October 2018: Aquatics & Diabetes



ID 126290752 © Róbert László Róka | Dreamstime.comContent courtesy of the National Swimming Pool Foundation


The roll of structured exercise in the life of the patient with diabetes cannot be overstated. Time and again, research has shown the ability for an ongoing exercise program to improve cardiopulmonary factors, quality of life and diabetic markers for patients with chronic conditions like diabetes. But this begs the question: Is it more effective to workout in the pool or on land? The answer is, it depends. Patients with significant mobility limitations due to obesity or severe deconditioning will find the pool a welcoming environment. It is easier to perform activities like running and jumping when supported by the buoyancy inherent in water.

But the water can also make things too easy. Patients who spend a lot of time hanging in the deep water, making use of buoyant devices such as noodles or belts, may not be elevating the heart rate, oxygen consumption or other signals of “effort” to nearly high enough rates to burn calories. Patients who are immersed in the water to chest deep have a powerful force aiding their heart in pushing blood – hydrostatic pressure. So, while immersion will increase the work of breathing by up to 60%, it will make it harder to reach target heart rates for training. A helpful tool for patients who want to get a good workout in water is to do a simple “talk test” where they try to carry on a conversation. If the patient needs to breath every word or two, he or she is working too hard, creating an oxygen debt which will not allow aerobic activity to occur. If it is possible for the patient to belt out a phrase of music or complete a sentence without needing a breath, it is definitely time to up the amp on the workout parameters! 


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