And sticking with it to reap the benefits
HSP community member Lauren writes:
I’m now 61 years old, with SPG4 HSP, use two trekking poles outside the house and a single cane (or furniture surfing) inside. Before the pandemic, for years I was often in the gym, doing weight work and stretching, as instructed by my physio. However, for the past two years with the pandemic, I stopped the gym, but I realized I needed to find some sort of cardio workout for good heart health. I found that in water exercise, I just wish someone had convinced me to do it 10 years ago! I think it’s a great workout.
I’d heard others talk about pool work and I thought they meant swimming. In googling around for HSP articles I learned that a group of German HSPers began doing pool work. I found this (translated), “Experience aqua fitness with lots of fun and music – gymnastics at a depth of 1.34 m and 28.5°C warm water of our indoor pool. Our aqua course is taught by qualified trainers”. They plan to create a video when they’ve learned more.
My local library had one book about water workouts (Water Exercise by Melissa Layne) and from it I learned this:
- Hydrostatic pressure facilitates the efficiency of the cardiovascular system. With constriction of blood vessels, the heart is pumping through a smaller area so does not need to pump as often and the heart rate decreases.
- Water provides resistance in every direction, so you work opposing muscle groups at the same time. This resistance is referred to as ‘drag’. Your body must exert muscular force that is 12-15 times greater than the force needed when moving through air, thus developing muscular fitness. Water also provides a stabilizing effect, meaning you don’t fall down.
- Warmer water decreases muscles spasticity.
- Ideal water depth is mid-chest deep. At this depth you can plant your feet flat on the pool bottom.
- Water exercise improves all facets of heart health.
I found a heated indoor pool nearby with various classes, went to check it out, feel the water temp and caught a class in session. I decided to give it a try. It was hard for me! The instructor led the session from the pool’s edge. We did all this hard stuff and then the instructor said, “okay, that’s the 10 minute warm up, now we’ll begin”. I won’t tell you what I said to the woman next to me but she said, “it’s okay, we all just do what we can”. The instructor suggested I shift to a less challenging class and that was clearly a better option for me. That was in April this year and I’ve been doing aqua workouts ever since.
In the pool classes everyone wears water shoes (also called aqua shoes or reef walkers) as it’s important to have some grip on the pool bottom. I decided early on to also buy long water pants to keep the leg muscles warm and reduce spasticity. I also wear a long-sleeved pool top over my bathing suit, again to stay warmer. People in the classes who need them wear glasses or hearing aids. In typical hour-long aquatic classes, we walk, march, bicycle motion, walk backwards and do those movements with variations but we are all generally upright for the entire session. Some of these movements were very difficult with my lack of lower body strength and poor balance. When I was new to aqua workouts, I had a private session with the instructor. She clearly saw my poor balance and recommended I use the light weight pool barbells for balance. They are enormously helpful for maintaining stability.
I am now to almost 50 pool sessions and really enjoy them! I have built muscles and increased strength, including hip muscles. My legs are different – in a good way. I can tell by the way my shorts, underwear and pants fit. HSP causes weakness below the waist and poor balance for me, so building strength and improving balance is helping. I’m better going up stairs. The regular cardio workouts are good for my heart health and I’ve made some new friends in the pool.
I mentioned balance just above. I did a second private lesson with the instructor. She has a Master’s Degree in Recreational Therapy with a specialty in Aquatics and has been teaching aquatic workouts for over 20 years. I was asking her thoughts on building balance in the pool. She had me put down the pool barbells that I use so often and instead put on aquatic gloves. I can say more about that if anyone gets in the pool and is curious about balance work.
Now sometimes I do solo workouts. Whatever moving around in the water I do, I’m pushing against the water so it’s all good, but my time is valuable too, so I have worked out a routine that I like. I spend 15 minutes warming up by walking and marching forward, sideways and backwards. Then, standing chest deep next to the pool wall, I do some of the HSP exercises I found online here: https://treathsp.net/klinik/physiotherapie/uebungen. This is in German but the videos are self-explanatory. Although these are in a gym setting, in the pool I get the extra benefits of pushing against water and not falling down! I do about 15 minutes of exercises 2,3,9 and 10. Then 15 minutes doing exercises #1,5 and 6 on the pool steps and finish with about 15 minutes of balance work, walking in the pool wearing the aqua gloves.
I’m really happy to have discovered aquatic exercise.
I asked my instructor what leads to lifting the feet when walking, as I tend to drag my feet and not get enough ground clearance. She said it comes from two things, a backward kick followed by a forward kick. That’s TWO things I have trouble doing and I need to do them both in succession? But I’ve been working on this in the pool. When I’m warming up, I’ll walk this way, lifting my foot behind me (like I want to kick myself in the backside) and then swinging that leg forward… followed by the other leg. My hamstrings are weak but I’m gaining strength by practising walking this way in the pool.
The instructor also suggested spending some time facing a wall and lifting, lifting, lifting my toes while keeping weight on my heels. I find it easier to do this, not by working harder but by relaxing more.
Human Kinetics Publishers
by Melissa Layne
Gait Posture. 2014 Apr;39(4):1074-9. doi: 10.1016/j.gaitpost.2014.01.010. Epub 2014 Jan 29.
The effect of hydrotherapy treatment on gait characteristics of hereditary spastic paraparesis patients
Yanxin Zhang 1 , Richard Roxburgh 2 , Liang Huang 1 , John Parsons 3 , T Claire Davies 4
1 Department of Sport and Exercise Science, University of Auckland, New Zealand.
2 Auckland City Hospital, Private Bag 92-024, Auckland, New Zealand; Centre for Brain Research, University of Auckland, Auckland, New Zealand.
3 School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, New Zealand; Institute of Healthy Ageing, Waikato District Health Board, Hamilton, New Zealand.
4 Department of Mechanical Engineering, University of Auckland, New Zealand.
Full text: https://pubmed.ncbi.nlm.nih.gov/24556467/
Brain&Life, American Academy of Neurology, Oct/Nov 2018
5 Reasons to Try Water Exercise
By Lori J. Batcheller
Full text: https://www.brainandlife.org/articles/5-reasons-to-try-water-exercise
Lauren, HSP community member.