44 | Akwa | March / April / May 2023 AQUATIC THERAPY 101 As the COVID-19 pandemic rages on, many are beginning to understand symptom longevity and how the lives of millions of COVID-19 sufferers are impacted. Many people recover from the symptoms of a typical COVID-19 infection within days. However, respiratory issues, muscle and joint pain, and cardiovascular concerns are among many symptoms scien- tists and physicians are beginning to see persist much longer than the initial infection2. Though this information may be daunting, utilizing the aquatic environment for exercise can help alleviate these chronic symptoms for some individuals. AQUATIC EXERCISE CAN IMPROVE RESPIRATORY DEFICITS Common chronic COVID symptoms impact the body through the respiratory system; shortness of breath and dif- ficulty breathing. The aquatic environment provides many benefits for our respiratory system. Hydrostatic pressure compresses all parts of the body when submerged in water; therefore, the respiratory muscles work harder during inha- lation1, and are assisted with exhalation. The aquatic environment is great for training the inspira- tory muscles, including the intercostals, because immersion alters resistance. For example, being submerged in water to the shoulders adds more resistance than being submerged to the ribcage. In addition, gradually strengthening the breath- ing muscles may reduce feelings of shortness of breath or difficulty breathing. The aquatic environment can also train the muscles of expi- ration (internal and external obliques, rectus abdominis, transverse abdominis). Numerous core exercises can be per- formed in the pool, both with and without equipment, to alter the degree of difficulty. For example, a good core exer- cise would be a plank utilizing the pool wall. To add chal- lenge, use a pool noodle as opposed to the wall. This trains the abdominal muscles is a good way to facilitate expiration, making breathing easier overall. Another way that aquatic exercise could help improve lung function is through aerobic exercise. From shallow-water HIIT to deep-water running, there are a plethora of aquatic aerobic workouts to improve aerobic capacity. Aerobic exercise can improve exercise capacity and lung function4, and the aquatic environment provides a safe, fun setting! As tolerated, con- tinued aerobic training can help clients return post-COVID respiratory function to normal levels and may also improve respiratory health above pre-COVID functionality. AQUATIC EXERCISE CAN REDUCE MUSCLE AND JOINT PAIN A coronavirus infection can be extremely taxing for the body. The inflammation caused by the infection can cause muscle and joint pain that may last for months2. Additionally, indi- viduals may be bedridden for much of the duration of the illness. The more time spent in this sedentary state, the more muscles weaken and atrophy7. The reduction in strength can cause the muscles to fatigue more quickly and induce ach- ing pain. As well, the lack of movement can result in stiffer, more painful joints7, especially for those already suffering from arthritic conditions. The muscles and joints can benefit from the aquatic environ- ment’s properties. For example, hydrostatic pressure plays a significant role in pain reduction by reducing swelling and improving blood flow6. Another property of water that aids in pain reduction is buoyancy, which allows less impact stress on the joints than land. Exercising in warmer water has also been proven to be an effective way to manage pain during exercise, enabling individuals to improve fitness without restrictions6. Studies show that neck pain, resulting from different condi- tions, can be significantly decreased with aquatic exercise3. This principle can apply to all parts of the body. Increas- ing mobility, muscular strength, endurance, as well as aer- obic capacity can all lead to pain reduction and improved fitness levels6 that help return the body to normal, or even improved, function post-COVID. The use of resistance and supportive equipment alters exer- cise intensity. For example, drag equipment makes it harder for the limbs to move in all directions of submerged move- ment, requiring more muscular effort. Whereas supportive equipment, such as a pool noodle, can assist with balance. AQUATIC EXERCISE CAN IMPROVE CARDIOVASCULAR HEALTH As mentioned before, hydrostatic pressure does an incredible job of promoting cardiovascular function when submerging the body in water. The pressure exerted on the body aids in venous return, allowing for improved circulation and overall heart function. In a study by Klonizakis et al.,5 , aerobic- focused aquatic exercise improved flow-mediated dilation (FMD) of the cardiovascular system more than land-based aerobic exercise. Flow-mediated dilation is a direct indicator of cardiovascular health and function5. In a nutshell, FMD Chronic COVID Conditions & Water Exercise By Sydney J. Zimla, BS To learn more about this topic, plan to attend the IAFTC 2023 lecture, Treatment and Strategies for Long Covid, by Beth Scalone.
