The impact of swimming training on physiological and psychological indicators in individuals of different age groups: a cross-sectional study

Swimming training is a kind of aquatic exercise that has been shown to be beneficial to physical fitness at any age. This study aimed to determine how mental and physical aspects of swimming affect aerobic and anaerobic capacity describes the physiologicaland psychological effects of swimming training at different ages. This studyexamines how swimming impacts youthful and elderly cardio-respiratory fitness, muscular strength, flexibility, and body composition. A correlation and stepwise regression analysis was performed on the information gathered from a RESTQ-76 sport questionnaire, aHeart Rate Variability (HRV) test, and the efforts of swimmers to improve their aerobic and anaerobic swimming performance. We also investigate the benefits that swimming has on lowering stress, boosting self-esteem, and improving mental health for people of varying ages. We useSPSS version 17.0 was used for the statistical analysis. An examination of the relevant research reveals that swimmers of all ages enjoy significant advantages as a result of their training, including enhancements to their physical and mental health. In that case, they can be able to tailor swimming programs to match the changing physiological and psychological needs of their swimmers. Findings from this study add to a growing body of evidence that open-water swimming is perceived to have positive effects on participants' mental and physical health regardless of age and can be used to inform co-created policy formation to advance outdoor recreation possibilities that are safer, healthier, and more sustainable about this expanding outside activity (AU)

OUTdoor Swimming as a nature-based Intervention for DEpression (OUTSIDE): study protocol for a feasibility randomised control trial comparing an outdoor swimming intervention to usual care for adults experiencing mild to moderate symptoms of depression.

BACKGROUND: Depression is common and the prevalence increasing worldwide; at least 1 in 10 people will experience depression in their lifetime. It is associated with economic costs at the individual, healthcare and societal level. Recommended treatments include medication and psychological therapies. However, given the long waiting times, and sometimes poor concordance and engagement with these treatments, a greater range of approaches are needed. Evidence for the potential of outdoor swimming as an intervention to support recovery from depression is emerging, but randomised controlled trials (RCTs) evaluating clinical and cost-effectiveness are lacking. This study seeks to investigate the feasibility of conducting a definitive superiority RCT, comparing an 8-session outdoor swimming course offered in addition to usual care compared to usual care only, in adults who are experiencing mild to moderate symptoms of depression. Feasibility questions will examine recruitment and retention rates, acceptability of randomisation and measures, and identify the primary outcome measure that will inform the sample size calculation for a definitive full-scale RCT. This study will also explore potential facilitators and barriers of participation through evaluation questionnaires, focus-group discussions and interviews. METHODS/DESIGN: To address these aims and objectives, a feasibility superiority RCT with 1:1 allocation will be undertaken. We will recruit 88 participants with mild to moderate symptoms of depression through social prescribing organisations and social media in three sites in England. Participants will be randomised to either (1) intervention (8-session outdoor swimming course) plus usual care or (2) usual care only. Both groups will be followed up for a further 8 weeks. DISCUSSION: If findings from this feasibility RCT are favourable, a fully powered RCT will be conducted to investigate the clinical- and cost-effectiveness of the intervention. Findings from the definitive trial will provide evidence about outdoor swimming for depression for policymakers and has the potential to lead to greater choice of interventions for adults experiencing symptoms of depression. TRIAL REGISTRATION: Current controlled trial registration number is ISRCTN 90851983 registered on 19 May 2022.

Case report: Open water swimming as a possible treatment for asthma.

Asthma is a complex medical problem for which currently available treatment can be incompletely effective. This case report describes a 49 year old woman who had suffered from asthma since her teenage years that resolved after she took up regular open water swimming. After sharing this case report with an international open water swimming community on social media, over one hundred people with asthma commented that their symptoms had also improved after taking up this activity. The mechanism whereby open water swimming might alleviate asthma has not been established. Possibilities include benefits to mental health, anti-inflammatory effects, being more fit, improved immune function and suppression of the bronchoconstrictive component of the diving reflex. Further research might usefully confirm or refute these clinical observations.

Analysis of the Consumption of Sports Supplements in Open Water Swimmers According to the Competitive Level.

BACKGROUND: Sports supplements (SS) are widely consumed by many types of athletes to improve their performance. These SS are classified according to their level of scientific evidence, by the ABCD system from the Australian Institute of Sport (AIS). In open water swimming, their use may be necessary due to the physiological challenges posed by this sport discipline. However, there is currently little literature on the use of SS in open water swimmers. The aim of this work is to analyze the pattern of consumption of SS by open water swimmers, by studying the differences according to the competitive level (regional vs. national). METHODS: Descriptive and cross-sectional study on the consumption and use of SS by federated open water swimmers in Spain in the 2019/2020 and 2020/2021 seasons. The data were collected through a validated questionnaire. RESULTS: 79.5% of the participants consumed SS, with significant differences according to their level, being higher in athletes at the national level. The most-consumed SS by the swimmers studied were sports drinks, energy bars, caffeine, vitamin C, and vitamin D. CONCLUSIONS: It was observed that the consumption of SS in open water swimmers was high, and of the five most-consumed SS, four of them belonged to the category of greatest scientific evidence.

Nutritional support for a person with type 1 diabetes undertaking endurance swimming.

Long distance and open water swimming have increased in popularity over recent years. Swimming a long distance in lakes, rivers and the sea present numerous challenges, including cold water exposure and maintaining adequate nutritional intake to fuel exercising muscles. Guidelines exist outlining issues to consider and potential solutions to overcome the difficulties in feeding athletes. Exercising with type 1 diabetes adds further complexity, mostly around matching insulin to the recommended high carbohydrate intake, but also because of the way in which higher circulating insulin levels affect glucose utilisation and fat oxidation. This paper describes the nutritional considerations for people with type 1 diabetes intending to undertake long distance open water events, and insulin management suggestions to trial alongside. In addition, we include personal testimony from a swimmer with type 1 diabetes describing the challenges and considerations he faced when undertaking marathon swimming.

Perceived Impact of Outdoor Swimming on Health: Web-Based Survey.

BACKGROUND: Outdoor swimming in lakes, lidos (outdoor pools), rivers, and the sea has grown in popularity in many countries, including the United Kingdom. Many anecdotal accounts indicate improvements in medical conditions, which are considered a consequence of outdoor swimming. OBJECTIVE: The aim of this study is to better understand outdoor swimmers' perceptions of their health and the extent to which participation impacted their existing self-reported symptoms. METHODS: A survey was conducted to investigate outdoor swimming behaviors and reports of any diagnosed medical conditions. Medical conditions were coded into categories, and descriptive statistics were generated regarding the outdoor swimmers' behaviors and the effect that outdoor swimming had on their medical symptoms if any. The medical categories were clustered into five larger categories based on their prevalence in the current sample: mental health; musculoskeletal and injury; neurological; cardiovascular and blood disease; and other, which comprises inflammatory, immune, endocrine, and respiratory conditions. RESULTS: In total, 722 outdoor swimmers responded, of whom 498 (68.9%) were female. The probability of outdoor swimming having some positive impact on health across all medical categories was 3.57 times higher compared with no impact (B=1.28, 95% CI 0.63-1.91; P<.001), 44.32 times higher for the mental health category (B=3.79, 95% CI 2.28-5.30; P<.001), 5.25 times higher for musculoskeletal and injury category (B=1.66, 95% CI 0.52-2.79; P=.004), and 4.02 times higher for the other category (B=1.39, 95% CI 0.27-2.51; P=.02). Overall, outdoor swimming was associated with perceived reductions in symptoms of poor mental health (χ22=25.1; P<.001), musculoskeletal and injury (χ22=8.2; P=.04), cardiovascular and blood (χ22=14.7; P=.006), and other conditions (χ22=18.2; P<.001). CONCLUSIONS: Physical activity in the form of outdoor swimming is perceived to have positive impacts on health and is associated with perceived symptom reductions in mental health, musculoskeletal and injury, and cardiovascular and blood conditions. This study cannot provide causal relationships or provide mechanistic insights. However, it does provide a starting point for more targeted prospective intervention research into individual conditions or categories of conditions to establish the impact in those who choose to start outdoor swimming.

Dizzy triathlete-evidence supporting vestibular etiology.

Dizziness during or after the swimming leg is a common complaint among triathletes. We hypothesized that the dizziness is caused by asymmetrical cooling of the vestibular organ. This caloric response is characterized by involuntary eye movements called nystagmus. Altogether, 125 triathletes completed an electronic questionnaire. Fifteen triathletes who had frequently experienced dizziness during the swimming leg agreed to take part in a cold water swimming test. The test comprised two cold water swimming legs, first without earplugs and then with earplugs to prevent a potential caloric response. Eye movements and possible nystagmus were recorded immediately after the swimming legs. A majority (87%, 109/125) of athletes had experienced dizziness during triathlon races or training. Of these, almost all (97%, 106/109) experienced it during or after swimming. Dizziness affected the triathlon performance in half of the athletes with dizziness (50%, 51/102). Fifteen athletes participated in a cold water swimming test. During the first leg (without earplugs), 11/15 athletes (73%) experienced dizziness. Of these, six had nystagmus (55%), four had uncertain nystagmus (36%), and one did not have nystagmus (9%). Only one of these athletes experienced dizziness during the second leg with earplugs. The prevalence of dizziness among triathletes is notable. A large part of the dizziness is likely to be caused by caloric reaction of the vestibular organ. We recommend earplug usage for triathletes suffering from dizziness during the swimming leg.

Researching at sea: Exploring the 'swim-along' interview method.

Interest in researching embodied experiences of activity connected to therapeutic landscapes, spaces or places has led to a range of evolving methods that aim to move beyond traditional sit-down, talk-based qualitative modes of researching. Following the sensory turn, this paper explores a novel 'swim-along' method used to interview people whilst swimming immersed in sea water. By juxtaposing this with insights gleaned from a subsequent sit-down interview, the paper examines implications for deepening our understanding of visceral, sensory, embodied experiences, the methods we can use to access them and how these structure researcher/participant interaction.

Evaluation of the Heart Function of Swimmers Subjected to Exhaustive Repetitive Endurance Efforts During a 500-km Relay.

Aim: Knowledge of the human body's ability to adapt to repeated endurance efforts during swimming is limited. We echocardiographically assessed the impact of an exhausting and repetitive swimming effort on cardiac activity. Materials: Fourteen well-trained amateur swimmers (8 female swimmers aged 16-43 years and 6 male swimmers aged 13-67 years old) participated in an ultramarathon relay. Over 5 days, swimmers swam 500 km in the Warta River (in 5-km intervals). Each swimmer swam seven intervals, each within 44:46 to 60:02 min. Objective difficulties included low water temperatures, strong winds, rain, and night conditions. Methods: Transthoracic echocardiography (TTE) was performed three times: at baseline (the day before exertion), at peak effort, and during recovery (48 h after the event). The heart rate (HR) of each swimmer was monitored. Results: Swimmers completed the ultramarathon relay within approximately 91 h. The average HR value at the end of each interval was 91% HRmax. TTE test results showed no significant changes indicative of deterioration of myocardial function at peak effort or after 48 h. Significant increases in left ventricular (LV) ejection fraction, LV fractional shortening (LVFS), LV myocardial systolic velocity, and right ventricular (RV) fractional area changes observed on day 2 after swimming were compared to baseline values and peak effort values. No significant changes in diastolic heart function were observed. Conclusion: Echocardiography assessment indicated that prolonged intense swimming does not affect LV or RV function. Supercompensation of the post-event RV function and increased global LV systolic function demonstrated ventricular interaction after prolonged intense swimming.

Total energy expenditure in elite open-water swimmers.

This study aimed to examine the total energy expenditure (TEE) and physical activity level (PAL) of elite open-water swimmers. Our study group included 5 world-class competitive open-water swimmers. TEE was measured using the doubly labeled water method for 1 week. The TEE was 4549 ± 1185 kcal/day. The PAL was 3.22 ± 0.46. Our results may provide a reference to optimize energy requirement support.

Swimming-induced pulmonary edema: current perspectives.

With the growing popularity of water-based sports, cases of swimming-induced pulmonary edema (SIPE) are becoming increasingly recognized. SIPE, a potentially life-threatening condition, is an acute cause of breathlessness in athletes. It has been described frequently in scuba divers, swimmers, and triathletes and is characterized by symptoms and signs of pulmonary edema following water immersion. It is important to recognize that athletes' symptoms can present with a spectrum of severity from mild breathlessness to severe dyspnea, hemoptysis, and hypoxia. In most cases, there is rapid resolution of symptoms within 48 hours of exiting the water. Recent advances in the understanding of the pathophysiology of SIPE, particularly regarding exaggerated pulmonary vascular pressures, have begun to explain this elusive condition more clearly and to distinguish its predisposing factors. It is essential that event organizers and athletes are aware of SIPE. Prompt recognition is required not only to prevent drowning, but also to implement appropriate medical management and subsequent advice regarding return to swimming and the risk of recurrence. This manuscript provides a current perspective on SIPE regarding the incidence rate, the current understanding of the pathophysiology, clinical presentation, medical management, recurrence rates, and advice on return to sport.

Anthropometric Profiles of Elite Open-Water Swimmers.

Reports detailing the physiques of open-water (OW) swimmers are limited. Data from anthropometric screening around competition provides a unique opportunity to describe the current physical attributes of elite OW swimmers peaking for international competition. Anthropometric screening was undertaken on a group of Australian and French OW swimmers as part of performance monitoring within 2 wk of the 2015 FINA World Championships. Height, mass, and sum of 7 skinfolds were measured using ISAK standardized measurement techniques by 2 trained anthropometrists. Data were collated and compared with previously published data on OW and pool swimmers. French swimmers had lower skinfolds (57.3 ± 6.1 vs 80.5 ± 21.3 mm, P = .0258), were lighter (64.7 ± 10.8 vs 74.6 ± 11.8 kg, P = .013), and had lower lean-mass index (LMI) (34.7 ± 7.3 vs 38.2 ± 8.8, P = .035) than Australian swimmers. Male and female OW swimmers had skinfolds similar to their contemporary OW swimmers but were lower than earlier reports of OW swimmers; however, they were higher than those of pool swimmers. Male and female OW swimmers had 9% and 6% lower LMI, respectively, than pool swimmers. Lower body mass and LMI were correlated with better World Championships finishing positions (R2 = .46, P = .0151, and R2 = .45, P = .0177, respectively). These data are a unique report of elite OW swimmers' physiques around international competition and demonstrate a potential morphological optimization in OW swimmers that warrants further investigation in larger populations.

Swimming Three Ice Miles within Fifteen Hours.

Ice Mile swimming (1608 m in water of below 5 °Celsius) is becoming increasingly popular. This case study aimed to identify body core temperature and selected haematological and biochemical parameters before and after repeated Ice Miles. An experienced ice swimmer completed three consecutive Ice Miles within 15 h. Swim times, body core temperatures, and selected urinary and haematological parameters were recorded. Body core temperature reached its maximum between 5, 8 and 15 min after immersion (37.7°C, 38.1°C, and 38.0°C, respectively). The swimmer suffered hypothermia during the first Ice Mile (35.4°C) and body core temperature dropped furthermore to 34.5°C during recovery after the first Ice Mile. He developed a metabolic acidosis in both the first and the last Ice Mile (pH 7.31 and pH 7.34, respectively). We observed hyperkalaemia ([K⁺] > 5.5 mM) after the second Ice Mile (6.9 mM). This was followed by a drop in [K⁺] to3.7 mM after the third Ice Mile. Anticipatory thermogenesis (i.e. an initial increase of body core temperature after immersion in ice cold water) seems to be a physiological response in a trained athlete. The results suggest that swimming in ice-cold water leads to a metabolic acidosis, which the swimmer compensates with hyperventilation (i.e. leading to respiratory alkalosis). The shift of serum [K⁺] could increase the risk of a cardiac arrhythmia. Further studies addressing the physiology and potential risks of Ice Mile swimming are required to substantiate this finding.

The Body Mass Index of San Francisco Cold-water Swimmers: Comparisons to U.S. National and Local Populations, and Pool Swimmers.

To determine if cold-water swimmers have substantial differences in BMI, which might have a protective effect against heat loss during swims in cold water without wetsuits, and to determine if obesity is more or less prevalent in cold-water swimmers, we compared the body mass index (BMI) values of 103 recreational open-water swimmers (mean age 54.3 ±10.8 years) to data from various population groups. Swimmers swam consistently throughout the winter months, in the San Francisco Bay (water temperature range: 9.6° C [49.3 ° F] to 12.6° C [54.7 ° F]), without wetsuits. After matching for age and sex, the average BMI of cold-water swimmers (25.9 kg/m2) was lower than the corresponding predicted U.S. average BMI (29.2 kg/m2; p<.001), the predicted California state average BMI (28.0 kg/m2; p<.001), and the predicted San Francisco city average BMI (26.6 kg/m2; p=.047). The average BMI value for cold-water swimmers (25.9 kg/m2) was not significantly different from values of North American masters pool swimmers (25.1 kg/m2; p=.15) or international masters pool swimmers (25.3 kg/m2; p=.16). 10.7% of cold-water swimmers were classified as obese (BMI > 30 kg/m2) vs. 35.7%, 25.8%, and 11.8% of the U.S., California, and San Francisco populations, respectively. The lower or similar BMI values of our swimmers suggest that successful recreational swimming in cold water is influenced by factors other than body habitus, such as acclimatization, heat production while swimming, and most importantly, limiting immersion time. The relatively low prevalence of obesity in our swimmers suggests that cold-water swimming could contribute to a healthy lifestyle.

The effect of cold water endurance swimming on core temperature in aspiring English Channel swimmers.

BACKGROUND: The purpose of this study was to determine if cold water swimmers (CWS) developed hypothermia over a 6-h cold water endurance swim and whether body composition, stroke rate (SR) or personal characteristics correlated with core temperature (TC) change. Nine experienced male and female CWS who were aspiring English Channel (EC) swimmers volunteered to participate. Subjects aimed to complete their 6-h EC qualifying swim (water 15-15.8 °C/air 15-25 °C) while researchers intermittently monitored TC and SR. Data obtained included anthropometry (height, mass, segmental body composition), training volume and EC completion. RESULTS: Of the nine swimmers who volunteered, all successfully completed their EC qualifying swim. Six CWS had complete data included in analysis. One CWS demonstrated hypothermia (34.8 °C) at 6-h. TC rate of decline was slower in the first 3 h (-0.06 °C/hr) compared to the last 3 h (-0.36 °C/hr) of the swim. Older age was significantly correlated to TC change (r = -0.901, p < 0.05) and SR change (r = -0.915, p < 0.05). Absolute and percentage body fat (BF) were not significantly associated with higher TC. Mean SR over the 6-h swim was 57.8 spm (range 48-73 spm), and a significant (p < 0.05) decline in SR was observed over the 6 h (-9.7 %). A strong, positive correlation was found between SR change between 3 and 6 h and TC over the 6 h (r = 0.840, p < 0.05) and TC from 3-6 h (r = 0.827, p < 0.05). Seven of the nine participants (77.8 %) in this study successfully completed the EC crossing. Successful EC swimmers swam in the pool and open water (OW); however, they swam significantly [t (7) = -2.433, p < 0.05] more kilometres (M = 19.09 km/wk ± 5.55) in OW than unsuccessful (M = 9 km/wk ± 1.41) EC swimmers. There was a significant relationship between EC crossing time and height (r = -0.817, p < 0.05), but no other variables and EC crossing time. CONCLUSIONS: Cold water endurance swim (CWES) of 6-h duration at 15-16 °C resulted in TC reduction in the majority of swimmers regardless of anthropometry. More research is required to determine why some CWS are able to maintain their TC throughout a CWES. Our results indicate that older swimmers are at greater risk of developing hypothermia, and that SR decline is an indicator of TC decline. Our results also suggest that OW swimming training combined with pool training is important for EC swim success.

Ice swimming and changes in body core temperature: a case study.

INTRODUCTION: 'Ice Mile' swimming is a new discipline in open-water swimming introduced in 2009. This case study investigated changes in body core temperature during preparation for and completion of two official 'Ice Miles', defined as swimming 1.609 km in water of 5°C or colder, in one swimmer. CASE DESCRIPTION: One experienced ice swimmer (56 years old, 110.2 kg body mass, 1.76 m body height, BMI of 35.6 kg/m(2), 44.8% body fat) recorded data including time, distance and body core temperature from 65 training units and two 'Ice Miles'. DISCUSSION AND EVALUATION: During training and the 'Ice Miles', body core temperature was measured using a thermoelectric probe before, during and after swimming. During trainings and the 'Ice Miles', body core temperature increased after start, dropped during swimming but was lowest during recovery. During training, body core temperature at start was the only predictor (ß = -0.233, p = 0.025) for the increase in body core temperature. Water temperature (ß = 0.07, p = 0.006) and body core temperature at start (ß = -0.90, p = 0.006) explained 61% of the variance for the non-significant decrease in body core temperature. Water temperature (ß = 0.077, p = 0.0059) and body core temperature at finish (ß = 0.444, p = 0.02) were the most important predictors for the lowest body core temperature. In 'Ice Miles', body core temperature was highest ~6-18 min after the start (38.3-38.4°C), dropped during swimming by 1.7°C to ~36.5°C and was lowest ~40-56 min after finish. The lowest body core temperature (34.5-35.0°C) was achieved ~100 min after start. CONCLUSIONS: In an experienced ice swimmer with a high BMI (>35 kg/m(2)) and a high percent body fat (~45%), body core temperature decreased by 1.7°C while swimming and by 3.2-3.7°C after the swim to reach the lowest temperature in an official 'Ice Mile'. The swimmer suffered no hypothermia during ice swimming, but body core temperature dropped to <36°C after ice swimming. Future athletes intending to swim an 'Ice Mile' should be aware that a large body fat prevents from suffering hypothermia during ice swimming, but not after ice swimming.

Swimming in warm water is ineffective in heat acclimation and is non-ergogenic for swimmers.

Heat acclimation (HA) in air confers adaptations that improve exercise capabilities in hot and possibly temperate air. Swimmers may benefit from HA, yet immersion may constrain adaptation. Therefore, we examined whether warm-water swimming constitutes effective HA. In a randomized-crossover study, eight male swimmers swam 60 min/day on 7 days in 33 °C (HA) or 28 °C (CON) water. They performed 20-min distance trials before and after each regime: in 33 °C water (Warm); 28 °C water (Temperate); and cycling in 29 °C air (Terrestrial) following standardized exercise. Rectal temperature (Tre ) rose ∼ 1 °C in HA sessions, and sweat loss averaged 1.4 L/h. After accounting for CON, HA did not confer any clear expansion of plasma volume [1.9% (95% CI: 7.7)], reduction in heart rate during standardized cycling exercise [1 b/min (9)], reduction in Tre during rest [+0.1 °C (0.1)] or exercise, or change in sudomotor function. Only perceived temperature and discomfort tended to improve. Performance was clearly not improved for Warm [+0.3% (1.8)] or Temperate [+0.3% (1.9)], was unclear for Terrestrial [+0.4% (17.7)], and was unrelated to changes in resting plasma volume (r < 0.3). In conclusion, short-term HA using swimming in 33 °C water confers little adaptation and is not ergogenic for warm or temperate conditions.

Exercise-associated hyponatremic encephalopathy in an endurance open water swimmer.

Exercise-associated hyponatremia and its more serious form, known as exercise-associated hyponatremic encephalopathy, are recognized as some of the most important medical problems seen in a variety of different forms of endurance exercise. We describe a case of exercise-associated hyponatremic encephalopathy presenting as altered conscious state and seizures in a woman who had completed a 20-km open ocean swim. Her serum sodium measured approximately 1 hour after her seizure was 119 mmol/L on point-of-care testing. With ongoing critical care support and the use of hypertonic saline, she was able to be extubated the next day, neurologically intact, and ultimately was discharged from hospital without neurological sequelae. This case emphasizes both the importance of considering exercise-associated hyponatremic encephalopathy as a cause of neurological impairment in all athletes and the pivotal role of hypertonic saline in the treatment of this condition.

Moving in extreme environments: open water swimming in cold and warm water.

Open water swimming (OWS), either 'wild' such as river swimming or competitive, is a fast growing pastime as well as a part of events such as triathlons. Little evidence is available on which to base high and low water temperature limits. Also, due to factors such as acclimatisation, which disassociates thermal sensation and comfort from thermal state, individuals cannot be left to monitor their own physical condition during swims. Deaths have occurred during OWS; these have been due to not only thermal responses but also cardiac problems. This paper, which is part of a series on 'Moving in Extreme Environments', briefly reviews current understanding in pertinent topics associated with OWS. Guidelines are presented for the organisation of open water events to minimise risk, and it is concluded that more information on the responses to immersion in cold and warm water, the causes of the individual variation in these responses and the precursors to the cardiac events that appear to be the primary cause of death in OWS events will help make this enjoyable sport even safer.