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Updated 26 September 2013

Water exercise boosts endurance in COPD

Water workouts may be the best type of exercise for people with chronic lung disease and other health problems, according to a small study.

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Water workouts may be the best type of exercise for people with chronic lung disease and other health problems, according to a small study.

Australian researchers found that exercising in a pool boosted physical endurance and energy levels in people with chronic obstructive pulmonary disease (COPD) and physical comorbidities such as obesity or back pain.

What the study found

"Participants in the water-based exercise training group reported an improvement in many functional aspects of their daily life such as improved stamina and ability to complete tasks such as walking long distances when shopping," said Renae McNamara, a physical therapist at The Prince of Wales Hospital in Randwick.

"They reported less fatigue, as well as less breathlessness when completing activities of daily living such as showering and dressing," she said.

But patients with COPD often drop out of training programmes, which can be particularly strenuous for people who also have other health issues. The new study, published online in the European Respiratory Journal, is the first to test the benefits of exercise in this group of patients, McNamara said.

They enrolled 53 patients in the study, assigning them randomly to workouts in a hydrotherapy pool, gym-based training or standard medical care without exercise. The exercise programmes include three weekly one-hour sessions over two months. Forty-five patients completed the study.

Whether they worked out on land or in water, patients were able walk faster after the training than when they just got usual care. But those who exercised in the pool reported less fatigue than the gym group and also developed more physical endurance.

Water workouts more beneficial

On the endurance shuttle walk, for instance, patients who'd exercised in water outpaced those trained in a gym by 228 metres (748 feet). Researchers consider a difference of 203 metres important.

"We believe that water-based exercise training was more beneficial for a number of reasons," McNamara said. "The water environment is unique because of the effect of buoyancy which supports the body weight, reduces forces on joints and allows greater movement; warm water assists with pain control by increasing circulation; and the water provided resistance to all movements, unlike moving on land."

There had been some concerns that people with COPD might not tolerate the pressure from the water on the chest, which makes it harder to breathe. But the researchers saw no drop-outs due to worsening COPD in patients training in the pool - they did see some in the gym group - although they caution that most of the participants in the study did not have severe disease.

McNamara said patients "also reported a very high level of enjoyment in the group water-based exercise sessions and many said they felt less depressed and felt a great sense of achievement in being able to participate in exercise training which was previously too difficult or painful on land."

(Reuters Health, October 2012)

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