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Hydrotherapy--a new approach to improve function in the older patient with chronic heart failure

Journal article
Authors Åsa Cider
Maria Schaufelberger
Katharina S Sunnerhagen
Bert Andersson
Published in Eur J Heart Fail
Volume 5
Issue 4
Pages 527-35
Publication year 2003
Published at Cardiovascular Institute
Institute of Occupational Therapy and Physiotherapy
Institute of Clinical Neurosciences
Pages 527-35
Language en
Keywords Aged, Chronic Disease, *Exercise Therapy, Exercise Tolerance, Female, Hand Strength, Health Status Indicators, Heart Failure, Congestive/*rehabilitation, Humans, *Hydrotherapy, Male, Quality of Life
Subject categories Physiotherapy, Cardiac and Cardiovascular Systems


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.

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