The Effects of Aquatic Exercise Training on Functional and Hemodynamic Responses in Patients With Heart Failure: A Systematic Review and Meta-Analysis

Objective: This study aimed to investigate the impacts of water exercise training on functional and hemodynamic responses in HF patients. Methods: A systematic review and meta-analysis were conducted until February 15, 2024, using multiple databases. Mean difference (MD) with corresponding 95% confidence intervals (CIs) were calculated. Results: Sixteen studies, comprising 349 participants with HF, were included. Water exercise led to enhancements in peak VO2 (MD, 2.85 mL/kg/min; 95% CI, 1.89 to 3.80; p < .00001) and resting heart rate (MD, -4.16 bm; 95% CI, -6.85 to -1.46; p = .002) compared to no exercising controls. Water plus land exercise reduced resting heart rate (MD, -1.41 bm; 95% CI, -2.13 to -0.69; p = .0001) compared to land exercise alone. Furthermore, acute water exercises decreased resting heart rate (MD, -3.85 bm; 95% CI, -6.49 to -1.21; p = .004) and increased stroke volume (MD, 14.68 mL/beat; 95% CI, 8.57 to 20.79; p < .00001) and cardiac output (MD, 0.5 L/min; 95% CI, 0.27 to 0.73; p < .00001) compared to baseline. Conclusion: These findings suggest that water exercise holds promise as an effective intervention for enhancing functional capacity and hemodynamic parameters in individuals with HF, highlighting the importance of further research to optimize its implementation and elucidate long-term benefits.