McNamara et al 2013 ERJ Letter to Editor

Introduction to Obesity and COPD

Obesity complicates chronic obstructive pulmonary disease (COPD) by exacerbating symptoms like dyspnea, reducing health-related quality of life, and limiting exercise performance. Water-based exercise offers a potential therapeutic intervention for obese individuals with COPD, potentially mitigating these adverse effects.

Study Overview

A study by McNamara and colleagues focuses on the efficacy of water-based exercise for obese COPD patients. They conducted a randomized controlled trial involving 24 obese COPD patients, comparing the outcomes of water-based exercise, land-based exercise, and no exercise over eight weeks. The results revealed that the water-based exercise group experienced significant weight loss and improvements in exercise capacity and quality of life.

Exercise Capacity and Quality of Life Improvements

The water-based exercise group showed remarkable improvements in exercise capacity, as evidenced by significant increases in the 6-minute walking distance, incremental shuttle walk distance, and endurance shuttle walk distance. This group also reported significant enhancements in all aspects of health-related quality of life measured by the Chronic Respiratory Disease Questionnaire. These improvements were not observed in the land-based exercise or control groups.

Comparative Analysis of Exercise Modalities

The study found that water-based exercise was superior to land-based exercise and no exercise in reducing body weight, enhancing exercise capacity, and improving quality of life for obese COPD patients. The aquatic environment likely facilitated higher exercise intensity due to reduced weight-bearing and increased resistance, which, along with the warm water and air temperature, might have contributed to the observed weight loss.

Enjoyment and Compliance

Participants in the water-based exercise group reported higher enjoyment levels compared to those in the land-based exercise group. This increased enjoyment could play a critical role in adherence to exercise regimens, further supporting the efficacy of water-based exercise for this population.

Implications for Clinical Practice

The findings suggest that water-based exercise should be considered a viable and effective component of pulmonary rehabilitation for obese individuals with COPD. Future research should explore the combined effects of water-based exercise and nutritional interventions to provide comprehensive management strategies for this demographic.


Water-based exercise presents an effective, enjoyable, and beneficial intervention for obese COPD patients, improving exercise capacity, quality of life, and potentially facilitating weight loss. These findings underscore the importance of tailored exercise programs in managing COPD comorbidities, particularly obesity.

Keywords: Obesity, COPD, water-based exercise, exercise capacity, quality of life, weight loss.

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