Dunlap Emily, Alhalimi Taha, McLaurin Natalie, Tanaka Hirofumi
Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA.
J Aging Phys Act. 2024 Aug 1;33(1):35-41. doi: 10.1123/japa.2023-0338. Print 2025 Feb 1.
BACKGROUND/OBJECTIVES: Orthostatic hypotension (OH) is a common condition among older adults that increases the risk of falls. The study objectives are to determine the influence of distinct environments (water vs. land) on OH and the consequent effects of walking in these environments in older adults. Additionally, we aimed to assess the differences in response between two groups: older adults with OH and those without OH.
A randomized crossover design was utilized including one session involving water walking and the other session involving land walking, with a 1- to 3-day washout period. Orthostatic hemodynamic measurements were obtained before, immediately after, and 2 hr after a 15-min walking session. Two subgroups were formed for analysis: participants with OH (n = 14, 81 ± 7 years) and participants without OH (n = 11, 84 ± 7 years).
Compared with the land environment, an 86% reduction in the frequency of OH episodes was noted when the older adults were immersed in water. This reduction was accompanied by greater mean arterial pressure, while participants without OH showed no such changes. The frequency of OH episodes was similar when assessed immediately after emerging from the pool following water-based walking or after land-based walking. All participants exhibited elevated mean arterial pressure immediately after water-based walking, but not after land-based walking. Two hours after walking, all participants demonstrated similar mean arterial pressure and frequency of OH episodes, regardless of the environment.
Water immersion resulted in a substantial reduction in the frequency of OH episodes among older adults. Additionally, the frequency of OH episodes was not affected by prior walking exercise in either environment. Significance/Implication: These findings underscore the safety and potential advantages of water-based exercise for older adults dealing with OH.
背景/目的：直立性低血压（OH）在老年人中很常见，会增加跌倒风险。本研究的目的是确定不同环境（水与陆地）对OH的影响以及老年人在这些环境中行走的后续影响。此外，我们旨在评估两组之间的反应差异：患有OH的老年人和未患OH的老年人。
采用随机交叉设计，包括一个水上行走环节和另一个陆地行走环节，洗脱期为1至3天。在15分钟步行环节之前、之后立即以及之后2小时进行直立性血流动力学测量。形成两个亚组进行分析：患有OH的参与者（n = 14，81±7岁）和未患OH的参与者（n = 11，84±7岁）。
与陆地环境相比，老年人浸泡在水中时OH发作频率降低了86%。这种降低伴随着平均动脉压升高，而未患OH的参与者没有出现这种变化。水上行走后从泳池出来后立即评估或陆地行走后，OH发作频率相似。所有参与者在水上行走后立即表现出平均动脉压升高，但在陆地行走后没有。步行2小时后，无论环境如何，所有参与者的平均动脉压和OH发作频率都相似。
水浸使老年人OH发作频率大幅降低。此外，OH发作频率在两种环境中均不受先前步行运动的影响。意义/启示：这些发现强调了水上运动对患有OH的老年人的安全性和潜在益处。
