title: Relevance of water gymnastics in rehabilitation programs in patients with chronic heart failure or coronary artery disease with normal left ventricular function.
abstract: BACKGROUND
  Exercise training is included in cardiac rehabilitation programs to enhance physical capacity and cardiovascular function. Among the existing rehabilitation programs, exercises in water are increasingly prescribed. However, it has been questioned whether exercises in water are safe and relevant in patients with stable chronic heart failure (CHF), coronary artery disease (CAD) with normal systolic left ventricular function. The goal was to assess whether a rehabilitation program, including water-based gymnastic exercises, is safe and induces at least similar benefits as a traditional land-based training.
  
  
  RESULTS
  Twenty-four male CAD patients and 24 male CHF patients with stable clinical status participated in a 3-week rehabilitation. They were randomized to either a group performing the training program totally on land (CADl, CHFl; endurance + callisthenic exercises) or partly in water (CADw, CHFw; land endurance + water callisthenic exercises). Before and after rehabilitation, left ventricular systolic and cardiorespiratory functions, hemodynamic variables and autonomic nervous activities were measured. No particular complications were associated with both of our programs. At rest, significant improvements were seen in CHF patients after both types of rehabilitation (increases in stroke volume and left ventricular ejection fraction [LVEF]) as well as a decrease in heart rate (HR) and in diastolic arterial pressure. Significant increases in peaks VO(2), HR, and power output were observed in all patients after rehabilitation in exercise test. The increase in LVEF at rest, in HR and power output at the exercise peak were slightly higher in CHFw than in CHFl.
  
  
  CONCLUSIONS
  Altogether, both land and water-based programs were well tolerated and triggered improvements in cardiorespiratory function.
authors.affiliation: Université de Poitiers, Laboratoire des Adaptations Physiologiques aux Activités Physiques, Poitiers, France.
authors.forename: Daline
authors.initials: D
authors.lastname: Teffaha
authors.forename: Laurent
authors.initials: L
authors.lastname: Mourot
authors.forename: Philippe
authors.initials: P
authors.lastname: Vernochet
authors.forename: Fawzi
authors.initials: F
authors.lastname: Ounissi
authors.forename: Jacques
authors.initials: J
authors.lastname: Regnard
authors.forename: Catherine
authors.initials: C
authors.lastname: Monpère
authors.forename: Benoit
authors.initials: B
authors.lastname: Dugué
mesh_terms: D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D006173:Gymnastics / Q000502:physiology*; D006333:Heart Failure / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left / Q000502:physiology*; D014867:Water
chemical_list: D014867:Water