My friend’s dad suffers from chronic obstructive pulmonary disease (COPD), as well as back pain, so it’s hard for him to move around and breathe easily. Of all the types of workouts that he has tried, group aquatic exercise is the one that he has stuck with the longest.

Heading to an indoor pool isn’t exactly convenient for him—he needs someone to drive him there…and then he has to change into his swimsuit…and afterward, he needs to shower and change…etc. It would be much easier for him to simply go for a walk around the block or putter around in a weight room!

But apparently there is just something about being in a pool with an instructor and other folks just like him. He says that he likes the social aspect, the heated water is soothing and he finds the activity more fun than working out on land—I suspect that it makes him feel like a kid again when he splashes around.

So I was pleased when I saw a new Australian study that shows that aquatic exercise builds more endurance and decreases fatigue and shortness of breath more substantially for people like him than land exercise—and this finding may apply to people with other sorts of respiratory problems and chronic conditions, too.


The new research focused specifically on people who had both COPD, an all-too-common respiratory problem that is the third-leading cause of death in the US, and an additional chronic condition that makes exercise difficult—such as obesity, joint problems or back pain. But there’s every reason to think that the study’s results will apply to people with other sorts of medical issues, especially those with respiratory conditions, said lead researcher Renae McNamara, BAppSc (Phty), a respiratory physiotherapist in Australia. Future studies will need to examine that.

Researchers were interested in finding out which type of workout would help people find the most relief—land-based exercise (a mixture of walking, cycling, aerobics and dumbbell lifts) or water-based exercise (aquatic calisthenics done in chest-to-neck high water in a pool heated to 93°F).

The patients were split into three groups. One group did one-hour water exercises three times a week for eight weeks with a trained physiotherapist. Another group did land exercises for the same amount of time with the same trained physiotherapist. And a third group performed no exercise (the control).

At the end of the study, when each group was asked to perform a walking test to measure endurance, members of the water group could walk 118% farther than they could at the start of the study, on average…the land group’s distance improved, too, but by only 53%…and the control group actually got weaker—their distance was 13% shorter.

Also, the people who had been exercising in a pool saw a 9% decrease in shortness of breath and a 13% decrease in fatigue by the end of the study…while the people who had been exercising on land saw only a 4% decrease in shortness of breath and a 3% decrease in fatigue.


So why did water workouts come out on top? “Water may have helped more for a few reasons. First of all, you have the effect of buoyancy, which supports your weight and reduces impact on your joints,” said McNamara. “Warm water also helps with pain control and increases blood flow to muscles. Plus, water offers resistance to all your movements, so your muscles work harder, and that strengthens them.”

What’s ironic is that it wasn’t all that long ago that people with COPD were warned not to do water-based exercise. Doctors worried that the water would compress the chest and that the exertion would stress the heart. But studies that have analyzed COPD and water exercise under controlled conditions (as in, when patients were under the watchful eye of a health professional) have shown that these fears are unfounded, said McNamara.


Now that we have these study results, if you suffer from COPD as well as obesity, joint problems or back pain, you owe it to yourself to talk to your doctor or physical therapist about trying pool-based therapy with a trained health professional. (If you have COPD but none of those other conditions…or if you have one of the other conditions but not COPD…or if you suffer from a different type of respiratory problem…you may still find pool-based therapy to be more beneficial than land exercises, so it’s worth a try, said McNamara.)

Group classes are usually easier to find than individual classes (plus, they tend to be cheaper and more fun). But either type of class is useful. To find one, call your local YMCA ( or a community recreation center that has a pool or a hospital with an aquatic rehab center.

You might find, like my friend’s dad, that all it takes is a little water to ease your pain and help you stay active.