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Abstract Background Breast cancer is a prevalent form of cancer among women worldwide, often accompanied by physical and psychological side effects due to the disease and the treatment’s aggressiveness. Regular physical exercise has emerged as a non-pharmacological approach to improve the quality of life of breast cancer survivors. We herein report the protocol of the WaterMama Study, which aims to evaluate the effects of land- or water-based aerobic exercise programs, compared to a health education program, on cancer-related fatigue and other health-related outcomes in breast cancer survivors. Methods The WaterMama trial is a randomized, single-blinded, three-arm, parallel, superiority trial. We aim to recruit 48 women ≥ 18 years of age who have completed primary treatment for stage I–III breast cancer. Participants are randomly allocated in a 1:1:1 ratio to 12-week interventions of aerobic exercise training programs either in the aquatic or land environment (two weekly 45-min sessions) plus health education (a weekly 45-min session), or an active-control group receiving health education alone (a weekly 45-min session). The primary outcome is cancer-related fatigue, and the secondary outcomes include cardiorespiratory fitness, muscular performance, muscle morphology, functional capacity, mental health, cognitive function, pain, and quality of life. Outcomes assessments are conducted before and after the 12-week intervention period. The analysis plan will employ an intention-to-treat approach and per protocol criteria. Discussion Our conceptual hypothesis is that both aerobic exercise programs will positively impact primary and secondary outcomes compared to the health education group alone. Additionally, due to its multi-component nature, we expect the aquatic exercise program promote more significant effects than the land exercise program on cancer-related fatigue, muscular outcomes, and pain. Trial registration The study was prospectively registered at ClinicalTrials.gov NCT05520515. Registered on August 26, 2022. https://clinicaltrials.gov/ct2/show/NCT05520515

This paper represents Part 1 of a study that explored the effects of an underwater treadmill (UT) walking program on pain and function in adults with knee osteoarthritis (KOA). The Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC), numerical rating scale (NRS), timed up-and-go (TUG), and 10-m walk were assessed in 6 adults (62.7 ±14.2 years) who participated in an 8-week (3x/wk) UT walking intervention based on the Arthritis Foundation's Walk With Ease (WWE) program. Walking pace was self-selected, and walking duration of each session was increased from 10 to 45 minutes throughout the study. Knee pain and function were assessed pre-control (PRC), pre-intervention (PRI) and postintervention (PST). NRS improved from PRC and PRI to PST (p = .03, d = .37). WOMAC subscale scores of pain, (d = .36); stiffness (d = .44); pain during daily activities (d = .41); and total scores (d = .42) improved (p < .05) from PRC to PST. Self-selected walking speed increased concurrently with decreased knee pain (NRS) from PRI to PST. The results support the WWE as a model for an UT walking program for improving knee pain in KOA. [ABSTRACT FROM AUTHOR]

This paper presents Part 2 of a study that investigated the effects of an 8-week (3x/week) underwater treadmill (UT) walking intervention on knee osteoarthritis (KOA) outcomes in 6 adults with KOA (62.7 ± 14.2 years). The Knee Outcome Survey (KOS) for activities of daily living and muscle activity during a 10-m walk and a 20 cm step down were measured before and after the intervention. The following KOS measures improved after the UT walking program (p < 0.05; g > 0.8): stiffness, swelling, weakness, walking, going up stairs, going downstairs, kneeling on the front of the knee, squatting, and sitting with the knee bent. Knee flexion excursion during stance of walking increased after the UT walking intervention (p = .01). Co-activation between the tibialis anterior and medial gastrocnemius decreased during the 20 cm step down (p = .04). The findings of this study support using the WWE as a model for UT walking interventions in KOA. [ABSTRACT FROM AUTHOR]

Objectives This study investigated the impacts of exercise on irisin and fibroblast growth factor 21 (FGF-21) expression, as well as triiodothyronine (T3) and free fatty acid (FFA) levels in elderly women. Methods Thirty women aged 65 to 70 years (10 per group) were randomly assigned to aquatic exercise, land exercise, and control groups. The aquatic and land groups engaged in 3 exercise sessions per week (60 min/session) for 16 weeks. The intensity was progressively increased every 4 weeks. Results Irisin and FGF-21 levels significantly increased in the aquatic exercise group. In the post-test, the aquatic exercise group had the highest irisin levels. Significant findings were observed for irisin and FGF-21 for the main effect between aquatic and band exercise groups (p

Objectives. This study aimed to analyze the effectiveness, benefits and safety of water aerobic exercise in improving the quality of life of pregnant women from a psychological and physical perspective. Materials and methods. The present study is defined as a type of systematic review research using searches from journal databases such as MEDLINE-PubMed, Web of Science, Scopus and Science Direct. The inclusion criteria for this study were articles published in the last 5 years and articles discussing pregnancy, aquatic aerobic exercise and quality of life in pregnancy. A total of 53 articles from the Science Direct, PubMed, and Web of Science databases were identified. A total of 8 articles that met the inclusion criteria were selected and analyzed for this systematic review. For standard operations, this study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) assessment. Results. The findings of this systematic review indicate that participating in aquatic aerobic exercises has been found toreduce pain during labour, reduce the use of epidural analgesics during labour, reduce depression during pregnancy, reduce the risk of fetal distress, stabilize blood pressure, reduce back pain, and improve the psychological condition of pregnant women. Conclusions. The regular practice of water aerobic exercise carried out from the 2nd trimester of pregnancy contributes to having a positive impact on improving the quality of life of pregnant women.

Abstract Background Balance plays a crucial role in the daily activities of older adults. Aquatic-based exercises (AE) are widely conducted as an alternative to land-based exercises (LE). Previous studies have compared AE and LE as effective ways to improve balance and have yielded inconsistent results. Therefore, this review aimed to compare the effects of AE and LE on balance function in older adults. Methods Electronic databases, including PubMed, Web of Science, Scopus, and Embase, were searched. Randomized controlled trials published from January 2003 to June 2023 were included following predetermined criteria. Data extraction was carried out by two independent reviewers. Data synthesis was conducted using RevMan 5.3 software. The fixed-effect model or random-effect model was chosen based on the results of the heterogeneity test. Meta-analysis for the effect sizes of balance outcomes was calculated as standardized mean difference (SMD) with 95% confidence intervals (CI). The quality of the included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. This review was registered at PROSPERO CRD42023429557. Results A total of 29 studies involving 1486 older adults (with an average age of 66.2 years) were included. Meta-analysis results indicated that AE could improve balance ability based on two tests: the Berg balance scale (BBS: SMD = 1.13, 95% CI 0.25 to 2.00, p = 0.01, I2 = 94%) and the 30-s chair stand test (30 CST: SMD = 2.02, 95% CI 0.50 to 3.54, p = 0.009, I2 = 96%). However, there were no significant differences between the AE group and the LE group in terms of the 6-min walking test (6 MWT: SMD = 0.13, 95% CI -0.16 to 0.43, p = 0.38, I2 = 62%) and time up to go test (TUGT: SMD = 0.44, 95% CI -0.44 to 0.91, p = 0.07, I2 = 85%). Older adults with different health conditions have different gains in different balance measurements after AE intervention and LE intervention. Conclusions Although this was influenced by participant health status, transfer effects, sample size, and other factors, AE offers better benefits than LE for improving balance function in older adults.

Background: Primary dysmenorrhea leads to significant gynecological consultations, school absenteeism, disrupted daily activities, and adversely affects overall quality of life (QOL). Purpose: This study compared the effects of aquatic exercise versus aerobic exercise on primary dysmenorrhea and QOL in adolescent females. Subjects and Methods: Sixty adolescent females suffering from primary dysmenorrhea with moderate to severe intensity were distributed randomly and equally into two groups was registered at ClinicalTrials.gov (NCT06129708) the Registration Date, November 13, 2023; group A was treated by aquatic exercise for 12 weeks, while group B was treated by aerobic exercise for 12 weeks. Assessment of both groups before and after treatment involved evaluating dysmenorrhea severity using the WaLIDD Score, measuring pain intensity with the numeric pain rating scale (NPRS), determining pressure pain threshold (PPT) with an algometry, and evaluating the QOL using EuroQol—5 Dimension—3 Level (EQ‐5D‐3L) and EuroQol‐visual analog scale (EQ‐VAS). Results: Both groups, A and B, experienced significant reductions in the WaLIDD score, NPRS, and all domains of EQ‐5D‐3L (p < 0.05), coupled with significant increases in PPT and EQ‐VAS (p < 0.05). Posttreatment comparisons between the groups showed insignificant differences in WaLIDD score, NPRS, and PPT (p > 0.05). However, there was a significant decrease in EQ‐5D‐3L and a significant increase in EQ‐VAS, favoring group A (p < 0.05). Conclusion: Both aquatic and aerobic exercises are effective methods in primary dysmenorrhea management and QOL improvement in adolescent females, with a better effect of aquatic exercise in enhancing QOL. [ABSTRACT FROM AUTHOR]

Objectives. This study aimed to analyze the effectiveness, benefits and safety of water aerobic exercise in improving the quality of life of pregnant women from a psychological and physical perspective. Materials and methods. The present study is defined as a type of systematic review research using searches from journal databases such as MEDLINE-PubMed, Web of Science, Scopus and Science Direct. The inclusion criteria for this study were articles published in the last 5 years and articles discussing pregnancy, aquatic aerobic exercise and quality of life in pregnancy. A total of 53 articles from the Science Direct, PubMed, and Web of Science databases were identified. A total of 8 articles that met the inclusion criteria were selected and analyzed for this systematic review. For standard operations, this study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) assessment. Results. The findings of this systematic review indicate that participating in aquatic aerobic exercises has been found to reduce pain during labour, reduce the use of epidural analgesics during labour, reduce depression during pregnancy, reduce the risk of fetal distress, stabilize blood pressure, reduce back pain, and improve the psychological condition of pregnant women. Conclusions. The regular practice of water aerobic exercise carried out from the 2nd trimester of pregnancy contributes to having a positive impact on improving the quality of life of pregnant women. [ABSTRACT FROM AUTHOR]

Cerebral palsy (CP) is a disorder of movement and posture resulting from a non-progressive injury to the developing brain. The aim of the study was to determine the functional level of performance in water and enjoyment of children with CP, after participating in aquatic therapy classes. Nine children diagnosed with CP were involved in an eight-month aquatic program based on the Halliwick concept and provided as a part of a special school education program. The outcome measurements were the Water Orientation Test Alyn (WOTA 1) and an original enjoyment questionnaire. The data showed a statistically significant improvement in six out of 13 trials of WOTA 1. The children described aquatic therapy as joyful, easy, and their favourite form of physical activity among those offered by the school. The results suggest that aquatic therapy classes can be effectively used among children with CP to improve body position control and mental adjustment in the water. [ABSTRACT FROM AUTHOR]

Background: Balance plays a crucial role in the daily activities of older adults. Aquatic-based exercises (AE) are widely conducted as an alternative to land-based exercises (LE). Previous studies have compared AE and LE as effective ways to improve balance and have yielded inconsistent results. Therefore, this review aimed to compare the effects of AE and LE on balance function in older adults. Methods: Electronic databases, including PubMed, Web of Science, Scopus, and Embase, were searched. Randomized controlled trials published from January 2003 to June 2023 were included following predetermined criteria. Data extraction was carried out by two independent reviewers. Data synthesis was conducted using RevMan 5.3 software. The fixed-effect model or random-effect model was chosen based on the results of the heterogeneity test. Meta-analysis for the effect sizes of balance outcomes was calculated as standardized mean difference (SMD) with 95% confidence intervals (CI). The quality of the included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. This review was registered at PROSPERO CRD42023429557. Results: A total of 29 studies involving 1486 older adults (with an average age of 66.2 years) were included. Meta-analysis results indicated that AE could improve balance ability based on two tests: the Berg balance scale (BBS: SMD = 1.13, 95% CI 0.25 to 2.00, p = 0.01, I2 = 94%) and the 30-s chair stand test (30 CST: SMD = 2.02, 95% CI 0.50 to 3.54, p = 0.009, I2 = 96%). However, there were no significant differences between the AE group and the LE group in terms of the 6-min walking test (6 MWT: SMD = 0.13, 95% CI -0.16 to 0.43, p = 0.38, I2 = 62%) and time up to go test (TUGT: SMD = 0.44, 95% CI -0.44 to 0.91, p = 0.07, I2 = 85%). Older adults with different health conditions have different gains in different balance measurements after AE intervention and LE intervention. Conclusions: Although this was influenced by participant health status, transfer effects, sample size, and other factors, AE offers better benefits than LE for improving balance function in older adults. [ABSTRACT FROM AUTHOR]

Abstract There are various definitions of sarcopenia. Among them, the European Working Group on Sarcopenia in Older Persons (EWGSOP) has defined sarcopenia as "a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, which carries the risk of unwanted consequences such as physical disability, poor quality of life and death". As a person ages, various changes occur in the skeletal muscle. Nutrition is one of the important factors affecting muscle mass and is a characteristic feature of the continuous loss of muscular mass in the aging process. However, sarcopenia, defined as age-related loss of skeletal muscle mass, leads to a deterioration in muscle quantity and quality, gradual slowdown in movements, decreased strength and performance, increased risk of fall-associated injury, and often a decrease in body weight. Treatment options for sarcopenia include lifestyle changes, including physical activity and exercise training, medical nutrition therapy, and pharmacological therapy. Aquatic exercises are a type of exercise that involves the use of all the muscles of the body in a vertical position in the water, opposing the resistance of the water to its own body weight, while cardio and strength training are performed in parallel. Eliminating the risk of falling in sarcopene individuals, working against their own body weight and water resistance can reduce muscle stress while increasing their strength. Healthy lifestyle patterns, proper nutrition and proper exercise programs are effective in preventing sarcopenia and at every stage of the treatment.

Background/Objective: Despite prevalence of studies indicating the positive effect of land-based exercise on bone metabolism, there are limited findings regarding the effect of aquatic exercise. The present study aimed to evaluate the effects of aquatic training and vitamin D3 supplementation on femur bone mineral density (BMD), serum 25(OH)D, and parathyroid hormone (PTH) in postmenopausal obese women with vitamin D insufficiency. Methods: 40 postmenopausal obese women were randomly divided into four groups of aquatic training + vitamin D3 intake group; (ATD), aquatic training with placebo intake group (AT), vitamin D3 intake group (D), and control group with placebo intake (CON). AT groups performed aerobic aquatic exercises for 8 weeks. Vitamin D3 supplementation groups consumed oral dose of 4000 IU/d for 8 weeks. Results: The femur BMD was significantly higher in the ATD than the AT and D and CON groups; in AT it was higher than the D and CON groups. Serum 25(OH)D level in the ATD was more than AT and CON, and in the D was more than the CON and AT. PTH in the ATD group was lower compared to AT, D, and CON groups. PTH was lower in the AT and D compared to the CON. Conclusion: In postmenopausal obese women with vitamin D insufficiency or deficiency, combining vitamin D supplementation and aquatic training was the most effective method for improving bone metabolism; Vitamin D supplementation (alone) was not sufficient to affect some of bone metabolism indices; Aquatic training could not improve serum vitamin D. By priority, ATD, AT, and D indicated better bone related metabolism indices.

We aimed to analyze the usefulness of the 6–20 rating of perceived exertion (RPE) scale for prescribing and self-regulating high-intensity interval (HIIE) and moderate-intensity continuous (MICE) aerobic exercise performed in a heated swimming pool (32 °C). Fifteen older individuals (65 ± 3 years) treated for hypertension underwent a symptom-limited maximal graded exercise test to determine their heart rate at anaerobic threshold, and respiratory compensation point. On different days, participants were randomized to HIIE (walking/jogging between 11 and 17 of RPE; 25 min) and MICE (walking at 11–13 of RPE; 30 min). Heart rate during the low-intensity intervals of HIIE and MICE remained below the graded exercise test's heart rate at anaerobic threshold (−7 ± 18 bpm/−16 ± 15 bpm) and respiratory compensation point (−18 ± 18 bpm/−30 ± 16 bpm), respectively, and maintained in the aerobic training zone during the high-intensity intervals of HIIE (+8 ± 18 bpm/−4 ± 19 bpm). The RPE scale at 15–17 is a useful tool for prescribing and self-regulating heated water-based HIIE and may have important implications for water-based exercise in older individuals with hypertension. [ABSTRACT FROM AUTHOR]

Despite prevalence of studies indicating the positive effect of land-based exercise on bone metabolism, there are limited findings regarding the effect of aquatic exercise. The present study aimed to evaluate the effects of aquatic training and vitamin D3 supplementation on femur bone mineral density (BMD), serum 25(OH)D, and parathyroid hormone (PTH) in postmenopausal obese women with vitamin D insufficiency. 40 postmenopausal obese women were randomly divided into four groups of aquatic training + vitamin D3 intake group; (ATD), aquatic training with placebo intake group (AT), vitamin D3 intake group (D), and control group with placebo intake (CON). AT groups performed aerobic aquatic exercises for 8 weeks. Vitamin D3 supplementation groups consumed oral dose of 4000 IU/d for 8 weeks. The femur BMD was significantly higher in the ATD than the AT and D and CON groups; in AT it was higher than the D and CON groups. Serum 25(OH)D level in the ATD was more than AT and CON, and in the D was more than the CON and AT. PTH in the ATD group was lower compared to AT, D, and CON groups. PTH was lower in the AT and D compared to the CON. In postmenopausal obese women with vitamin D insufficiency or deficiency, combining vitamin D supplementation and aquatic training was the most effective method for improving bone metabolism; Vitamin D supplementation (alone) was not sufficient to affect some of bone metabolism indices; Aquatic training could not improve serum vitamin D. By priority, ATD, AT, and D indicated better bone related metabolism indices. [ABSTRACT FROM AUTHOR]

Background and Purpose: Children with spastic cerebral palsy have many problems in terms of movement and balance. The crooked structure of children with spastic cerebral palsy disturbs their balance function. Due to the constant muscle tension in these people, a permanent spasm is seen in their flexor muscles. Together with other features of the disease, this leads to limited mobility for those affected. Recently, training in water and on land have become very popular in both sports and rehabilitation, especially for people with limited mobility. The aim of this study was to investigate the effects of a functional training protocol combining water and land exercises on the balance and proprioception of the lower limbs of children with cerebral palsy and diplegia. Materials and Methods: Thirty children with diplegia cerebral palsy were selected through available sampling and randomly divided into two equal groups of experimental (age, 9.33±1.63 years; height, 1.32±0.06 m; weight, 33.88±3.63 kg) and control group (age, 9.46±1.30 years; height, 1.30±0.05 m; weight, 32.04±3.52 kg). Subjects in the experimental group performed a training protocol on the ground including strength exercises, balance exercises and functional exercises and training protocol in water for 8 weeks and 4 sessions per week. Before and after the training period static balance was evaluated by using the functional reaching test, the dynamic balance by using the time up and go test (TUG), and joint proprioceptive by measuring the angle of dorsiflexion. To statistically analyze the data, two-way repeated measures of ANOVA was used at a significant level of p≤0.05. Results: After 8 weeks of land and water combined training, there were significant improvements in the functional balance test (p<0.05) and ankle joint proprioception (p=0.001), as well as a significant reduction in time of TUG test(p=0.001). No significant within-group differences were observed in any of the variables in the control group (p > 0.05). Conclusion: The results of the present study showed that performing combined strength, aquatic, functional and balance exercises improve balance, joint proprioception, movement and walking performance in children. In addition, combined water and land exercises can improve the balance and proprioception of children with cerebral palsy and diplegia, and as a result the movement problems and falls of these children could be reduced, which is important for improving the health and lifestyle of these children. Therefore, prescribing this exercise training modality is recommended to trainers and therapists. [ABSTRACT FROM AUTHOR]

Fibromyalgia is a chronic condition characterized by musculoskeletal pain. The aim of this study was to synthesize scientific evidence on the effects of aquatic exercise programs on pain and quality of life in individuals with fibromyalgia. This review was carried out using the following databases in January 2024: Cochrane Library, PEDro, PubMed, SCOPUS, and Web of Science. Four clinical trials focusing on aquatic exercise as a treatment for patients with fibromyalgia were selected. These trials were published in English between 2019 and 2024. Pain recorded using the Visual Analog Scale (VAS) and quality of life with the Short Form-36 Health Survey (SF-36) or Fibromyalgia Impact on Quality of Life (FIQ) were the most commonly analyzed variables. This review was carried out according to the PRISMA statement and was registered in PROSPERO (CRD42024510219). The results in terms of pain and quality of life were positive. In conclusion, these findings support the incorporation of aquatic exercise into fibromyalgia physical therapy treatment. However, the benefits could be equivalent to those of other exercise modalities, underscoring the need for individualized adaptation to each patient's needs. [ABSTRACT FROM AUTHOR]

Objectives: The aims of the study are to systematically evaluate the effect of body weight support training on lower extremity motor function(s) in patients with spinal cord injury and to compare the effect differences among three body weight support training methods. Design: PubMed, Web of Science, Cochrane Library, Embase, CNKI, CBM, China Scientific Journal, and Wan Fang databases were searched until December 31, 2022. Meta-analysis and network meta-analysis were conducted using RevMan 5.4 and ADDIS 1.16.8. Results: Nineteen randomized controlled trials involving 864 patients were included. The meta-analysis showed that body weight support training could improve lower extremity motor scores according to the International Standards for Neurological Classification of Spinal Cord Injury standard (mean difference = 6.38, 95% confidence interval = 3.96–8.80, P < 0.05), walking speed (standard mean difference = 0.77, 95% confidence interval = 0.52–1.02, P < 0.05), and modified Barthel Index scores (mean difference = 9.85, 95% confidence interval = 8.39–11.30, P < 0.05). The network meta-analysis showed no significant difference among the three body weight support training methods for improving lower extremity motor scores in patients with spinal cord injury. The best probability ranking of the body weight support training methods for improving lower extremity motor scores in patients with spinal cord injury was robot-assisted gait training (P = 0.60), followed by aquatic exercise (P = 0.21) and body weight support training (P = 0.19). Conclusions: Body weight support training can improve lower extremity motor score in patients with spinal cord injury. No significant difference was observed among the three body weight support training methods, but robot-assisted gait training may produce the best effect. [ABSTRACT FROM AUTHOR]

The present study investigated the effects of aquatic exercise on parameters of functional autonomy, mental health, and oxidative dysfunction in elderly patients with DM2. A total of 130 elderly were included in the longitudinal clinical study and were attributed to the non-diabetic group (n = 27) and diabetes the group (n = 22). Both groups participated in 24 sessions of Hydro-HIIT, 48 h before and after Hydro-HIIT, the GDLAM index, depression, and anxiety scores and markers of oxidative dysfunction were quantified. After intervention, GI decreased in both groups (non-diabetes group = −24%; diabetes group = −22%) (p < 0.05), markers of depression (−46%), anxiety (−60%), DCFH-DA (−55%), SOD (+59%), TNF-α (−37%) and IL-1 (−48%) in diabetes group (p < 0.05). The intervention with Hydro-HIIT improves aspects related to functional autonomy, mental health, and exerts consequently, a modulating effect on oxidative stress and inflammatory response in elderly people diagnosed with DM2. [ABSTRACT FROM AUTHOR]

Exercising using an underwater treadmill (UTM) has become a popular modality; however, few studies have focused on the physiological demands of UTM walking at varying water depths. Thus, the objective of this study was to investigate changes in heart rate (HR) and core temperature (CT) values in college-aged males and females while exercising at different water immersion depths using an UTM. Twenty participants (age = 21.50 ± 2.19 years; height = 169.04 ± 10.85cm; weight = 75.56 ± 22.28kg) walked at water depths of 10cm below the xiphoid process and at the level of the superior iliac crest (I.C.). Each UTM session lasted 15 minutes, consisting of 5-minute bouts at 1, 2, and 3 mph. Polar HR monitors and ingestible thermoregulatory pills were used to measure HR and CT. Results indicated that HR at 1 (p = .305) and 2 mph (p = .864) were not significantly different between water depths. Heart rate was significantly higher at 3 mph (p = .003) at the I.C. water level. No significant differences were found in CT at 1 (p = .919), 2 (p = .392), or 3 mph (p = .310) during either immersion depth. As a result, higher immersion depths resulted in a lower average HR during higher intensity exercise due to the increased buoyancy effects and the reduced gravity environment of the water. Thus, exercising in higher immersion depths allows participants to exercise at a higher intensity with less overall stress placed on the lower extremities. [ABSTRACT FROM AUTHOR]

As aquatic programs re-open and/or expand as COVID restrictions lift, avoiding virus transmission is a top health and safety concern. This article presents options for safe social distancing for professionals and participants during teaching of swim lessons, coaching sessions, and aquatic exercise classes. Emphasis is on practical, session-to-session issues. Suggestions are applicable to all ages of participants in aquatic programs. Focus is on information for aquatic professionals providing direct participant service. Guidelines for program management are also included. [ABSTRACT FROM AUTHOR]

This study investigated the acute blood pressure (BP) effects of different exercise modalities in older adults with hypertension. Sixty volunteers were randomly assigned (n = 15/group) into different exercise protocols: resistance, bike, water-based exercise (WE), and a control session—all for ∼45 min. Clinic BP measurements were taken before, immediately after, and 15 and 30 min after protocols. The data were analyzed by one-way analysis of variance; generalized estimating equations, following Bonferroni post hoc (p <.05). Immediately after exercise, the systolic BP (SBP) increased in all exercise protocols (resistance exercise = Δ10.3, bike exercise = Δ5.8, WE = Δ9.5 mmHg; p <.001), while the diastolic BP was not altered. Afterward, the SBP reached the value observed before exercise. In Minute 30, only WE presented a significant reduction for SBP (WE = Δ−4.6 mmHg; p <.05). This study has important clinical implications in hemodynamic safety for acute BP increases immediately after exercises, as well as, in the SBP, reduction benefits for older adults with hypertension. [ABSTRACT FROM AUTHOR]

As the population ages, maintaining an active lifestyle becomes increasingly vital to promote overall health and well-being in older individuals. Water- and land-based exercises have emerged as popular options, each offering a distinct set of benefits tailored to the unique needs of this population group. An electronic database search, including PubMed, Scopus, MEDLINE, and Web of Science, was conducted until 15 September 2023, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to investigate the effects of water-based compared to land-based exercise on selected fitness parameters in older healthy individuals. The eligibility criteria included studies with at least two groups of participants aged 60 and older, with physical fitness outcome measures. A total of ten studies met the inclusion criteria and were analyzed. While both exercise modalities may offer significant benefits, this review's findings emphasized the absence of conclusive evidence and consensus for recommending a single exercise category applicable to aquatic or land environments and providing more definite guidance to improve health-related physical fitness parameters in healthy older individuals. Finally, combining both training approaches may lead to a comprehensive array of health benefits for this age group population by also considering individual's needs, preferences, and fitness goals. [ABSTRACT FROM AUTHOR]

Purpose: Recent studies suggest that episodic increases in cerebral blood flow (CBF) may contribute to the improvement in brain health associated with exercise training. Optimising CBF during exercise may enhance this benefit. Water immersion in ~ 30–32 °C augments CBF at rest and during exercise; however, the impact of water temperature on the CBF response has not been investigated. We hypothesised that cycle ergometry in water would increase CBF compared to land-based exercise, and that warm water would attenuate the CBF benefits. Methods: Eleven young heathy participants (nine males; 23.8 ± 3.1 yrs) completed 30 min of resistance-matched cycle exercise in three separate conditions; non-immersion (Land), 32 °C and 38 °C water immersion up to the level of the waist. Middle cerebral artery velocity (MCAv), blood pressure, and respiratory measures were assessed throughout the exercise bouts. Results: Core temperature was significantly higher in the 38 °C immersion than 32 °C (+ 0.84 ± 0.24 vs + 0.04 ± 0.16, P < 0.001), whilst mean arterial pressure was lower during 38 °C exercise compared to Land (84 ± 8 vs 100 ± 14 mmHg, P < 0.001) and 32 °C (92 ± 9, P = 0.03). MCAv was higher in 32 °C immersion compared to the Land and 38 °C conditions throughout the exercise bout (68 ± 10 vs 64 ± 11 vs 62 ± 12 cm/s, P = 0.03 and P = 0.02, respectively). Conclusion: Our findings suggest that cycle exercise in warm water attenuates the beneficial impact of water immersion on CBF velocity due to redistribution of blood flow to subserve thermoregulatory demand. Our findings suggest that, whilst water-based exercise can have beneficial effects on cerebrovascular function, water temperature is a key determinant of this benefit. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Sport & Exercise / Türk Spor ve Egzersiz Dergisi is the property of Turkish Journal of Sport & Exercise and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Children with intellectual disabilities often face challenges in balance ability and lower limb muscle strength, which negatively impact their daily lives and motor function. Therefore, it is crucial to enhance the balance ability and lower limb muscle strength of children with intellectual disabilities. This study aimed to investigate the effects of a 12-week aquatic exercise and floor curling intervention on the balance ability and lower limb muscle strength of children with intellectual disabilities. Forty-two participants were randomly assigned to the aquatic exercise group, floor curling group, and control group. The aquatic exercise and floor curling groups received a 12-week intervention, while the control group engaged in supervised free activities. The participants' balance ability and lower limb muscle strength were assessed using the Berg Balance Scale and a muscle strength testing device before and after the intervention. The results showed significant improvements in balance ability and lower limb muscle strength for both the aquatic exercise group and the floor curling group after the intervention. The aquatic exercise group demonstrated an average improvement of 10.84% in balance ability and an overall average improvement of 16.28% in lower limb muscle strength. The floor curling group showed an average improvement of 9.04% in balance ability and an overall average improvement of 15.67% in lower limb muscle strength. These improvement results were statistically significant (p < 0.05) and ranged from medium to large effect sizes (d = 0.5~0.8). The findings of this study validate the positive effects of aquatic exercise and floor curling on the balance ability and lower limb muscle strength of children with intellectual disabilities. These interventions can be considered effective approaches for functional rehabilitation in children with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Women after surgical treatment of breast cancer are less likely to engage in physical activity and may exhibit depressive symptoms even for many years post-treatment. The aim of the study was to compare the impact of 6 months aquatic and land exercise on mental well-being of women after breast cancer surgery. Methods: The study was based on a survey which involved a total of 90 women ≥ 50 years of age (including 60 subjects after treatment of breast cancer ≥ 2 years after surgery and 30 healthy control). The study participants were divided into three groups, i.e. women attending general exercise sessions in a gym (A, n = 30), participating in aquatic exercise (B, n = 30), as well as healthy female peers reporting no regular physical exercise for the period of 6 months (C, n = 30). The present data were acquired using standardized questionnaires designed to assess physical activity (IPAQ-SF), mental well-being (WHO-5) and level of anxiety, i.e., Generalized Anxiety Disorder Questionnaire (GAD-7). Results: Both the aquatic and land exercise had positive effect on mental well-being of woman after breast cancer surgery and there were no significant differences between them. Analysis of the anxiety level (GAD-7) confirms that women after breast cancer treatment were more exposed to a feeling of generalised anxiety disorder, i.e. 8.67 vs. 6.73, 4.5 (p = 0.001). The results of WHO-5 index were significantly higher in the A and B groups comparing to healthy control, i.e. 13.27 vs. 14.18; 10.10 (p < 0.001), but the obtained results still indicate the low self-esteem of the study group. Women after breast cancer surgery who regularly participated in aquatic exercise were engaged in more vigorous physical activity compared to the other groups, i.e. 1049.33 vs. 521.33; 860.00 MET min/week (p = 0.001). Conclusion: Regardless of the type of physical activity, 6 months aquatic and land exercise contributed to improved mental well-being and ensured adequate levels of moderate physical activity of woman after BC surgery. Regular physical activity is crucial in the rehabilitation after mastectomy and can be an effective treatment to achieve beneficial mental outcomes. [ABSTRACT FROM AUTHOR]

Background: Despite the fact that aquatic exercise is one of the most popular alternative treatment methods for children with cerebral palsy (CP), there are few research regarding its effectiveness. Objects: The purpose of this study was to examine the effects of aquatic exercise on upper extremity function and postural control during reaching in children with CP. Methods: Ten participants (eight males and two females; 4–10 years; Gross Motor Function Classification System levels II–IV) with spastic diplegia were recruited to this study. The aquatic exercise program consisted of four modified movements that were selected from the Halliwick 10-point program to enhance upper extremity and trunk movements. The participants attended treatment two times a week for 6 weeks, averaging 35 minutes each session. The Box and Block Test (BBT), transferring pennies in the Bruininks-Oseretsky Test (BOT), and pediatric reaching test (PRT) scores were used as clinical measures. Three-dimensional motion analysis system was used to collect and analyze kinematic data. Differences in BBT and BOT values among pre-treatment, post-treatment, and retention (after 3 weeks) were analyzed using a Friedman test. In addition, the PRT scores and variables (movement time, hand velocity, straightness ratio, and number of movement units) from the three-dimensional motion analysis were tested using a Wilcoxon signed-rank test. The significance level was established at p < 0.05. When the results appeared to be statistically significant, a post-hoc test for multiple comparisons was performed with the Wilcoxon signed-rank test. Results: All clinical measures, which included BBT, transferring pennies of BOT, and PRT, were significantly increased between pre-intervention and post-intervention scores and between pre-intervention and retention scores after treatment (p = 0.001). Three-dimensional motion analysis mostly were significantly improved after treatment (p = 0.001). Conclusion: Aquatic exercise may help to improve body function, activity, and participation in children with varying types of physical disabilities.

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease that, due to dyspnea, decreases patients' physical function and quality of life. The aim of the research was to evaluate the effectiveness of water-based exercise (WE) in improving functional capacity and respiratory muscle strength in patients with COPD. It consisted of a systematic review and meta-analysis of eight randomized clinical trials (RCTs) from the last 10 years, found in PubMed, PEDro, Scopus and Web of Science databases. Methodological quality was analyzed using the PEDro scale and the Cochrane Collaboration Risk of Bias Tool. Regarding the evaluation of functional capacity, mainly assessed were lung function, respiratory muscle strength, and maximal or aerobic exercise. The results showed that WE improves functional capacity compared to a non-exercising control group (SMD: 73.42; IC 95%: 40.40 to 106.45; I2: 0%). There are no statistically significant differences between a WE treatment and a land exercise (LE) treatment (p = 0.24) in functional capacity, nor with respect to respiratory muscle strength (p = 0.97). These data should be interpreted with caution, as more RCTs with aquatic intervention in COPD patients are needed to elucidate whether there are differences between WE or LE according to patient characteristics and comorbidities. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular disease (CVD) remains the main cause of death in the Western world. Our recent findings demonstrate potential CVD risk reduction in older adults who undertake regular swimming exercise. Nevertheless, it remains unknown whether an exercise intervention based on swimming is feasible and effective prior to a wider implementation of a CVD risk prevention strategy. Methods: This was a pragmatic, two-group, randomised controlled trial. A total of 40 older adults were randomly split into two groups (n = 20 per group). The swimming exercise group consisted of participants who engaged in swimming exercise (2-3 days/week, for 8 weeks). The control group did not perform any exercise. Flow-mediated dilation (%FMD) was the primary outcome. Secondary outcomes included raw cutaneous vascular conductance. Feasibility outcomes (e.g., recruitment, adherence, and attrition rates) were also assessed. Results: Statistically significant macrovascular (%FMD; swimming group: 9.8% ± 4.2%, p <0.001; control group: 4.6% ± 2.5%) and microvascular function (raw cutaneous vascular conductance; swimming group: 4.1 ± 0.9, p <0.01; control group: 3.2 ± 1.1) improvements were observed in the swimming group compared to the control group. Compliance to twice and thrice weekly in an 8-week swimming exercise was 92.6% and 88.4%, respectively, with no dropouts. Conclusion: Our 8-week, community-based, pragmatic swimming exercise intervention is a feasible and effective exercise programme that could be implemented in older adults for the prevention of age-related CVD. These findings suggest that swimming exercise could significantly reduce CVD risk in older adults, and a large research clinical trial is warranted to establish these findings. [ABSTRACT FROM AUTHOR]

Detecting the physiological and biomechanical alterations in shallow water walking (SWW) due to water depth and speed is important for health professionals to perform accurate exercise prescription. This systematic review with meta-analysis aimed to investigate the acute physiological and biomechanical responses of SWW at different immersion depths in comparison to dry land walking. The main result (initial search: 1960 studies; systematic review: 42 studies; meta-analysis: 22 studies) indicated that metabolic power was higher in the immersion depth levels of xiphoid process (standardized mean differences (SMD) = 0.90; 95% confidence intervals (CI): 0.26 to 1.54) and waist (SMD = 3.35; 95% CI: −0.18 to 6.87) in comparison to dry land. SWW at xiphoid and waist depths seems to be an adequate exercise if the objective is to increase the energy expenditure and cardiovascular demand while the lower limb impact forces are reduced in comparison to dry land walking. PROSPERO registration: CRD42018113040. [ABSTRACT FROM AUTHOR]

This study aims to explore the effects of aquatic strength training on the postural balance and walking function of stroke patients. A total of 56 chronic stroke patients more than 6 months post-stroke with walking and balance impairments were included in this study. After baseline evaluations, patients were randomly assigned to either the experiment group (n = 29) or control group (n = 27). Patients in the control group underwent conventional hydrotherapy, whereas patients in the experiment group received conventional hydrotherapy combined with aquatic lower extremity strength training. After six weeks of rehabilitation, all patients were evaluated by a blinded assessor, and the functional assessments including: Berg Balance Scale (BBS); Timed Up and Go Test (TUG and mTUG); 2 Minute Walk Test (2MWMT); and Gait analysis. There were no significant differences (P >.05) between the two groups in all evaluation indexes before rehabilitation. Six weeks after treatments, the results from both groups showed significant improvements compared with those in the baseline evaluations (P <.05). Notably, compared with the control group, BBS, TUG and mTUG, 2MWMT, and Gait analysis including stride length in the non-hemiplegic side, stride length, as well as walking speed and stride frequency in the hemiplegic side in experiment group were markedly improved (P <.05) Aquatic strength training can improve postural balance and lower extremity motor functions in chronic stroke patients. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare the effects of three water-based training on blood pressure (BP) in older women. A total of 57 participants were randomized into the following groups: (a) aerobic training (AT), (b) concurrent training in which resistance training progresses to the use of resistive equipment (CTRE), and (c) concurrent training in which resistance training progresses to multiple sets (CTMS). The participants trained twice a week for 16 weeks. Systolic BP decreased from pretraining to after 8 weeks of training and, subsequently, to after 16 weeks of training (AT: −6.53 mmHg, CTRE: −10.45 mmHg, and CTMS: −10.73 mmHg). Diastolic BP decreased from pretraining to after 8 and 16 weeks of training (AT: −6.23 mmHg, CTRE: −4.61 mmHg, and CTMS: −6.19 mmHg). Furthermore, 16% of the AT participants, 23% of the CTRE participants, and 28.5% of the CTMS participants were no longer classified as hypertensive. Water-based aerobic and concurrent training are efficient nonpharmacological measures to reduce BP in older women. [ABSTRACT FROM AUTHOR]

Previous studies have shown that normal and complex land walking (e.g. dual-task and obstacle walk) have a positive effect on the prefrontal cortex (PFC) and executive function. However, little is known about the benefits of aquatic walking. The underwater environment is a complex environment with water flow and resistance. Such an environment may induce different brain responses than the land environment. These responses can possibly affect brain function. Therefore, we hypothesized that aquatic walking enhances PFC and executive function more than land walking. Seven participants (age: 57.6 ± 7.0 years, body mass index: 22.9 ± 4.6 kg m−2) performed walking for 10 mins at a self-selected comfortable speed in both conditions. Then, the color-word Stroop task (CWST) was administered at pre- and post-exercises. The left prefrontal hemoglobin activity was monitored via functional near-infrared spectroscopy during the CWST and walking trial. Stroop interference performance, which reflects executive function, was calculated using reaction time and hemoglobin activity during the CWST. Compared to land walking, aquatic walking enhanced cortical activations and reaction time in the Stroop interference. In addition, aquatic walking was more likely to enhance cortical function than land walking. Hence, aquatic walking can induce higher cortical activation relative to land walking at a similar intensity, and it promotes executive function in healthy middle- and old-aged individuals.

Fibromyalgia is a chronic condition characterized by musculoskeletal pain. The aim of this study was to synthesize scientific evidence on the effects of aquatic exercise programs on pain and quality of life in individuals with fibromyalgia. This review was carried out using the following databases in January 2024: Cochrane Library, PEDro, PubMed, SCOPUS, and Web of Science. Four clinical trials focusing on aquatic exercise as a treatment for patients with fibromyalgia were selected. These trials were published in English between 2019 and 2024. Pain recorded using the Visual Analog Scale (VAS) and quality of life with the Short Form-36 Health Survey (SF-36) or Fibromyalgia Impact on Quality of Life (FIQ) were the most commonly analyzed variables. This review was carried out according to the PRISMA statement and was registered in PROSPERO (CRD42024510219). The results in terms of pain and quality of life were positive. In conclusion, these findings support the incorporation of aquatic exercise into fibromyalgia physical therapy treatment. However, the benefits could be equivalent to those of other exercise modalities, underscoring the need for individualized adaptation to each patient’s needs.

Context: Deep water running (DWR) is an aquatic aerobic exercise which involves running in water without the feet touching the bottom of the pool, and it may involve different activation of trunk muscles compared with running or walking on land. This form of exercise is gradually being adopted as a form of therapeutic exercise for people with low back pain. It is proposed that different types of running or walking in water may be a more comfortable form of training for the trunk and abdominal muscles compared with exercising on dry land. Objectives: This study aimed to examine the trunk muscle activation in DWR in 2 different styles-high knee style and cross-country style, and these were compared with walking on land. Participants: Eleven healthy individuals (2 females and 9 males, mean age = 24 [4.6]) were recruited for this study. Outcome Measures: Surface electromyography was used to examine the activities of the right transversus abdominis, rectus abdominis, lumbar multifidus, and lumbar erector spinae muscles in 5 conditions: static standing on land and in water, running in deep water with high knee and cross-country styles, and finally walking on a treadmill. Results: The percentage of maximal voluntary contraction of the transversus abdominis was significantly higher for both running styles in DWR, compared with that of static standing in water. Comparing directly the 2 styles, muscle activity was higher with a high knee action compared to without. The activation of transversus abdominis during high-knee DWR was comparable with that during treadmill walking and this may have clinical implications. Conclusion: The results of this study confirmed that running in deep water with a high knee action activated trunk muscles differently compared with standing or walking on land. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular disease (CVD) remains the main cause of death in the Western world. Our recent findings demonstrate potential CVD risk reduction in older adults who undertake regular swimming exercise. Nevertheless, it remains unknown whether an exercise intervention based on swimming is feasible and effective prior to a wider implementation of a CVD risk prevention strategy.Methods: This was a pragmatic, two-group, randomised controlled trial. A total of 40 older adults were randomly split into two groups (n = 20 per group). The swimming exercise group consisted of participants who engaged in swimming exercise (2–3 days/week, for 8 weeks). The control group did not perform any exercise. Flow-mediated dilation (%FMD) was the primary outcome. Secondary outcomes included raw cutaneous vascular conductance. Feasibility outcomes (e.g., recruitment, adherence, and attrition rates) were also assessed.Results: Statistically significant macrovascular (%FMD; swimming group: 9.8% ± 4.2%, p

Persons living with chronic spinal cord injury (SCI) demonstrate an increased risk of cardiovascular diseases. The aim of this report was to assess the cardiopulmonary and metabolic impact of prescribed aquatic exercise in combination with dietary guidance for four individuals experiencing chronic SCI. We measured peak oxygen consumption (peak VO2), resting energy expenditure (REE), weight, food logs, fasting glucose, insulin and glycated hemoglobin (HbA1C) in four men with incomplete SCI, aged 34 to 63 years. The men received a group aquatic exercise program three times per week for 10 weeks, and a weekly individual nutritional consultation by phone. Peak VO2 increased by 7.9% and 34.4% in participants #3 and #4 and decreased by 12% and 16.4% in #1 and #2. Glucose values decreased by 19.6% and 14.2% for #1 and #3, and increased by 9.3% for both #2 and #4. Body mass decreased by 9.9%, 3.0% and 5.7% for participants #1, #2 and #3, but demonstrated no change for participant #4. Dietary guidance and education produced positive changes, including reduced fat, carbohydrate, daily sugar, and average calorie intake. Moderate exercise with weekly nutritional guidance appeared to positively impact body mass and dietary selections with varied metabolic and cardiopulmonary results. [ABSTRACT FROM AUTHOR]

To (1) describe the state of the literature on water-based therapeutic exercise (WBTE) for people living with stroke, (2) describe the content and structure of interventions, (3) summarize the effects of interventions described in the literature, and (4) identify gaps in the literature limiting application and implementation. Scoping review methodology described by Arksey and O'Malley (2005) and Levac et al. (2010). Electronic databases were searched for articles with eligibility criteria including: (1) adult stroke survivors (18 years or older) of any type (ischemic/hemorrhagic) or stage (acute/chronic) in any setting, and (2) the study intervention involved WBTE to address a post-stroke deficit. 40 articles were included in this review. Five trials had a treatment control, 20 had an active comparison. Calculated intervention effect sizes demonstrated a strong effect of WBTE on balance and gait related outcomes in 80% of controlled and comparison trials. This scoping review highlights common parameters of WBTE interventions and provides an inventory of the differences in the treatment approaches utilized in this population. Opportunities for future work include the development of a standardized treatment protocol, qualitative or mixed methodology research, and greater inclusion of more individuals with more severe stroke-related impairments. Water-based therapeutic exercise is an approach that may allow stroke survivors to carry out challenging activities in a safe and accessible environment. Water-based interventions for stroke survivors appear to have a beneficial impact on walking and balance. Given that an aquatic environment offers an opportunity for individuals with more significant physical impairments to carry out early practice of walking and balance related tasks, clinicians should explore the feasibility and effectiveness for this subset of stroke survivors. [ABSTRACT FROM AUTHOR]

Introduction: Knee osteoarthritis (OA) is one of the commonest problems in general population that is more likely to increase in future as the population ages. Aquatic exercises are advanced non-invasive techniques used in the management of knee OA. This research aims to provide evidence regarding effects of aquatic exercises and its general feasibility in reducing pain, improve body function and quality of life (QOL). Material & Methods: A systematic review was conducted following PRISMA guidelines. Literature search was done using PubMed and PEDro database. Randomized Controlled Trials using different mesh terms related to knee OA and aquatic intervention were included. The main outcome parameters were pain, range of motion, power and QOL. Results: We identified a total of 32 studies for this systematic review. After screening, 15 articles were included. All studies showed that aquatic exercises may decrease pain and increase ROM. The result suggests that aquatic exercises are effective in decreasing pain and increasing ROM, muscles power and QOL. Conclusion: Aquatic exercises are effective for the patients with knee OA. Aquatic exercises decrease knee joint pain, reduce joint stiffness and enhance walking speed, range of motion, muscle power and QOL.

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Aquatic or water-based exercise is a very popular type of exercise in particular for people with physical limitations, joint problems and fear of falling. The present systematic review and meta-analysis aimed to provide evidence for the effect of aquatic exercise on Bone Mineral Density (BMD) in adults. Methods: A systematic literature search of five electronic databases (PubMed/ MEDLINE, Cochrane Library, Scopus, Web of Science and CINAHL) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted until 2022/01/30, with an update to 2022/10/07. We included controlled trials with a duration of more than 6 months and at least two study groups, aquatic exercise (EG) versus non-training controls (CG) with no language restrictions. Outcome measures were standardized mean differences (SMD) with 95%-confidence intervals (95%-CI) for BMD changes at the lumbar spine (LS) and femoral neck (FN). We applied a random-effects meta-analysis and used the inverse heterogeneity (IVhet) model to analyze the data. Results: Excluding an outlier study with an exceptionally high effect size for LSBMD, we observed a statistically significant (p = .002) effect (EG vs. CG) of aquatic exercise for the LS-BMD (n = 10; SMD: 0.30; 95%-CI: 0.11–0.49). In parallel, the effect of aquatic exercise on FN-BMD was statistically significant (p = .034) compared to the CG (n = 10; SMD: 0.76, 95%-CI: 0.06–1.46). Of importance, heterogeneity between the trial results was negligible for LS (I² : 7%) but substantial for FN-BMD (I² : 87%). Evidence for risks of small study/publication bias was low for LS-BMD and considerable for FN-BMD. Discussion: In summary, the present systematic review and meta-analysis provides further evidence for the favorable effect of exercise on bone health in adults. Due to its safety and attractiveness, we particularly recommend waterbased exercise for people unable, afraid or unmotivated to conduct intense landbased exercise programs. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effects of 16 weeks of aerobic training (AT) to 8 weeks of AT followed by 8 weeks of combined training (CT), as well as to a control group (CG), on the functional, cognitive and hemodynamic responses of older women exercising in the aquatic environment. Materials andMethods: The study is a three-armed parallel randomized controlled clinical trial. For this, 52 older women were first randomized in an aerobic training (AT; n = 35) or control group (CG; n = 17). After 8 weeks of intervention, participants from AT group were again randomized into another 8-week period of either AT (n = 17) or combined training (CT; n = 18). AT was performed at the percentage of the heart rate corresponding to the anaerobic threshold, resistance training was performed with sets at maximal effort and the control group performed low-intensity therapeutic exercises in water. All outcomes were assessed before (week 0) and after the intervention (week 17). In addition, some outcomes were also investigated in the middle timepoint (week 9). Generalized Estimating Equations (GEE) and Bonferroni post-hoc tests (α = 0.05) were used to compare timepoints and groups. Results: All groups similarly improved functional capacity (3–11%) and blood pressure (−4 to −10%), whereas cognitive function was not modified for any group. Conclusion: Water-based training programs and therapeutic exercises (i.e., CG) improve functional capacity and blood pressure responses in older women. Clinical Trials NCT03892278. [ABSTRACT FROM AUTHOR]

Objective: To examine the efficacy and safety of aquatic exercise for people with knee osteoarthritis. Data sources: PubMed, Web of Science, Embase, CENTRAL, CNKI and WanFang databases were searched from 1966 to September 2022. Review methods: Randomized controlled trials evaluating aquatic exercise for people with knee osteoarthritis compared with no exercise and land-based exercise were included. The Grading of Recommendations Assessment, Development and Evaluation system was used to evaluate the certainty of evidence. Results: Twenty-two studies with 1394 participants were included. Compared with no exercise (13 trials with 746 participants), low-to high-certainty evidence revealed that aquatic exercise yielded significant improvements in patient-reported pain (SMD −0.58, 95% CI −0.82 to −0.33), stiffness (SMD −0.57, 95% CI −1.03 to −0.11) and physical function (SMD −0.35, 95% CI −0.52 to −0.18) immediately postintervention. A sustained effect was observed only for pain at three months postintervention (SMD −0.48, 95% CI −0.91 to −0.06). The confidence intervals demonstrated that the pooled results do not exclude the minimal clinically important differences. There were no significant differences between the effects of aquatic exercise and land-based exercise (13 trials with 648 participants) on pain (SMD −0.12, 95% CI −0.29 to 0.04), stiffness (SMD −0.17, 95% CI −0.49 to 0.16) or physical function (SMD −0.13, 95% CI −0.28 to 0.02). No study reported a serious adverse event in relation to aquatic exercise. Conclusion: Aquatic exercise provides a short-term clinical benefit that is sustained for at least three months postintervention in terms of pain in people with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Physical activity has been shown to have many benefits, including reducing cancer-related fatigue (CRF) and improving psychological and physical recovery from breast cancer. Some authors have shown the benefits of aquatic practice, while others have detailed the benefits of group and supervised practice. We hypothesize that an innovative sports coaching proposal could allow a significant adherence of patients and contribute to their health improvement. The main objective is to study the feasibility of an adapted water polo programme (aqua polo) for women after breast cancer. Secondarily we will analyse the effect of such a practice on patients' recovery and study the relationship between coaches and participants. The use of mixed methods will allow us to question the underlying processes precisely. This is a prospective, non-randomized, monocentric study with a sample of 24 breast cancer patients after treatment. The intervention is a 20 week programme (1 session per week) of aqua polo in a swim club facility, supervised by professional water-polo coaches. The variables measured are patient participation, quality of life (QLQ BR23), CRF (R–PFS) and post-traumatic growth (PTG-I) as well as different variables to observe physical capacity (strength with dynamometer, step-test and arm amplitude). The quality of the coach-patient relationship will be evaluated (CART-Q) to explore its dynamics. Participatory observations and interviews will be carried out to report on the interactions between the coach and the participants during the sessions. Registration number and name of trial registry: No. EudraCT or ID-RCB: 2019-A03003-54 and NCT: NCT04235946

As the population ages, maintaining an active lifestyle becomes increasingly vital to promote overall health and well-being in older individuals. Water- and land-based exercises have emerged as popular options, each offering a distinct set of benefits tailored to the unique needs of this population group. An electronic database search, including PubMed, Scopus, MEDLINE, and Web of Science, was conducted until 15 September 2023, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to investigate the effects of water-based compared to land-based exercise on selected fitness parameters in older healthy individuals. The eligibility criteria included studies with at least two groups of participants aged 60 and older, with physical fitness outcome measures. A total of ten studies met the inclusion criteria and were analyzed. While both exercise modalities may offer significant benefits, this review’s findings emphasized the absence of conclusive evidence and consensus for recommending a single exercise category applicable to aquatic or land environments and providing more definite guidance to improve health-related physical fitness parameters in healthy older individuals. Finally, combining both training approaches may lead to a comprehensive array of health benefits for this age group population by also considering individual’s needs, preferences, and fitness goals.

Children with intellectual disabilities often face challenges in balance ability and lower limb muscle strength, which negatively impact their daily lives and motor function. Therefore, it is crucial to enhance the balance ability and lower limb muscle strength of children with intellectual disabilities. This study aimed to investigate the effects of a 12-week aquatic exercise and floor curling intervention on the balance ability and lower limb muscle strength of children with intellectual disabilities. Forty-two participants were randomly assigned to the aquatic exercise group, floor curling group, and control group. The aquatic exercise and floor curling groups received a 12-week intervention, while the control group engaged in supervised free activities. The participants’ balance ability and lower limb muscle strength were assessed using the Berg Balance Scale and a muscle strength testing device before and after the intervention. The results showed significant improvements in balance ability and lower limb muscle strength for both the aquatic exercise group and the floor curling group after the intervention. The aquatic exercise group demonstrated an average improvement of 10.84% in balance ability and an overall average improvement of 16.28% in lower limb muscle strength. The floor curling group showed an average improvement of 9.04% in balance ability and an overall average improvement of 15.67% in lower limb muscle strength. These improvement results were statistically significant (p < 0.05) and ranged from medium to large effect sizes (d = 0.5~0.8). The findings of this study validate the positive effects of aquatic exercise and floor curling on the balance ability and lower limb muscle strength of children with intellectual disabilities. These interventions can be considered effective approaches for functional rehabilitation in children with intellectual disabilities.

Background/Objective: The effects of land-based high-intensity interval training (HIIT) on the cardiovascular system have already been demonstrated. However, the water environment is different from that on land. Therefore, we investigated the effects of 6-week aquatic HIIT and moderate-intensity continuous training (MICT) on central hemodynamic parameters, endothelial function, and aerobic fitness in inactive adults. Methods: Thirty-one inactive adults were randomly assigned to HIIT or MICT group. HIIT group performed twelve 30-s swimming exercise bouts with the intensity of 95% HRmax and 15–18/20 RPE with a 60-s rest period between each bout. MICT group performed a 30-min uninterrupted swimming exercise with the intensity of 70%–75% HRmax and 12–14/20 RPE. Training frequency for both groups was three times a week. The pulse wave analysis and flow-mediated dilation (FMD) were measured by non-invasive equipments. Results: The aerobic fitness significantly increased after HIIT, but no change was seen after MICT. Augmentation pressure (AP) and augmentation index normalized at 75 bpm (AIx@HR75) significantly decreased after HIIT but not MICT, whereas MICT rather than HIIT improved subendocardial viability ratio (SEVR), central and peripheral blood pressure, and resting HR. Only HIIT significantly increased brachial endothelial function. Conclusion: A six-week aquatic HIIT and MICT had no differences in hemodynamic parameters, endothelial function, and aerobic fitness, however 6 weeks of aquatic HIIT reduced arterial stiffness, increased endothelial function and aerobic fitness, while 6 weeks of aquatic MICT reduced arterial blood pressure and resting HR and increased the coronary blood flow reserve.