Water Exercise

Dear Dr. Mahler: I recently took an aquatic session (mild exercise) which i found very helpful in getting good exercise.  I stayed close to the deck and  had my  oxygen on the side of the pool.  This setup worked well with the class. Fortunately the class was attended by several nurses from one  of our hospitals (did not need their services.)  I am a good swimmer, but it very hard when attached to oxygen tube.  I think I will take another class early this fall if offered.  What do you think of this exercise? Sally from Lansing, MI Dear Sally, I am glad to hear that you enjoyed the water exercise program, and I congratulate you on doing this while using oxygen. Your example may help others be more active. Although actual swimming may be quite challenging for anyone, especially someone with COPD, upright exercise in water is considered safe. In fact, water exercises are a great alternative to land based activities which may difficult for those with arthritis, pain problems, or are overweight. sm00055-water-walking-with-hand-webs Standing in water is called immersion and creates pressure on the abdomen (stomach area) and chest. The higher the water level is relative to the chest (see photos), the greater the outward pressure on the chest and the harder the lungs must work. Over time, this extra work by the diaphragm and other breathing muscles will increase their strength and endurance. Before someone with COPD starts an exercise program in water, make sure that the water temperature is warm and comfortable. Use albuterol or other short-acting bronchodilators 15 minutes before you enter the pool. I suggest that the person stand in water up to the waist to get used to the experience. You might walk back and forth in the pool to warm up and see what it feels like. Then, you can try going into deeper water and note if there is any change in your breathing. You can always move into shallower water if breathing becomes too difficult. For those that require oxygen, the oxygen tank should be stabilized on the pool deck along with long (40 inch) tubing that can provide some flexibility for movement. Whether you participate in a water aerobics class depends on your interest and motivation. Many men and women who exercise in a pool report that they love the experience and appreciate the benefits of the buoyancy of the water. I hope that this information is helpful for you, and I encourage you to enroll in the fall class. Sincerely, Donald A. Mahler, M.D.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.