Effect of water-based exercise in people with COPD with physical comorbidities

Abstract

People with chronic obstructive pulmonary disease (COPD) and physical comorbidities such as obesity, musculoskeletal, orthopaedic and neurological conditions have reduced free-living daily physical activity compared to people with COPD and healthy age-matched individuals. Less time is spent in light and moderate intensity physical activity and greater time is spent in sedentary behaviours. Water-based exercise training (WBET) may be an alternative to traditional land-based exercise training (LBET) for people with COPD and physical comorbidities (COPD+PC). Previous studies have shown positive outcomes for exercise capacity and quality of life following WBET, however these results were inconclusive given the trials were low in quality. In a prospective randomised controlled trial comparing an eight-week supervised WBET program to an equivalent eight-week supervised LBET program and a control group of no exercise training, WBET was found to be significantly more effective than LBET and no exercise training in increasing peak and endurance exercise capacity and improving aspects of quality of life in people with COPD+PC. In addition, obese participants randomised to the WBET program lost a greater amount of weight over the eight-week training period than participants in the LBET and no exercise training groups. WBET was found to be well accepted by people with COPD+PC, with no adverse events occurring during the training period. Furthermore, high satisfaction with the aquatic environment was reported. In a Cochrane review examining the effect of WBET in people with COPD, WBET was found to significantly improve exercise capacity (functional, peak and endurance exercise capacity) and quality of life compared to no exercise training. Compared to LBET, WBET was found to significantly improve endurance exercise capacity and fatigue. Limited quality evidence exists that WBET in people with COPD is safe and effective.