title: Influence of different levels of immersion in water on the pulmonary function and respiratory muscle pressure in healthy individuals: observational study.
abstract: OBJECTIVE
  Immersion in water, with the head above the water line, causes acute physiological changes in the pulmonary and cardiovascular systems. The aim of this study was to evaluate the acute physiological responses to immersion on lung volumes and respiratory muscle strength at different depths.
  
  
  METHODS
  A cross-sectional study was conducted in 28 healthy individuals (21.75 ± 1.99 years; 13 men and 15 women). Anthropometric and spirometric data as well as respiratory muscle strength were evaluated. Evaluations were carried out on dry land (DL) and in a pool at three different levels of immersion: iliac crests (IC), xiphoid appendix of the sternum (XA) and clavicles (CL). The order of evaluation for spirometry and maximal inspiratory and expiratory pressures between DL and the different levels of immersion was randomized. The ANOVA test for repeated measures with post hoc Tukey was applied to compare the variables.
  
  
  RESULTS
  Vital capacity exhibited lower values at the CL level compared with DL, XA and IC (p < 0.01). The most significant change in forced expiratory volume in the first second (FEV(1)) occurred under immersion at CL and XA levels. No differences in maximal expiratory pressure were found in the comparisons between the different levels of immersion and DL (p = 0.19). There was nevertheless a decrease in maximum inspiratory pressure with immersion at the CL level (91 ± 23 cmH(2)O) compared with DL (105 ± 29 cmH(2)O), XA (99 ± 24 cmH(2)O) and IC (101 ± 25 cmH(2)O) values (p < 0.01).
  
  
  CONCLUSIONS
  The results suggest that immersion at the level of the clavicles and xiphoid appendix alters lung function and respiratory muscle strength when compared with the values measured out of the water and immersed at the IC level in healthy individuals, demonstrating the influence of hydrostatic pressure on the respiratory system.
authors.affiliation: Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Armèle Dornelas
authors.initials: AD
authors.lastname: de Andrade
authors.forename: Jader Carneiro
authors.initials: JC
authors.lastname: Júnior
authors.forename: Talita Lourdes
authors.initials: TL
authors.lastname: Lins de Barros Melo
authors.forename: Catarina Souza Ferreira
authors.initials: CS
authors.lastname: Rattes Lima
authors.forename: Daniella Cunha
authors.initials: DC
authors.lastname: Brandão
authors.forename: Jacqueline
authors.initials: J
authors.lastname: de Melo Barcelar
mesh_terms: D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D006874:Hydrostatic Pressure; D007101:Immersion / Q000503:physiopathology*; D008168:Lung / Q000502:physiology*; D008176:Lung Volume Measurements; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D012132:Respiratory Muscles / Q000502:physiology*; D013147:Spirometry; D014797:Vital Capacity / Q000502:physiology; D014867:Water; D055815:Young Adult
chemical_list: D014867:Water
keywords: immersion; pulmonary function test; respiratory muscle