Original Research

The effects of warm water immersion on blood pressure, heart rate and heart rate variability in people with chronic fatigue syndrome

Romy Parker, Zeenath Higgins, Zandiswa N.P. Mlombile, Michaela J. Mohr, Tarryn L. Wagner
South African Journal of Physiotherapy | Vol 74, No 1 | a442 | DOI: https://doi.org/10.4102/sajp.v74i1.442 | © 2018 Romy Parker, Zeenath Higgins, Zandiswa N.P. Mlombile, Michaela J. Mohr, Tarryn L. Wagner | This work is licensed under CC Attribution 4.0
Submitted: 08 December 2017 | Published: 28 August 2018

About the author(s)

Romy Parker, Department of Anaesthesia and Perioperative Medicine, University of Cape Town, South Africa; and, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
Zeenath Higgins, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
Zandiswa N.P. Mlombile, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
Michaela J. Mohr, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
Tarryn L. Wagner, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa


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Abstract

Background: Chronic fatigue syndrome (CFS) is a central sensitisation syndrome with abnormalities in autonomic regulation of blood pressure (BP), heart rate (HR) and heart rate variability (HRV). Prior to exploring the effects of hydrotherapy as a treatment for this population, changes in BP, HR and HRV during warm water immersion need to be established.

Objectives: The study aimed to determine the effects of warm water immersion on BP, HR and HRV in adults with CFS compared to matched-pair healthy adults.

Method: A quasi-experimental, single-blinded study design was used with nine CFS participants and nine matched controls. Participants’ BP, HR and HRV were measured before, after 5 minutes and post warm water immersion at the depth of the fourth intercostal space, using the Ithlete® System and Dräger BP monitor.

Results: There was a significant difference between groups in HRV prior to immersion (control group: 73 [55–74] vs. chronic fatigue syndrome group: 63 [50–70]; p = 0.04). There was no difference in HRV post-immersion. A significant difference in HR after immersion was recorded with the control group having a lower HR than those with CFS (78 [60–86] vs. 86 [65–112]; p = 0.03). The low HRV present in the CFS group prior to immersion suggests autonomic dysregulation. Individuals with CFS may have reduced vagal nerve activation post-immersion. During immersion, HRV of the CFS participants improved similar to that of the healthy controls.

Conclusion: Prior to immersion, differences were present in the HRV of the participants with CFS compared to healthy controls. These differences were no longer present post-immersion.

Clinical implications: Warm water immersion appears safe and may be beneficial in the management of individuals with CFS.


Keywords

Chronic Fatigue Syndrome; Autonomic Nervous System; immersion; Heart Rate Variability; blood pressure

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