[Physical therapy in a pool as rehabilitation for chronic obstructive pulmonary disease in the elderly]

The pulmonary function test and arterial blood gas analysis were performed before and after a 2-month rehabilitation program in a pool filled with 38 degrees C hot-spring water in 15 elderly patients (75.7 +/- 3.7 years of age; 12 males and 3 females; 6 cases of pulmonary emphysema and 9 cases of bronchial asthma) and 10 young patients (56.4 +/- 14.2 years of age, 7 males and 3 females; 4 cases of pulmonary emphysema and 6 cases of bronchial asthma) with stable chronic obstructive pulmonary disease treated at Gunma University Hospital between 1995 and 1996. After the exercise program, the ratio of forced expired volume in one second to forced vital capacity (FEV1.0%) was significantly increased (p < 0.05), while the ratio of forced vital capacity to predicted normal value (%VC) did not change in either group. Furthermore, a tendency toward an increase in peak flow (PF) and maximal expiratory flow at 25 and 50 percent (V25 and V50) was observed in both groups. An increase in PaO2 was observed in both groups, while an decrease in PaCO2 was observed in the young group (p < 0.05). These effects were observed more clearly in patients with asthma than in those with emphysema. The changes in pulmonary function and arterial blood gas were considered to be resulted from respiratory muscle training and expiration into water in addition to an increase in cardiac output by hydraulic pressure. Therefore, physical therapy in a pool filled with hot-spring water may be useful in treating chronic obstructive pulmonary disease in elderly as well as in young patients.