Aquatic Exercise for Heart Failure

Aquatic Exercise Training and Stable Heart Failure: a systematic review and meta-analysis

By Julie A. Adsett from the Heart Failure Service and the Physiotherapy Department at the Royal Brisbane and Women's Hospital, Brisbane, Australia; The School of Allied Health Sciences, Griffith University, Gold Coast, Australia. Julie.adsett@health.qld.gov.au. | Alison M. Mudge from the Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Brisbane, Australia.| Norman Morris from the School of Allied Health Sciences, Griffith University, Gold Coast, Australia.| Suzanne Kuys from the School of Physiotherapy, Australian Catholic University, Brisbane, Australia. | Jennifer D. Paratz from the Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Australia. | May 2015

A meta-analysis and review of the evidence was conducted to determine the efficacy of aquatic exercise training for individuals with heart failure compared to traditional land-based programmes.

METHODS

A systematic search was conducted for studies published prior to March 2014, using MEDLINE, PUBMED, Cochrane Library, CINAHL and PEDro databases. Key words and synonyms relating to aquatic exercise and heart failure comprised the search strategy. Interventions included aquatic exercise or a combination of aquatic plus land-based training, whilst comparator protocols included usual care, no exercise or land-based training alone. The primary outcome of interest was exercise performance. Studies reporting on muscle strength, quality of life and a range of haemodynamic and physiological parameters were also reviewed.

RESULTS

Eight studies met criteria, accounting for 156 participants. Meta-analysis identified studies including aquatic exercise to be superior to comparator protocols for 6 minute walk test (p<0.004) and peak power (p<0.044). Compared to land-based training programmes, aquatic exercise training provided similar benefits for VO(2peak), muscle strength and quality of life, though was not superior. Cardiac dimensions, left ventricular ejection fraction, cardiac output and BNP were not influenced by aquatic exercise training.

CONCLUSIONS

For those with stable heart failure, aquatic exercise training can improve exercise capacity, muscle strength and quality of life similar to land-based training programmes. This form of exercise may provide a safe and effective alternative for those unable to participate in traditional exercise programmes.