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Evidence summaries

Water-Based Exercise Training for Chronic Obstructive Pulmonary Disease

Water-based exercise training compared with no exercise training improves exercise capacity and may improve health-related quality of life in COPD. Water-based exercise training appears to improve endurance exercise capacity compared with land-based exercise training. Level of evidence: "A"

Summary

A Cochrane review [Abstract] 1 included 5 studies with a total of 176 subjects. All studies compared supervised water-based exercise training versus land-based exercise training and/or no exercise training in people with COPD. The exercise training programmes lasted from 4 to 12 weeks, and the mean age of participants ranged from 57 to 73 years.

Compared with no exercise, water-based exercise training improved the 6-minute walk distance (MD 62 metres, 95% CI 44 to 80 metres; 3 studies, n=99), the incremental shuttle walk distance (MD 50 metres, 95% CI 20 to 80 metres; 1 study; n=30) and the endurance shuttle walk distance (MD 371 metres, 95% CI 121 to 621 metres; 1 study; n=30). Quality of life was also improved after water-based exercise training compared with no exercise (SMD -0.97, 95% CI -0.37 to -1.57; 2 studies, n=49).

Compared with land-based exercise training, water-based exercise training did not significantly change the 6-minute walk distance (MD 11 metres, 95% CI -11 to 33 metres; 3 studies, n=62) or the incremental shuttle walk distance (MD 9 metres, 95% CI -15 to 34 metres; 2 studies, n=59). However, the endurance shuttle walk distance improved following water-based exercise training compared with land-based exercise training (MD 313 metres, 95% CI 232 to 394 metres; 2 studies, n=59). No significant differences were found between water-based exercise training and land-based exercise training for quality of life, as measured by the St George's Respiratory Questionnaire or by three of four domains of the Chronic Respiratory Disease Questionnaire (CRDQ); however, the fatigue domain of the CRDQ showed a statistically significant difference in favour of water-based exercise (MD -3.00, 95% CI -5.26 to -0.74; 1 study, n=30).

Clinical comments

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    References

    • McNamara RJ, McKeough ZJ, McKenzie DK et al. Water-based exercise training for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2013;(12):CD008290. [PubMed]

Primary/Secondary Keywords