Come on in, the water’s fine: Experts discuss benefits of water-based exercise in COPD
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Key takeaways:
- Water walking/jogging, arm circles and leg and knee lifts are examples of water-based exercises.
- Patients with COPD should check with their doctor prior to beginning this exercise because of potential risks.
It has been previously found that reduced levels of moderate to vigorous intensity physical activity are linked to increased symptom burden in patients with COPD, stressing the importance of exercise.
One form of exercise patients with this disease might consider taking up is aquatic/water-based exercise. In a study assessing the impact of an 8-week water-based vs. land-based exercise program involving two sessions per week in patients with COPD, researchers observed more improvement in maximal inspiratory pressure and the endurance shuttle walk test among those training in the water.
To learn more about water-based exercise, the benefits it offers and steps a patient with COPD should take before engaging in this type of exercise, Healio spoke with Raj Dasgupta, MD, FACP, FCCP, FAASM, chief medical advisor for Fortune Recommends, and Karen Selby, RN, patient advocate with The Mesothelioma Center at Asbestos.com.
Healio: Could you describe a typical water-based exercise program, ie, what exercises it includes, its frequency, duration, where they are conducted, etc?
Dasgupta: A typical water-based exercise program includes gentle activities such as walking or jogging in water, water aerobics and simple strength exercises using water dumbbells.
These exercises are usually done two to three times weekly for about 45 to 60 minutes each session.
Selby: Water-based exercise is done while standing in waist-deep or slightly deeper water. This is a resistance-type training that can offer similar benefits as land exercise with fewer injuries. The pressure of the water provides the appropriate resistance with very little impact.
Water walking or jogging helps strengthen leg muscles and improves cardiovascular health. This can be done with water reaching the waist or slightly higher by taking long strides back and forth and even sideways across the pool. This is a great form of exercise for both arms and legs.
Another safe water-based exercise is leg and knee lifts. This exercise can be performed with the patient standing in waist-deep water by lifting one leg at a time to the front, side and back, helping strengthen leg muscles. Similar to leg lifts, knee lifts involve raising the knees toward the chest. This targets core muscles and balance.
Arm circles are another example of a water-based exercise. Standing in shoulder-deep water, patients can perform arm circles by moving their arms in circular motions. This helps improve shoulder flexibility and strength.
These exercises may be performed three to four times per week for 30 to up to 90 minutes. Choose three exercises and try to last anywhere from 6 to 10 minutes. Start slowly and increase the duration over time.
Healio: What are the benefits of water-based exercise for patients with COPD?
Selby: Water-based exercising historically has not been the first choice for patients suffering from COPD and other respiratory illnesses. Due to the increased chest pressure during submersion, it was thought that this could potentially cause increased shortness of breath during activity. However, research found that water immersion and exercise in the water can be very safe and effective. Plus, there has been evidence of a lower attrition rate with water-based exercise.
COPD and other respiratory patients find themselves dealing with chronic breathlessness, and the idea of exercise can be very daunting. Land-based exercise has a high dropout rate due to these stressors, but water-based exercise may be a perfect alternative.
Dasgupta: For COPD patients, water-based exercise may help to improve heart and lung fitness while being easy on the joints. It can also help to build muscle strength and endurance. Patients can adjust their exercise frequency and duration, based on their comfort and fitness levels.
Healio: What other types of patients seen by pulmonologists/respiratory therapists could benefit from this type of exercise?
Dasgupta: Others who might benefit from water-based exercise include those with asthma, arthritis or fibromyalgia. The water’s support helps reduce pain and stiffness while improving movement and fitness without putting extra strain on your body.
Healio: What steps should a patient take before engaging in water-based exercise? What are some potential risks/dangers patients with COPD face?
Dasgupta: Before starting water-based exercise, patients should check with their doctor to make sure it’s safe for them. It’s important to start slowly and avoid pushing too hard. Risks for COPD patients include worsening breathing problems, dehydration or overheating. Staying hydrated and monitoring breathing are also important.
Selby: It’s recommended to get approval from a pulmonary physician before starting any type of exercise routine. Some potential risks may include increased shortness of breath and increased heart rate. This may bring on anxiety for patients, especially those who are just starting with a new exercise routine.
It would be a good idea to begin training at a safe location such as a rehabilitation center or a monitored facility, such as the YMCA, with lifeguards on hand. Be sure to have appropriate medication and ask if there is oxygen available for emergencies, or bring your portable device if you use one.
Healio: If a patient is unable to participate in water-based exercise, what alternatives would provide some of the same benefits?
Dasgupta: If water-based exercise isn’t an option, alternatives such as riding a stationary bike, doing low-impact aerobics or using light weights can provide similar benefits. Breathing exercises and stretching can also help with fitness and respiratory health.
Selby: One notable alternative that would provide a similar benefit may be chair aerobics fitness.
Healio: What are your recommendations for a patient with COPD who may just be starting to exercise more frequently?
Selby: For a patient with COPD who may just be starting to exercise more frequently, start slow and gradually increase your duration. Be patient with yourself. Allow your body to adjust to the activity, and don’t expect quick results. It takes time to build strength and endurance. Keep a journal to share your progress with your doctor.
Your diagnosis of COPD or respiratory disorder does not have to limit you from exercising. Talk to your physician or rehab center for options that will be safe for you.
Dasgupta: Start with easy activities such as walking or lightweight exercises and keep an eye on breathing and energy levels. Work with your doctor to create a safe exercise plan. Regular exercise, along with getting enough rest, can help you manage COPD symptoms and improve your overall fitness.