46 | Akwa | December 2022 / January 2023 / February 2023 The lungs’ primary function is gas exchange, also referred to as respi- ration (or breathing). In respiration, oxygen from incoming air enters the blood, and carbon dioxide, waste gas from the metabolism, leaves the blood. A reduced lung function means that the ability of the lungs to exchange gases is reduced (European Environ- ment Agency, 2022). Regular exercise, eating a healthy diet, and avoiding tobacco smoke can help keep the lungs functioning at their best. As a result of specific diseases (such as asthma, COPD, and COVID-19), the lungs may not perform as efficiently, and air can become trapped. Over time, stale air builds up, leaving less room for the diaphragm to contract and bring in fresh oxygen. With the diaphragm not working to full capac- ity, the body uses other muscles in the neck, back, and chest for breathing. This translates into lower oxygen lev- els and less reserve for exercise and activity. If practiced regularly, breath- ing exercises can help rid the lungs of accumulated stale air, increase oxy- gen levels, and get the diaphragm to return to its job of helping you breathe (American Lung Association 2022). In the same way that aerobic exer- cise improves your heart function and resistance training strengthens your muscles, breathing exercises can make your lungs more efficient. These exercises may be a helpful tool to aid your recovery if you are experiencing ongoing problems post-COVID-19 (Pure Sports Medicine 2022). When you have healthy lungs, breathing is natural and easy. You breathe in and out with your diaphragm doing about 80 percent of the work to fill your lungs with a mixture of oxygen and other gases and then send the waste gas out. Lung capacity does not rely on the lungs alone. Your chest wall and the muscles of respiration, which include the diaphragm and the intercostal muscles (the muscles that lie between your ribs), also play a part. When immersed, hydrostatic pressure assists with exhalation, while making it harder to inhale against the resistance. Which aquatic exercises are best to improve lung function? Overall, aer- obic aquatic activities will provide the heart and lungs with the workout needed to enhance lung function. Mus- cle conditioning builds core strength, improves posture, and strengthens breathing muscles. Mobility training, especially improving the rotation in the thoracic spine, can help open the chest and provide more space to breathe deeply. Specific breathing techniques like pursed lip breathing (purse your lips as if you were going to whistle and breathe out) can rid stale air from the lungs. Focused breathing techniques can also help the lungs and diaphragm work more efficiently. The term “long COVID” refers to pro- longed symptoms following infec- tion with SARS-CoV-2 unexplained by an alternative diagnosis. Training results for one of my clients indi- cate that water exercise can improve post-COVID lung function, at least for some individuals. This client con- tracted COVID at age 55; she did not smoke and was considered a healthy person for her age. She was in a coma for three weeks. Afterward, she couldn’t perform daily activities like climbing stairs and doing laun- dry. Three months after her coma, she started working out in the pool. She began with walking and breathing exercises in the water once a week for one hour. After six months, she could run and jump in the pool and elevate her heart rate using interval formats. She expanded her training to include muscle strengthening and mobility training to improve rotation in the thoracic spine, still only working out once a week for one hour. After nine months, she could finally walk up the stairs with her laundry in her hand. Tears came to our eyes. n Author Dr. Daniela De Toia is a sports scientist. She specializes in aquatic fitness training. She trains people on land and in the water and has focused on infant and toddler swimming. Currently, she is the sporting director of the Sharky Sportsclub in Cologne where she also trains all trainers. Enhancing Lung Function with Water Exercise By Dr. Daniela De Toia
