Cider (2003) Hydrotherapy-a new approach to improve function in the older patient with chronic heart failure

Background and Aim

Chronic heart failure (CHF) significantly limits patients’ ability to perform daily activities, particularly in the elderly, who often have coexisting conditions that further impair their exercise capacity. Hydrotherapy, or exercise in warm water, presents a potentially safer alternative due to the buoyancy effect, which reduces loading on the body. Despite historical use, concerns about increased venous return in CHF patients have made hydrotherapy a controversial topic. This study by Cider et al. aimed to assess the feasibility, safety, and effectiveness of a hydrotherapy program in improving exercise capacity, muscle function, and quality of life in older CHF patients.


The study involved 25 CHF patients randomized into an 8-week hydrotherapy program or a control group. The intervention included exercises designed for cardiovascular fitness, mobility, and strength improvement, conducted in a temperature-controlled swimming pool. Exercise capacity and muscle function were evaluated through various tests, including ergometer exercise tests and muscle strength assessments. Quality of life was measured using the SF-36 and LHFQ questionnaires.


Hydrotherapy was well-tolerated with no adverse events, indicating its safety for CHF patients. The intervention group showed significant improvements in maximal exercise capacity and muscle function in small muscle groups compared to controls. These findings suggest that hydrotherapy can enhance physical performance and could be a viable exercise alternative for older CHF patients with mobility issues.

Conclusion and Implications

Hydrotherapy offers a safe and effective means to improve exercise capacity and muscle function in elderly CHF patients. This new approach could expand training options and encourage long-term exercise adherence in this population. Further research is needed to explore the long-term benefits and potential cardiovascular effects of hydrotherapy in CHF patients.

Keywords: Hydrotherapy, chronic heart failure, elderly, exercise capacity, muscle function, quality of life.

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