1.
Cardiorespiratory effects of warm water immersion in elderly patients with chronic heart failure.
Cider, A, Sunnerhagen, KS, Schaufelberger, M, Andersson, B
Clinical physiology and functional imaging. 2005;(6):313-7
Abstract
BACKGROUND Hydrotherapy might be included in the rehabilitation of patients with chronic heart failure (CHF), but little is known about the acute cardiorespiratory reaction in warm water. The aim of this study was to assess the acute cardiorespiratory effect of immersion in warm water, in a clinical setting, in elderly patients with CHF compared with healthy age and sex matched persons. METHODS Twelve patients (three females) with CHF, NYHA II-III, age 64 +/- 6 years, and 12 healthy subjects were studied. Cardiorespiratory changes, on land and in a temperature-controlled swimming pool (33-34 degrees C) were assessed during rest and exercise, in a sitting position, using continuous gas analyses. RESULTS There were no significant differences, land versus water, in carbon dioxide production, total ventilation, respiratory frequency, respiratory exchange ratio, heart rate or blood pressure in either of the groups. A significant difference was found in oxygen uptake, at rest, land versus water in patients with CHF in comparison with healthy subjects (-0.2 +/- 0.4 versus +0.3 +/- 0.6 ml kg(-1) min(-1), P < 0.01). Oxygen kinetics (tau) increased significantly (P = 0.01) in both groups during exercise in water. CONCLUSION Hydrotherapy was well tolerated and the vast majority of the cardiorespiratory responses, during warm water immersion in a clinical setting, are similar in patients with CHF compared with healthy subjects. However, further larger studies, are needed to better understand the physiological reactions during hydrotherapy.
2.
Functional roles of lower-limb joint moments while walking in water.
Miyoshi, T, Shirota, T, Yamamoto, S, Nakazawa, K, Akai, M
Clinical biomechanics (Bristol, Avon). 2005;(2):194-201
Abstract
OBJECTIVE To clarify the functional roles of lower-limb joint moments and their contribution to support and propulsion tasks while walking in water compared with that on land. DESIGN Sixteen healthy, young subjects walked on land and in water at several different speeds with and without additional loads. BACKGROUND Walking in water is a major rehabilitation therapy for patients with orthopedic disorders. However, the functional role of lower-limb joint moments while walking in water is still unclear. METHODS Kinematics, electromyographic activities in biceps femoris and gluteus maximums, and ground reaction forces were measured under the following conditions: walking on land and in water at a self-determined pace, slow walking on land, and fast walking in water with or without additional loads (8 kg). The hip, knee, and ankle joint moments were calculated by inverse dynamics. RESULTS The contribution of the walking speed increased the hip extension moment, and the additional weight increased the ankle plantar flexion and knee extension moment. CONCLUSIONS The major functional role was different in each lower-limb joint muscle. That of the muscle group in the ankle is to support the body against gravity, and that of the muscle group involved in hip extension is to contribute to propulsion. In addition, walking in water not only reduced the joint moments but also completely changed the inter-joint coordination. RELEVANCE It is of value for clinicians to be aware that the greater the viscosity of water produces a greater load on the hip joint when fast walking in water.