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15-08-2011 | Cardiology | Article

Water aerobics suitable for cardiac patient rehabilitation

Abstract

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MedWire News: The use of water-based exercises in the rehabilitation of chronic heart failure (CHF) and coronary artery disease (CAD) patients improves cardiorespiratory function without adversely affecting patient health, French researchers report.

Water-based exercise programs appear to produce similar benefits to conventional land-based rehabilitation programs, highlight Benoit Dugué (Université de Poitiers, France) and team in the Journal of Cardiac Failure.

They explain: "Significant benefits were obtained regarding cardiorespiratory efficiency after 3 weeks of rehabilitation in CAD and CHF patients in both land and water programs."

Dugué and colleagues carried out a study to investigate the theory that thermoneutral head-out water immersion can put too great a strain on the heart of cardiac disease patients.

The researchers recruited 48 men with CAD (n=24) or CHF (n=24) and randomly allocated them to undergo a 3-week land-only (n=12 CAD; 12 CHF) or combined land-and-water (n=12 CAD; 12 CHF) rehabilitation program.

The land-based program involved endurance exercises performed on an exercise bike (30 minutes, five times a week) and gymnastics performed on land (50 minutes every day). The land- and water-based programmes were the same except for the performance of gymnastics sessions in a swimming pool.

Prior to undergoing the program, all patients had severely reduced left ventricular ejection fractions (LVEF) of less than 40%, and poor physical capacities, reflected by peak oxygen uptakes of less than 20 ml/min/kg.

Cardiovascular fitness was assessed at baseline and at the end of the rehabilitation programs via the measurement of left ventricular systolic function, autonomic nervous system activity, cardiorespiratory function, and hemodynamic variables (heart rate [HR], stroke volume, cardiac output, and systolic and diastolic arterial pressures [DAP]).

At the end of the programs, CHF patients in both rehabilitation groups exhibited an improvement in cardiorespiratory function. Specifically, LVEF at rest rose from 29% at baseline to 31% at study-end in the land-based group, and from 30% at baseline to 33% at end of study in the land-plus-water group.

CAD patients in both rehabilitation groups showed an improvement of 1% in mean LVEF over the study period.

In CAD and CHF patients, DAP was significantly lower at the end of both programs compared with baseline.

Dugué and colleagues found that peak power output, HR, and oxygen uptake during peak exercise testing were significantly higher among all patients at study-end than at baseline testing.

No adverse effects of either rehabilitation program were observed.

Dugué et al conclude: "It would be of interest to evaluate the impact of our rehabilitation programs for a longer period than 3 weeks, to examine whether the progresses which were observed at the end of our programs are maintained afterwards and for how long."

By Lauretta Ihonor

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