the aquatic therapist

Water-based cardiac rehab... Better than land?

Laurent M, Daline T, Malika B, Fawzi O, Philippe V, Benoit D, Catherine M, Jacques R. Training-induced increase in nitric oxide metabolites in chronic heart failure and coronary artery disease: an extra benefit of water-based exercises? Eur J Cardiovasc Prev Rehabil. 2009 Apr;16(2):215-21.

Université de Franche Comté, IFR 133 EA3920, Physiologie, Faculté de Médecine, Besançon, France. mourotlaurent@hotmail.com

BACKGROUND: Rehabilitation programs involving immersed exercises are more and more frequently used, with severe cardiac patients as well.

DESIGN: This study investigated whether a rehabilitation program including water-based exercises has additional effects on the cardiovascular system compared with a traditional land-based training in heart disease patients.

METHODS: Twenty-four male stable chronic heart failure patients and 24 male coronary artery disease patients with preserved left ventricular function participated in the study. Patients took part in the rehabilitation program performing cycle endurance exercises on land. They also performed gymnastic exercises either on land (first half of the participants) or in water (second half). Resting plasma concentration of nitric oxide metabolites (nitrate and nitrite) and catecholamine were evaluated, and a symptom-limited exercise test on a cycle ergometer was performed before and after the rehabilitation program.

RESULTS: In the groups performing water-based exercises, the plasma concentration of nitrates was significantly increased (P = 0.035 for chronic heart failure and P = 0.042 for coronary artery disease), whereas it did not significantly change in the groups performing gymnastic exercise on land. No changes in plasma catecholamine concentration occurred.

CONCLUSION: In every group, the cardiorespiratory capacity of patients was significantly increased after rehabilitation. The water-based exercises seemed to effectively increase the basal level of plasma nitrates. Such changes may be related to an enhancement of endothelial function and may be of importance for the health of the patients.

Plyometric training in water produces better results... with less stress to the athlete

Triplett NT, Colado JC, Benavent J, Alakhdar Y, Madera J, Gonzalez LM, Tella V. Concentric and impact forces of single-leg jumps in an aquatic environment versus on land. Med Sci Sports Exerc. 2009 Sep;41(9):1790-6.

PURPOSE: This study investigated the kinetic and the kinematic differences in female athletes in single-leg static jumps in an aquatic environment compared with those performed on dry land.

METHODS: Twelve healthy, junior national team handball players participated. Subjects completed a familiarization and a testing session. The subjects performed a series of single-leg jumps, dry land and aquatic with and without devices, which were randomized to avoid fatigue effects. Peak concentric force, rate of force development, impact force, and time of the jumps were determined using a force plate.

RESULTS: Peak concentric force and rate of force development were significantly (P < 0.05) higher in the aquatic jumps, whereas impact force was significantly (P < 0.05) lower. There was a shorter total jump time (P < 0.05) for the aquatic jump without devices, whereas the time required to reach peak force was not significantly different between the two environments, despite the greater resistance to movement in the aquatic medium.

DISCUSSION: Aquatic jump exercises result in greater force production and rate of force development in the same amount of time with less impact and can thus offer a viable alternative to traditional dry-land jump exercises, which may also be beneficial for rehabilitating or aging populations. The benefits of this type of exercise include an exercise mode that can be performed without compromising speed while reducing the potential for joint injury.

Department of Health, Leisure, and Exercise Science, Appalachian State University, Boone, NC, USA. triplttnt@appstate.edu

Want a longer duration between shutdowns? Try daily dilution

It's the standard of care in Europe: Dilute DAILY.

Public pools should drain and replace 30 liters (approximately 8 gallons) of pool water per user per day.

Example: Have an average bather load of 60 people? You should be diluting your pool water daily by draining almost 500 gallons and refilling with fresh water.

SOURCE: German DIN (Deutsch Industrie Normen) Standard 19,643: "Treatment & Disinfection of Swimming & Bathing Pool Water".

The DIN Standard has been adopted by the European Community. It is not mandated in the United States (except for international swimming competitions), but it is considered a "best practice". This practice removes total dissolved solids from your pool and makes it possible to extend the duration the pool can remain open before a "drain and fill" is necessary.

More at: www.alisonosinski.com/pooltips/53.htm

From the CDC: Vomit and Blood Contamination of Pool Water

The most common germs spread through recreational water are germs that cause diarrheal illnesses and skin rashes. These are spread by swallowing water contaminated with feces or by skin exposure to contaminated water. Pool water is unlikely to spread illness.

Vomit in Pool Water

Vomiting while swimming appears to be a common event. Often, vomiting is a result of swallowing too much water and, therefore, the vomit is probably not infectious. However, if the full contents of the stomach are vomited, follow the guidance in these Q & As:

Q: What germs are likely to be spread by vomit?

A: Noroviruses (also known as Norwalk-like viruses)

Q: Assuming that norovirus is in the vomit, what should I do?

A: Respond to the vomit accident as you would respond to a formed fecal accident, using CDC's recommendations. The time and chlorine level combinations needed to kill noroviruses and Giardia are similar. Since killing Giardia is the basis of CDC’s formed fecal accident response recommendations, this protocol should be adequate for disinfecting a potentially infectious vomit accident.

Blood in Pool Water

Germs (e.g., Hepatitis B virus or HIV) found in blood are spread when infected blood or certain body fluids get into the body and bloodstream (e.g., by sharing needles and by sexual contact). CDC is not aware of any of these germs being transmitted to swimmers from a blood spill in a pool.

Q: Does chlorine kill the germs in blood?

A: Yes. These germs do not survive long when diluted into properly chlorinated pool water.

Q: Swimmers want something to be done after a blood spill. Should the pool be closed for a short period of time?

A: There is no public health reason to recommend closing the pool after a blood spill. However, some pool staff choose to do so temporarily to satisfy patrons.

Source: www.healthyswimming.com

Check for existing guidelines from your local or state regulatory agency before use. Healthy Swimming recommendations do not replace existing state or local regulations or guidelines.