidelines
American Thoracic Society oxygen therapy guidelines.
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Myth #3
“Oxygen tanks are too heavy to carry.”❌
Fact
A small D-size oxygen cylinder carried in a backpack weighs about 7 pounds, which is very similar to the weight of many portable oxygen concentrators with extended batteries. (Also a D sized oxygen tank will also last longer than a POC battery.)
Typical weights:
• Portable concentrator with large battery: 6–7 lbs
• D-size oxygen tank in backpack: ~7 lbs
The weight difference between the two systems is often much smaller than patients expect.
Sources
Manufacturer specifications for portable oxygen concentrators and D-size medical oxygen cylinders.
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Myth #4
“Portable concentrators provide enough oxygen for most exercise.”❌
Fact
Pulse-dose portable concentrators may work well for:
• Sitting
• Light walking
• Errands
• Travel
However, during brisk walking, hills, or strength training, breathing becomes faster and deeper. Some concentrators may not detect breaths quickly enough and they will NOT deliver enough oxygen per breath.
Pulmonary rehabilitation programs use continuous-flow oxygen systems during exercise for this reason.
Source
American Association of Cardiovascular and Pulmonary Rehabilitation.
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Myth #5
“Oxygen from concentrators and tanks is exactly the same.”
Fact
There is a small difference in oxygen purity.
Typical oxygen purity levels:
• Oxygen tank: ~99% oxygen
• Portable concentrator: ~87–95% oxygen
While this difference is usually not the main limitation, oxygen volume during activity is often the bigger factor.
Sources
U.S. Food and Drug Administration medical oxygen standards
Respiratory Care Journal.
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Myth #6
“Patients must choose only one oxygen system.”✅
Fact
This one’s not a myth.
Insurance and Medicare guidelines for covering supplemental oxygen only provide one type of portable oxygen. In some cases, the portable concentrator is considered a “luxury item” and not covered. Portable tanks are always covered by Medicare as long as there is a prescription from a Pulmonologist.
Many experienced oxygen users find that different devices work best for different situations, however, once they elect an option from their oxygen supplier, then in order to receive a secondary option, they will have to pay out-of-pocket for that option.
A practical approach is for those who can afford two delivery systems:
Portable concentrator
Best for
• Air travel (since tanks cannot be carried on airlines)
• Restaurants
• Shopping
• Light activity
Oxygen tanks
Best for
• Walking workouts
• Cardio exercise and cycling
• Pulmonary rehabilitation
• Strength training
This approach allows patients to maintain mobility and convenience while still supporting exercise and conditioning. However if exercise is a priority as it should be with most patients, then the portable tanks will serve both lifestyle needs with the exception of air travel where tanks are not allowed.
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The Bottom Line
Exercise is one of the most powerful tools for improving health for people with lung disease. To exercise safely and effectively, the body must receive adequate oxygen during activity.
Understanding how different oxygen systems deliver oxygen can help patients choose the equipment that supports both daily life and physical fitness.
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Sources
American Thoracic Society. Home Oxygen Therapy for Adults with Chronic Lung Disease, 2020.
McCoy R. “Oxygen Conserving Devices.” Respiratory Care Journal, 2013.
American Association of Cardiovascular and Pulmonary Rehabilitation. Pulmonary Rehabilitation Guidelines.
U.S. Food and Drug Administration medical oxygen standards.
Manufacturer specifications for portable oxygen concentrators and D-size medical oxygen cylinders.
2)Rebounding and vibration
Rebounding and Vibration Plates
Gentle Ways for Older Adults to Improve Strength, Circulation, and Balance
For older adults looking to improve overall health without high-impact exercise, rebounding (mini-trampoline exercise) and whole-body vibration platforms are two options that can provide meaningful benefits while placing relatively low stress on the joints.
Both methods stimulate muscles, circulation, and balance in ways that can support healthy aging.
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Rebounding (Mini-Trampoline Exercise)
Rebounding involves gentle bouncing on a small trampoline, sometimes called a rebounder. The movement can range from very light bouncing to walking or jogging in place on the trampoline surface.
Potential Health Benefits
Improves circulation and lymphatic flow
The up-and-down motion repeatedly changes gravitational forces on the body. This may stimulate lymphatic circulation, which helps move immune cells and metabolic waste through the body.
Builds leg strength and endurance
Even light bouncing activates the calves, quadriceps, hamstrings, and core muscles, which helps maintain muscle mass and mobility.
Low joint impact
The trampoline surface absorbs much of the impact that would normally occur when walking or jogging on hard surfaces.
Improves balance and coordination
The unstable surface requires continuous small adjustments, which can improve neuromuscular control and balance over time.
Supports cardiovascular health
Even moderate rebounding can elevate heart rate enough to improve aerobic conditioning.
A study from the American Council on Exercise found that rebounding can provide cardiovascular benefits comparable to moderate treadmill exercise while producing less joint stress.
Source: Porcari JP et al., Journal of Sport and Health Science / ACE Exercise Study.
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Whole-Body Vibration Plates
Whole-body vibration platforms are devices that gently vibrate while a person stands, squats, or performs light exercises on the platform.
The vibration stimulates muscle contractions through reflex activation.
Potential Health Benefits
Improves muscle strength
The vibration causes muscles to contract rapidly and repeatedly, which may help stimulate strength gains even during simple movements.
Supports bone density
Some studies suggest vibration training may help stimulate bone formation and slow bone loss in older adults.
Improves balance and fall prevention
Research shows vibration training can improve postural stability and balance, which may reduce fall risk in older adults.
Enhances circulation
The muscle contractions produced by vibration can increase blood flow in the legs.
Useful for deconditioned patients
Because exercises can be performed while simply standing or doing shallow squats, vibration platforms can help individuals who are not yet able to perform more demanding workouts.
A review in Journal of Musculoskeletal & Neuronal Interactions reported improvements in muscle strength, balance, and mobility in older adults using vibration training programs.
Source: Lai CL et al., Journal of Musculoskeletal & Neuronal Interactions, 2018.
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Which Is Better?
Both forms of exercise can support healthy aging, but they work in slightly different ways.
Exercise
Primary Benefits
Rebounding
Cardiovascular fitness, coordination, lymphatic circulation
Vibration plate
Muscle activation, bone support, balance
Some people use both methods as part of a weekly routine. They do not replace whole body exercise however.
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A Simple Starting Approach for Older Adults
For safety and gradual adaptation:
Rebounding
• Begin with gentle bouncing or marching in place
• 5–10 minutes per session
• Hold a support bar if balance is limited
Vibration plate
• Start with standing or light squats
• 5–10 minutes total exposure
• Use low vibration settings initially
Gradual progression helps muscles, joints, and balance adapt safely.
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The Bottom Line
Both rebounding and vibration platforms offer low-impact ways to stimulate muscles, circulation, and balance, making them useful tools for older adults who want to maintain strength and mobility.
When used consistently, these gentle forms of exercise can support cardiovascular health, muscle function, and fall prevention, all of which are important for healthy aging.
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Sources
Porcari JP et al. Rebounding exercise study. Journal of Sport and Health Science / American Council on Exercise.
Lai CL et al. Effects of whole-body vibration on muscle strength and balance in older adults. Journal of Musculoskeletal & Neuronal Interactions, 2018.
Rittweger J. “Vibration as an exercise modality.” European Journal of Applied Physiology.
3)A Mental Tip:
We’ve all experienced those worrisome thoughts that create a cyclic loop that plays over and over in our head, and just increases anxiety as we worry over a health health condition, a social interaction or something that is just unhealthy to continue to ruminate on. As a lung patient support group leader, I’ve seen it so often in patients who are stuck in cycles of worry and fear.
Tip: Here’s a 30 second video on an effective way to stop negative thought loops! https://substack.com/@beforeitbreaks/note/c-227618726?r=3e30u&utm_medium=ios&utm_source=notes-share-action
There are many methods for this such as simple free CBT (cognitive based therapy) available from many sources, but they all require us to take action to get out of that loop.
Thank you for reading this newsletter, and I hope that you have found value in it and may choose to pass along good information to fellow patients.
If you would like to see specific topics related to lung health in future newsletters, please reply to leefogle1@gmail.com with your suggestions. If you would rather not see this in your inbox, please reply with Unsubscribe in the subject line.
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