Physical Exercise in Aquatic Environment and its Role in Phase III of a Cardiac Rehabilitation Program

Authors

  • Nelson Albuquerque Serviço de Medicina Fisica e de Reabilitação, Centro Hospitalar Tondela Viseu, Viseu, Portugal http://orcid.org/0000-0002-6695-2181
  • Irina Peixoto Serviço de Medicina Fisica e de Reabilitação, Centro Hospitalar Tondela Viseu, Viseu, Portugal
  • Rui Cadilha Centro de Reabilitação do Norte Dr Ferreira Alves, Valadares, Portugal
  • Sofia Viamonte Centro de Reabilitação do Norte Dr Ferreira Alves, Valadares, Portugal

DOI:

https://doi.org/10.25759/spmfr.377

Keywords:

Cardiac Rehabilitation, Exercise Therapy, Heart Diseases/rehabilitation

Abstract

Introduction: The benefits of land-based aerobic physical training in patients with cardiac pathology are well studied. However, there are patients who, for personal reasons or osteoarticular limitations, prefer to exercise in water, so it is important to understand the advantages, disadvantages and precautions to be taken when the rehabilitation plan is carried out in an aquatic environment.

Methods: To carry out this narrative review, the following databases were accessed: MEDLINE, SCOPUS and Web of Science.

Results:With the increase of the immersion depth, the heart fills and consequent systolic volume increases, but the heart rate (HR) decreases. Peak oxygen uptake (VO2peak) and HRpeak values are 84% and 95% lower in water compared to those observed out of water, respectively. Therefore, a reduction of 13% or 10 bpm in relation to the target HR values established out of water is recommended. Aquatic exercise induces an increase in heart rate variation and cardiac autonomic modulation, both of which have a positive impact on the prognosis of these patients.

Conclusion: Physical exercise in water is safe, provides cardiovascular protection and improves the prognosis in low-risk cardiac patients who are in phase III of the cardiac rehabilitation program and who, for musculoskeletal or personal reasons, prefer to perform exercise in this context.

Downloads

Download data is not yet available.

References

Bjarnason-Wehrens B, McGee H, Zwisler AD, Piepoli MF, Benzer W, Schmid JP, et al; Cardiac Rehabilitation Section European Association of Cardiovascular Prevention and Rehabilitation. Cardiac rehabilitation in Europe: results from the European Cardiac Rehabilitation Inventory Survey. Eur J Cardiovasc Prev Rehabil. 2010;17:410-8. doi: 10.1097/HJR.0b013e328334f42d

Cornish AK, Broadbent S and Cheema BS. Interval training for patients with coronary artery disease: a systematic review. Eur J Applied Physiol. 2011; 111: 579-89.

Bock BC, Albrecht AE, Traficante RM, Clark MM, Pinto BM, Tilkemeier P, et al. Predictors of exercise adherence following participation in a cardiac rehabilitation program. Int J Behav Med. 1997;4:60-75. doi: 10.1207/s15327558ijbm0401_4.

Becker BE. Aquatic therapy: scientific foundations and clinical rehabilitation applications. PM R 2009; 1: 859-872. 2009/09/23. doi: 10.1016/j.pmrj.2009.05.017.

Tei C, Horikiri Y, Park JC, Jeong JW, Chang KS, Toyama Y, et al. Acute hemodynamic improvement by thermal vasodilation in congestive heart failure. Circulation. 1995;91:2582-90. doi: 10.1161/01.cir.91.10.2582

Laurent M, Daline T, Malika B, Fawzi O, Philippe V, Benoit D, et al.Traininginduced increase in nitric oxide metabolites in chronic heart failure and coronary artery disease: an extra benefit of water-based exercises? Eur J Cardiovasc Prev Rehabil. 2009;16:215-21. doi: 10.1097/HJR.0b013e3283292fcf.

Lazar JM, Khanna N, Chesler R, Salciccioli L. Swimming and the heart. Int J Cardiol. 2013;168:19-26. doi: 10.1016/j.ijcard.2013.03.063.

Tanaka H. Swimming exercise: impact of aquatic exercise on cardiovascular ealth. Sports Med. 2009; 39: 377-387. doi: 10.2165/00007256-200939050-00004.

Cider A, Sveälv BG, Täng MS, Schaufelberger M, Andersson B. Immersion in warm water induces improvement in cardiac function in patients with chronic heart failure. Eur J Heart Fail. 2006;8:308-13. doi:10.1016/j.ejheart.2005.08.001.

Igarashi Y and Nogami Y. The effect of regular aquatic exercise on blood pressure: A meta-analysis of randomized controlled trials. Eur J Prev Cardiol. 2018; 25: 190-199. doi: 10.1177/2047487317731164.

Brinks J, Franklin BA , Spring T. Water Exercise in Patients With and Without Cardiovascular Disease: Benefits, Rationale, Safety, and Prescriptive Guidelines. Am J Lifestyle Med. 2009; 3: 290-9. doi: 10.1177/1559827609334756.

Azevedo MJ, Viamonte S. Exercício em meio aquático: uma modalidade a considerar em doentes cardíacos? Rev Med Desportiva. 2012: 12-15.

Tokmakidis SP, Spassis AT, Volaklis KA. Training, detraining and retraining effects after a water-based exercise program in patients with coronary artery disease. Cardiology. 2008; 111: 257-264. doi: 10.1159/000127737.

Dionne A, Leone M, Goulet S, Andrich DE, Pérusse L, Comtois AS. Acute effects of water immersion on heart rate variability in participants with heart disease. Clin Physiol Funct Imaging. 2018; 38: 233-239. 2016/12/17. doi:10.1111/cpf.12405.

Adsett JA, Mudge AM, Morris N, Kuys S, Paratz JD. Aquatic exercise training and stable heart failure: A systematic review and meta-analysis. Int J Cardiol. 2015; 186: 22-8. 2015/03/26. doi: 10.1016/j.ijcard.2015.03.095.

Nagle EF, Sanders ME, Franklin BA. Aquatic High Intensity Interval Training for Cardiometabolic Health: Benefits and Training Design. Am J Lifestyle Med. 2017; 11: 64-76. doi: 10.1177/1559827615583640.

Fiogbe E, Ferreira R, Sindorf MG, Tavares SA, de Souza KP, de Castro Cesar M, et al. Water exercise in coronary artery disease patients, effects on heart rate variability, and body composition: A randomized controlled trial. Physiother Res Int. 2018; 23: e1713. doi: 10.1002/pri.1713.

Nagle EF, Sanders ME, Gibbs BB, Franklin BA, Nagle JA, Prins PJ, et al. Reliability and accuracy of a standardized shallow water running test to determine cardiorespiratory fitness. J Strength Cond Res. 2017; 31: 1669-77. doi: 10.1519/JSC.0000000000001638.

Vasic D, Novakovic M, Bozic Mijovski M, Barbič Žagar B, Jug B. Short-term water- and land-based exercise training comparably improve exercise capacity and vascular function in patients after a recent coronary event: a pilot randomized controlled trial. Front Physiol. 2019; 10: 903. doi: 10.3389/fphys.2019.00903.

Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med. 1970; 2: 92-8.

American College of Sports M. ACSM's guidelines for exercise testing and prescription. Philadelphia: Wolters Kluwer; 2018.

Lee JY, Joo KC, Brubaker PH. Aqua walking as an alternative exercise modality during cardiac rehabilitation for coronary artery disease in older patients with lower extremity osteoarthritis. BMC Cardiovasc Disord. 2017; 17: 252.

Volaklis KA, Spassis AT, Tokmakidis SP. Land versus water exercise in patients with coronary artery disease: effects on body composition, blood lipids, and physical fitness. Am Heart J. 2007; 154: 560. e561-560. e566.

Ferreira R, Abreu A. Reabilitação cardíaca: realidade Nacional e recomendações Clínicas. Lisboa: Coordenação Nacional para as Doenças Cardiovasculares; 2009.

Mangelsdorff G, Borzone G, Leiva A, Martínez A, Lisboa C. Strength of inspiratory muscles in chronic heart failure and chronic pulmonary obstructive disease. Rev Med Chile. 2001; 129: 51-9.

Published

2021-05-24

How to Cite

1.
Albuquerque N, Peixoto I, Cadilha R, Viamonte S. Physical Exercise in Aquatic Environment and its Role in Phase III of a Cardiac Rehabilitation Program. SPMFR [Internet]. 2021 May 24 [cited 2024 Nov. 22];33(1):25-32. Available from: https://spmfrjournal.org/index.php/spmfr/article/view/377

Issue

Section

Review Article

Similar Articles

<< < 13 14 15 16 17 18 19 > >> 

You may also start an advanced similarity search for this article.