High intensity physical group training in water—an effective training modality for patients with COPD

Abstract

The aim of this study was to examine the effect of high intensity physical group training in water and on land for patients with COPD with regard to physical capacity and health related quality of life (HRQoL). A controlled, semi-randomised study was conducted where 30 patients were randomised to training either in water or on land. Thirteen patients constituted a control group. Forty-three outpatients, with moderate to severe COPD (27w/16m), from two local hospitals in northern Sweden, were included in the study. High intensity physical group training in water (water group) or on land (land group) was performed for 12weeks, three times per week, 45min per session. The control group received no intervention. Pre- and post-intervention, all patients performed incremental and endurance shuttle walking tests (ISWT and ESWT), cycle ergometer tests and responded questionnaires about HRQoL (St. Georges Respiratory Questionnaire--SGRQ and SF-36). The patients trained with a mean heart rate of 80-90% of peak heart rate. Both training groups increased the distance walked, i.e. land group in ISWT (25m) and water group in ESWT (179m). The water group increased the distance in ESWT significantly more that both the land and the control groups. Both training groups increased the time cycled (40-85s) and work load (10-20W) in the cycle ergometer test. The control group deteriorated in HRQoL according to total score in SGRQ while the training groups remained constant. The water group improved their activity score in SGRQ and their physical health score in SF-36 and those improvements were significant as compared to the land and the control groups. In conclusion, high intensity physical group training in water is of benefit for patients with COPD. It was in some areas found to be even more effective regarding improvements in physical capacity and experienced physical health compared to the same kind of training on land.

Swimming pool-based exercise as pulmonary rehabilitatior for COPD patients in primary care: feasibility and acceptability

“…[21][22][23] A small body of research has examined the physiological effects of exercise in water for people with respiratory diseases. 6,10 Reported benefits need to be assessed in greater depth, but they are supported by the findings of this study.…”

“…[3][4][5] In Sweden, exercise in water has been shown to induce a lower heart rate compared to the same exercise intensity on land. 6 In a number of studies of hydro-therapy in a hospital setting, Kurabayashi and colleagues concluded that exercise in a hot spring-water pool may be useful in COPD. [7][8][9][10] Exercise in water has characteristics that may make it beneficial in the elderly.…”

Types of Physical Exercise Training for COPD Patients

“…Seven (Coppoolse et al, 1999;Kurabayashi et al, 2000;O'Shea, Taylor, & Paratz, 2004;Puente-Maestu, Sanz, Sanz, Cubillo et al, 2000;Puente-Maestu, Sanz, Sanz, Ruiz de Ona et al, 2000;Wadell, Sundelin, Henriksson-Larsen, & Lundgren, 2004;Wijkstra et al, 1995) agreed with the criteria of the American College of Sports Medicine (ACSM) (Garber et al, 2011) for the intervention period and number of sessions varied from eight weeks in the majority on trials to twelve weeks in two trials and from two to four sessions a weeks. Therefore, the number sessions a week were at least between two or four sessions a week.…”

“…The intensity of the training sessions in five articles (Coppoolse et al, 1999;Puente-Maestu, Sanz, Sanz, Cubillo et al, 2000;Puente-Maestu, Sanz, Sanz, Ruiz de Ona et al, 2000;Wadell, Sundelin, Henriksson-Larsen, & Lundgren, 2004;Wijkstra et al, 1995) showed that the goal is 60-90% of heart rate maximum (HR max ) set by the ACSM for improving aerobic fitness ("American college of sports medicine position stand. exercise and physical activity for older adults,"1998a; "American college of sports medicine position stand.…”

“…The reviewed articles covered incremental therapeutic aquatic exercise with an intensity ranging from 50% to 90% of maximal oxygen consumption (VO 2max ) with sessions of 30 to 50 minutes 2 to 5 days a week, for a total of 8 to 24 weeks at a temperature of 29 ºC to 38 ºC (Kurabayashi et al, 2000;Wadell, Sundelin, Henriksson-Larsen, Lundgren, 2004). COPD patients walked in water to the level of their shoulders, and they breathed out slowly through their mouth into water after sinking their nose 3-5 cm below the water level.…”