title: Hydrotherapy--a new approach to improve function in the older patient with chronic heart failure.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, Institution for Community Medicine, The Sahlgrenska Academy at Göteborg University, Sahlgrenska University Hospital, Goteborg, Sweden. asa.cider@fhs.gu.se
authors.forename: Asa
authors.initials: A
authors.lastname: Cider
authors.forename: Maria
authors.initials: M
authors.lastname: Schaufelberger
authors.forename: Katharina Stibrant
authors.initials: KS
authors.lastname: Sunnerhagen
authors.forename: Bert
authors.initials: B
authors.lastname: Andersson
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D018737:Hand Strength; D006305:Health Status Indicators; D006333:Heart Failure / Q000534:rehabilitation*; D006801:Humans; D006875:Hydrotherapy; D008297:Male; D011788:Quality of Life