Wadell (2004) High intensity physical group training in water–an effective training modality for patients with COPD.

Introduction to COPD and Exercise Training

Chronic Obstructive Pulmonary Disease (COPD) significantly impacts patients’ quality of life, leading to reduced exercise capacity and breathlessness. Despite medical treatments, patients often experience functional deficits. Exercise training has been recognized for its physiological benefits, improving exercise tolerance and quality of life in COPD patients. This study explores high-intensity physical group training in water versus on land, assessing its impact on physical capacity and health-related quality of life (HRQoL).

Study Design and Methodology

The study was a controlled, semi-randomized trial involving 43 outpatients with moderate to severe COPD. Participants were divided into water-based training, land-based training, and a control group. The training sessions were conducted three times a week for 12 weeks, focusing on high-intensity exercises. The effectiveness of these interventions was measured through walking tests, cycle ergometer tests, and HRQoL questionnaires (SGRQ and SF-36).

Key Findings

Both water and land training groups showed improvements in exercise performance. Notably, the water group demonstrated a significant enhancement in the Endurance Shuttle Walking Test (ESWT) and experienced substantial improvements in physical health as measured by the SF-36 questionnaire, outperforming the land group. The land group also showed progress but not as pronounced as the water group. The control group, without any intervention, displayed a decline in HRQoL.

Implications and Conclusions

High-intensity group training, both in water and on land, is beneficial for COPD patients, enhancing physical capacity and maintaining HRQoL. The water-based training, in particular, presented additional advantages in physical capacity and perceived physical health compared to land-based training. These findings suggest that incorporating aquatic exercises into COPD rehabilitation programs could offer significant benefits, potentially more so than traditional land-based exercises.

Keywords: COPD, aquatic therapy, land-based therapy, physical capacity, health-related quality of life, HRQoL, exercise training, rehabilitation