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PubMed2000

Drowning awareness. Prevention and treatment.

BACKGROUND: Drowning is a common, preventable problem, especially in childhood where it is the second most common cause of death by accident in Australia, with 0-4 year olds comprising 22% of all drownings. Commonest sites for drowning are nontidal lakes and lagoons; private swimming pools (especially preschool children); ocean/estuary and surfing beaches; bathtub and bucket drownings (especially in infants and toddlers with up to 10% of bucket drownings due to child abuse). OBJECTIVE: This article reviews the current information on the epidemiology, prevention and treatment of drowning. DISCUSSION: Despite prevention strategies, including pool fencing, drowning rates in young children have remained relatively static. In older children, drowning rates have declined dramatically despite the lack of prevention. The indigenous population have a much higher rate of drowning than the overall figure and their toddler rate is very high. Approximately 69% of near drowning victims will have complete neurological recovery, 28% will suffer some selective deficit, and 3% survive in a permanent vegetative state. Alcohol has been strongly implicated in drowning and banning alcohol from adjacent swimming areas has reduced drowning rates. Overseas tourists were 4.7% of all nonboating drownings in Australia with 89% of these drowning in the ocean. Further funding for drowning prevention strategies are essential, yet noticeably lacking.

Adolescent↗
PubMed1986

Plasma renin activity, aldosterone and catecholamine levels when swimming and running.

The purpose of this study was to determine the response of plasma renin activity (PRA), plasma aldosterone concentration (PAC) and catecholamines to two graded exercises differing by posture. Seven male subjects (19-25 years) performed successively a running rest on a treadmill and a swimming test in a 50-m swimming pool. Each exercise was increased in severity in 5-min steps with intervals of 1 min. Oxygen consumption, heart rate and blood lactate, measured every 5 min, showed a similar progression in energy expenditure until exhaustion, but there was a shorter time to exhaustion in the last step of the running test. PRA, PAC and catecholamines were increased after both types of exercise. The PRA increase was higher after the running test (20.9 ng AngI X ml-1 X h-1) than after swimming (8.66 ng AngI X ml-1 X h-1). The PAC increase was slightly greater after running (123 pg X ml-1) than swimming (102 pg X ml-1), buth the difference was not significant. Plasma catecholamine was higher after the swimming test. These results suggest that the volume shift induced by the supine position and water pressure during swimming decreased the PRA response. The association after swimming compared to running of a decreased PRA and an enhanced catecholamine response rule out a strict dependence of renin release under the effect of plasma catecholamines and is evidence of the major role of neural pathways for renin secretion during physical exercise.

Adult↗
PubMed2004

Community rehabilitation for older adults with osteoarthritis of the lower limb: a controlled clinical trial.

OBJECTIVE: To examine the effectiveness of a 12-month community-based water exercise programme on measures of self-reported health and physical function in people aged over 60 years old with knee-hip osteoarthritis (OA). DESIGN: A quasi-experimental design consisting of an exercise group and an age-matched control group. SETTING: Public community swimming pool in Sheffield, UK. SUBJECTS: One hundred and six community-dwelling sedentary older people, with confirmed knee-hip osteoarthritis, enrolled in an experimental controlled trial for 12 months. Sixty-six subjects in the exercise group were offered a water-exercise programme. Forty age-matched, nonexercising, 'control' subjects received monthly education material and quarterly telephone calls. INTERVENTIONS: Participants in the exercise group were asked to attend two exercise sessions a week of 1 hour duration led by specially trained swimming instructors. MAIN MEASURES: Primary outcome measure was the disease-specific Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Secondary outcomes included a battery of performance-based physical function tests. RESULTS: Adherence to exercise averaged 70% (+/- 14%) over the year: 77% of the exercising subjects and 89% control subjects completed both pre- and post-outcome measures. After one year, participants in the exercise group experienced a significant improvement in physical function (4.0 +/- 9.1 versus -0.4 +/- 7.3 units; 95% confidence interval (CI) 0.96-7.96, p < 0.05) and reduction in the perception of pain (1.3 +/- 3.7 versus 0.2 +/- 2.5 units; 95% CI -0.19-2.52, p < 0.05) compared with the control group, as measured by the WOMAC Osteoarthritis Index. In addition, the exercise group performed significantly better in the ascending and descending stairs tests (p < 0.05), had significantly greater improvements in knee range of movement (p < 0.01) and hip range of movements (p < 0.005). There were no significant differences in the two groups for quadriceps muscle strength and psychosocial well-being (Arthritis Impact Measurement Scales 2 questionnaire). CONCLUSIONS: Older people with knee/hip osteoarthritis gained modest improvements in measures of physical function, pain, general mobility and flexibility after participating in 12 months of community-based water exercise.

Aged↗
PubMedDate not supplied

Conditioned ethanol aversion in rats induced by voluntary wheel running, forced swimming, and electric shock: an implication for aversion therapy of alcoholism.

This study was planned to demonstrate rats' acquisition of aversion to ethanol solution consumed before voluntary running, forced swimming, or electric shock delivery. Wistar rats under water deprivation were allotted to four groups of eight rats each, and all rats were allowed to drink 5% ethanol solution for 15 min. Immediately after the ethanol drinking, rats of Group Run were put into the individual running wheels for 15 min, those of Group Swim were put into the individual swimming pools for 15 min, those of Group Shock received electric shocks for 15 min (15 0.45-mA shocks of 0.7s with the intershock interval of 1 min) in the individual small chambers, and those of Group Control were directly returned back to the home cages. This procedure was repeated for six days, followed by a two-day choice test of ethanol aversion where a bottle containing 5% ethanol solution and a bottle of tap water were simultaneously presented for 15 min. In the test, Groups Run, Swim, and Shock drank ethanol solution significantly less than tapwater, while Group Control drank both fluids equally. The effects of running, swimming, and shock were equivalent. The successful demonstration of acquired ethanol aversion induced by exercise (running and swimming) or shock in rats suggests an avenue for clinical application of exercise and shock treatments for human alcoholics, though there are many issues to be resolved before the practical use.

Alcohol Drinking↗
PubMed2004

Differences in stroke phases, arm-leg coordination and velocity fluctuation due to event, gender and performance level in breaststroke.

The purpose of this study was to analyse stroke phases, arm-leg coordination and trunk motion fluctuation during breaststroke in elite male and female 50, 100 and 200 m events at the 9th FINA World Swimming Championships, Fukuoka 2001. Four phases of the arm stroke and three phases of the leg kick as well as phases of simultaneous arm and leg propulsion and recovery were identified from video of swimmers' motions below the surface. The duration of each phase was expressed as a proportion of the whole stroke cycle. Three measures of the arm-leg coordination, percent simultaneous arm-leg recovery time (%SRT), percent arm lag time (%ALT) and percent simultaneous arm-leg propulsion time (%SPT) were calculated. Mean mid-pool swimming hip velocity (V), stroke rate (SR) and stroke length (SL) were also calculated. In addition, the intra-cycle hip velocity of the swimmers was obtained by cinematographic analysis. The SR decreased and SL increased significantly as the event distance increased. For the arm-leg coordination the %ALT, %SPT and %SRT indicated significant differences between event, gender and performance level. In particular, for increasing event distance and for the higher performing swimmer the lower the %SPT and the higher the %SRT. In addition, the range of the intra-cycle hip velocity fluctuation in the lower performing group was greater than the higher performing group. The non-propulsive phase seems to be a key factor for better performance. The breaststroke swimmers must avoid rapid deceleration during the non-propulsive phase by adopting a low resistance posture and stroking technique.

Arm↗
PubMed2006

Critical velocity and lactate threshold in young swimmers.

The purpose of the present study was to compare the critical swimming velocity (CV) in children, with the lactate threshold (LT) and the velocity corresponding to a blood lactate concentration of 4 mmol x l(-1) (V4). Twenty swimmers (ten females and ten males, mean +/- SD age: 12.9 +/- 1.1 years, body weight: 51.2 +/- 10.0 kg, height: 157.1 +/- 9.7 cm) performed four repetitions of 200 m swimming with increasing intensity (80, 85, 90 and 100% of their 200 m maximum velocity), interspersed with 15 minutes of passive rest. Blood lactate concentration was determined after each repetition. From the speed-lactate curve, the velocity corresponding to LT and V4 was calculated. In order to calculate CV, all swimmers were timed exerting maximum effort, on distances of 50, 100, 200 and 400 m. CV was expressed as the slope of the linear relationship of time versus distance and was calculated from combinations of four (CV4) three or two timed distances. Velocity on LT (1.079 +/- 0.114 m x s(-1)) and V4 (1.106 +/- 0.112 m x s(-1)) was comparable to CV4 (1.085 +/- 0.121 m x s(-1)). CV calculated from a combination including distances of 50, 100 or 200 m were higher compared to LT (p < 0.05). V4 was higher compared to CV of 100-200-400, CV of 200-400, CV of 100-400 (p < 0.05). The CV calculated from distances of 50 and 100 m was significantly higher than all other velocities (p < 0.05). These results confirm that the critical velocity seems to be a valid, practical and time-saving, non-invasive alternative method which can be applied in the swimming pool by a coach for the evaluation of the endurance capacity of young swimmers. For practical reasons, combinations of less than four distances can be used (i.e. 50-400 m, or 50-100-400 m).

Adolescent↗
PubMed1983

Stroke due to fibromuscular hyperplasia of the internal carotid artery.

An 11-year-old girl developed an ischemic stroke syndrome a few minutes after she had been swimming in a swimming pool. The motor deficit of the extremities reversed within 24 hours. The patient was discharged on the 6th hospital week with a completely recuperated neurological function. The left internal carotid arteriogram showed typical "string of beads" appearance of segmental fibromuscular hyperplasia.

Carotid Arteries↗
PubMed1985

Swimming and loss of consciousness.

Under certain circumstances, even a good swimmer may drown during swimming exercise. Two cases of drowning, a survivor and a dead, during swimming exercise in swimming-pool are described. These cases and experimental researches with dogs indicate that the initial aspiration of water may cause extremely low heart rate and low blood pressure by reflex vagal inhibition, which deprive a good swimmer of his consciousness and make him drown.

Apnea↗
PubMed1978

Drowning risks to epileptic children: a study from Hawaii.

The role of epileptiform seizures in causing drowning and near-drowning among children was studied by examining the case reports of all 140 childhood immersion accidents that occurred in an area of Hawaii over five years. Four of the 140 immersion accidents were caused partly by epileptiform seizures, but none were fatal. The combined results of the Hawaiian and Brisbane studies (total population studied over five years 1 600 000) showed that no epileptic children died from accidents in the sea or in swimming pools; and the 2.9% incidence of immersion accidents due to seizures in the Hawaiian study compares well with the incidence found in other series. If an epileptic child is mentally normal, well controlled with anticonvulsants, and supervised in the water then the risk of drowning is very small.

Adolescent↗
PubMed1991

Individualized aerobic and high intensity training for asthmatic children in an exercise readaptation program. Is training always helpful for better adaptation to exercise?

In order to define the role of individualized training intensity in a conditioning program for asthmatic children, we have trained seven asthmatics (age = 11.4 +/- 1.8 years) at their ventilatory threshold (VTh) intensity level for a three-month period (aerobic training) and at maximal intensity also for three months (high intensity training). VTh is the point at which a nonlinear increase of VE occurs. Another group of seven asthmatics (age = 11.4 +/- 1.5) served as control subjects. Cardiopulmonary fitness was determined on a cycle ergometer before and after each training session. This study demonstrated that aerobic training, correctly adapted to the child's physical ability, induces the following: (1) a rapid and marked cardiovascular fitness increase; and (2) a decrease in VE over a given work range so that VTh is increased. This is of great importance because hyperventilation is a major determinant of exercise-induced bronchospasm. In contrast, even if high intensity training is well tolerated in an indoor swimming pool, the long-term effects are unsuitable for asthmatic children because the decrease of VTh will involve an increase of hyperventilation, even when exercise is performed at submaximal intensity.

Adaptation, Physiological↗
PubMed1985

A deficit in ambient visual guidance following superior colliculus lesions in rats.

Rats were tested for their ability to locate a hidden platform in the Morris swimming pool in which extrapool cues are required to guide locomotion. At the end of each trial, the rats were either removed immediately or allowed to remain on the platform for 60 s. Bilateral lesions of the superior colliculus (SC), as in a previous experiment (Milner & Lines, 1983), were found to produce a severe deficit. Permitting the rats to stay on the platform did not significantly affect performance in either rats with SC lesions or sham-operated controls. The results indicated that the reduced orienting behavior on the platform observed in the rats with lesions in the previous experiment was not the cause of their navigational impairment. It is concluded that the impairment following SC lesions comes about during the swimming itself and therefore that it may be attributed to a disturbance of, or a failure to utilize, ambient vision.

Animals↗
PubMed2006

Beliefs and practices to prevent drowning among Vietnamese-American adolescents and parents.

OBJECTIVE: To determine the beliefs, attitudes and practices regarding water safety among Vietnamese-Americans through focus group interviews. PARTICIPANTS: 15 teenagers (aged 15-19 years) and 20 parents participated, and reported similar attitudes, beliefs and practices regarding water activities. Participants identified a lack of familiarity with water activities and few swimming skills, noting that these activities are not perceived as recreational sports among the Vietnamese. They reported recreating at open water sites because they are free and available, and attributed drowning to fate. Vietnamese youth swim unsupervised, responding to peer pressure despite lack of skills. Participants had negative attitudes toward life jackets using, swimming pools and lessons, because of the costs, but would attend lessons in Vietnamese. They identified schools and Vietnamese media as means of delivering injury-prevention messages. CONCLUSIONS: Decreasing drowning among Vietnamese-Americans requires changing the knowledge, attitudes and safety practices with programs and messages in Vietnamese, as well as targeting the dominant culture.

Adolescent↗
PubMed1990

[Water chutes and traumatic tetraplegia].

Diving into shallow water is unfortunately a well known cause to spinal cord injury (SCI). This case history describes how a 23 year old man, who slid head first into a swimming pool with insufficient depth of water contracted cervical fractures and SCI with complete loss of motor function caudal to the C7 segment. Because this seems to represent a new cause of SCI, we advise the authorities to reassess the security regarding chute construction and the necessary water depth. Furthermore, warning signs and lifeguard supervision to prevent people from sliding head first when the water depth is insufficient should be mandatory.

Adult↗
PubMedDate not supplied

Waterborne transmission of Cryptosporidium, Cyclospora and Giardia.

Waterborne transmission of Cryptosporidium, Cyclospora, and Giardia has been associated with numerous recent outbreaks of diarrheal disease. Epidemiologic evidence shows that many community-acquired infections originate from public water sources. Drinking water, even when chlorinated and filtered, has been implicated in several outbreaks. Cryptosporidium and Cyclospora are resistant to chlorine. Giardia cysts are not killed immediately by chlorine and are less susceptible than most other organisms. Swimming pools and other recreational waters have also been implicated as transmission sources. All 3 organisms pose a challenge to the water industry, as they are difficult to detect in water when small numbers of cysts or oocysts are present. Small numbers of these organisms can cause disease; therefore, the clinical laboratory must be vigilant in screening, identifying, and reporting outbreaks of illness due to these protozoa.

Animals↗
PubMed1986

Measurement of active drag during crawl arm stroke swimming.

In order to measure active drag during front crawl swimming a system has been designed, built and tested. A tube (23 m long) with grips is fixed under the water surface and the swimmer crawls on this. At one end of the tube, a force transducer is attached to the wall of the swimming pool. It measures the momentary effective propulsive forces of the hands. During the measurements the subjects' legs are fixed together and supported by a buoy. After filtering and digitizing the electrical force signal, the mean propulsive force over one lane at constant speeds (ranging from about 1 to 2 m s-1) was calculated. The regression equation of the force on the speed turned out to be almost quadratic. At a mean speed of 1.55 m s-1 the mean force was 66.3 N. The accuracy of this force measured on one subject at different days was 4.1 N. The observed force, which is equal to the mean drag force, fits remarkably well with passive drag force values as well as with values calculated for propulsive forces during actual swimming reported in the literature. The use of the system does not interfere to any large extent with normal front crawl swimming; this conclusion is based on results of observations of film by skilled swim coaches. It was concluded that the system provides a good method of studying active drag and its relation to anthropometric variables and swimming technique.

Biomechanical Phenomena↗
PubMed2002

Assessing the exposure of pregnant women to drinking water disinfection byproducts.

BACKGROUND: To evaluate associations between exposure to disinfection byproducts in drinking water and adverse birth outcomes, personal exposure to disinfection byproducts must take into consideration multiple routes of exposure. METHODS: We assessed the reproducibility and validity of a questionnaire measuring water consumption, showering and bathing habits, use of chlorine-based products, and swimming pool attendance in 237 pregnant Italian women enrolled between June and December 1999. The questionnaire was completed during the last trimester of pregnancy (preQ) and again a few days after delivery (postQ). Data from postQ were compared with a 7-day diary completed during the last trimester. RESULTS: According to postQ, total water intake was 2.6 liters per day, whereas tap water intake was 0.6 liters per day. Intraclass correlation coefficients of postQ compared with preQ were 0.85 for tap water daily intake and 0.77 for duration of showering and bathing. Pearson's correlation coefficients were 0.84 for tap water daily intake, 0.81 for frequency of showering, and 0.94 for bathing. The kappa statistics were 0.76 (95% confidence limits = 0.68, 0.85) for use of domestic chlorine-based products and 0.82 (0.70, 0.94) for indoor swimming. Pearson's coefficients for postQ compared with the diary were 0.78 for tap water daily intake, 0.62 for frequency of showering, and 0.64 for bathing. Compared with the diary, the sensitivity and specificity of postQ in assessing indoor swimming were 75% and 90%, respectively. CONCLUSIONS: The questionnaire appears to be a valid and reliable method for assessing exposure to disinfection byproducts in the last trimester of pregnancy.

Adolescent↗
PubMed1975

Death by drowning? Geelong 1959 to 1974.

This paper reviews the circumstances of 142 deaths by drowning which occurred in Geelong and district during the years 1959 to 1974. The effectiveness of safety nets and protective fences as a means of preventing the accidental submersion of young children in home swimming pools is questioned. Consumption of alcohol before submersion played a major role in the death of many adult males. Of males aged 26 years and over, 79% imbibed alcohol before death, and 57% had a blood alcohol concentration greater than 0.1% at autopsy. Of males aged 17 to 25 years of age, 25% imbibed alcohol before death and only half of these had a blood alcohol concentration greater than 0.1% at autopsy. The age preponderance for consumption of alcohol and drowning is opposite to that for fatal motor vehicular accidents (in these males aged 17 to 25 years more frequently have significant blood alcohol concentrations at autopsy than males aged 26 years and over). No female consumed alcohol before submersion. The writer suggests that the public, and in particular males aged 26 years and over, should be warned as forcibly against the dangers of "swimming and drinking" and "boating and drinking" as they are against the dangers of "driving and drinking".

Accidents↗
PubMed2006

Physical training decreases susceptibility to subsequent pilocarpine-induced seizures in the rat.

Regular motor activity has many benefits for mental and physical condition but its implications for epilepsy are still controversial. In order to elucidate this problem, we have studied the effect of long-term physical activity on susceptibility to subsequent seizures. Male Wistar rats were subjected to repeated training sessions in a treadmill and swimming pool. Thereafter, seizures were induced by pilocarpine injections in trained and non-trained control groups. During the acute period of status epilepticus, we measured: (1) the latency of the first motor sign, (2) the intensity of seizures, (3) the time when it occurred within the 6-h observation period, and (4) the time when the acute period ended. All these behavioral parameters showed statistically significant changes suggesting that regular physical exercises decrease susceptibility to subsequently induced seizures and ameliorate the course of experimentally induced status epilepticus.

Animals↗