© 2003 European Society of Cardiology
Hydrotherapy—a new approach to improve function in the older patient with chronic heart failure
a Department of Cardiology, Institution for Community Medicine, The Sahlgrenska Academy at Göteborg University Sahlgrenska University Hospital, Goteborg, Sweden
b Department of Rehabilitation Medicine, Institution for Community Medicine, The Sahlgrenska Academy at Göteborg University Sahlgrenska University Hospital, Goteborg, Sweden
* Corresponding author. Physiotherapy Department, SU/Sahlgrenska, S-413 45 Goteborg, Sweden. Tel.: +4631-3421195; fax: +4631-3424341 E-mail address: asa.cider{at}fhs.gu.se
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Abstract |
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Aims: Hydrotherapy, i.e. exercise in warm water, as a rehabilitation program has been considered potentially dangerous in patients with chronic heart failure (CHF) due to the increased venous return caused by the hydrostatic pressure. However, hydrotherapy has advantages compared to conventional training. We studied the applicability of an exercise programme in a temperature-controlled swimming pool, with specific reference to exercise capacity, muscle function, quality of life and safety.
Methods and results: Twenty-five patients with CHF (NYHA II–III, age 72.1±6.1) were randomised into either 8 weeks of hydrotherapy (n=15), or into a control group (n=10). The training program was well tolerated with no adverse events. Patients in the hydrotherapy group improved their maximal exercise capacity (+6.5 vs.–5.9 W, P=0.001), isometric endurance in knee extension (+4 vs.–9 s, P=0.01) together with an improvement in the performance of heel-lift (+4 vs. –3 n.o., P=<0.01), shoulder abduction (+12 vs. –8 s, P=0.01) and shoulder flexion (+6 vs. +4, P=0.01) in comparison to patients in the control group.
Conclusion: Physical training in warm water was well tolerated and seems to improve exercise capacity as well as muscle function in small muscle groups in patients with CHF. This new approach broadens the variety of training regimes for older patients with CHF.
Key Words: Exercise • Hydrotherapy • Water immersion • Elderly • Rehabilitation • Muscle function
Received April 15, 2002; Revised December 9, 2002; Accepted January 7, 2003
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