title: Acceptability of the aquatic environment for exercise training by people with chronic obstructive pulmonary disease with physical comorbidities: Additional results from a randomised controlled trial.
abstract: OBJECTIVE
  Water-based exercise training is a relatively new concept in the management of people with COPD. This study aimed to examine the acceptability of the aquatic environment as a medium for exercise training in people with COPD with physical comorbidities.
  
  
  METHODS
  Following a supervised eight week, three times a week, water-based exercise training programme conducted in a hospital hydrotherapy pool as part of a randomised controlled trial, participants completed a questionnaire about their experience with exercise training in the pool including adverse events, barriers and factors enabling exercise programme completion, satisfaction with the aquatic environment and their preference for an exercise training environment.
  
  
  RESULTS
  All 18 participants (mean (SD) age 72 (10) years; FEV1% predicted 60 (10) %) who commenced the water-based exercise training programme completed the questionnaire. Three participants withdrew from training. High acceptability of the water and air temperature, shower and change-room facilities, staff assistance and modes of pool entry was reported (94% to 100%). Six factors were highly rated as enabling exercise programme adherence and completion: staff support (chosen by 93% of participants), enjoyment (80%), sense of achievement (80%), noticeable improvements (73%), personal motivation (73%) and participant support (53%). Eighty-nine percent of the participants indicated they would continue with water-based exercise.
  
  
  CONCLUSIONS
  This study provides the first insight into the acceptability of the aquatic environment for exercise training in people with COPD and indicates water-based exercise and the aquatic environment is well accepted.
authors.affiliation: Clinical and Rehabilitation Sciences, The University of Sydney, 75 East Street, Lidcombe, New South Wales 2141, Australia; Department of Respiratory and Sleep Medicine, Prince of Wales Hospital, Barker Street, Randwick, New South Wales 2031, Australia; Department of Physiotherapy, Prince of Wales Hospital, Barker Street, Randwick, New South Wales 2031, Australia. Electronic address: renae.mcnamara@sesiahs.health.nsw.gov.au.
authors.forename: Renae J
authors.initials: RJ
authors.lastname: McNamara
authors.affiliation: Clinical and Rehabilitation Sciences, The University of Sydney, 75 East Street, Lidcombe, New South Wales 2141, Australia. Electronic address: zoe.mckeough@sydney.edu.au.
authors.forename: Zoe J
authors.initials: ZJ
authors.lastname: McKeough
authors.affiliation: Department of Respiratory and Sleep Medicine, Prince of Wales Hospital, Barker Street, Randwick, New South Wales 2031, Australia. Electronic address: david.mckenzie@sesiahs.health.nsw.gov.au.
authors.forename: David K
authors.initials: DK
authors.lastname: McKenzie
authors.affiliation: Clinical and Rehabilitation Sciences, The University of Sydney, 75 East Street, Lidcombe, New South Wales 2141, Australia; Department of Physiotherapy, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales 2050, Australia. Electronic address: jennifer.alison@sydney.edu.au.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Alison
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D013551:Swimming Pools; D013696:Temperature
keywords: COPD; Exercise; Hydrotherapy; Patient acceptance of health care; Questionnaire; Swimming pools