Abstract
The aquatic environment offers cardiorespiratory training and testing options particularly for individuals unable to adequately train or test on land because of weight bearing, pain or disability concerns. No systematic review exists describing cardiorespiratory fitness protocols used in an aquatic environment. This review investigated the different head-out water-based protocols used to assess cardiorespiratory fitness. Our comprehensive, systematic review included 41 studies with each included paper methodological quality assessed using the statistical review of general papers checklist. Diverse protocols arose with three major categories identified: conducted in shallow water, deep water, and using special equipment. Thirty-seven articles presented data for peak/maximal oxygen consumption (VO2peak/VO2max). Twenty-eight of 37 studies predefined criteria for reaching a valid VO2peak/VO2max with shallow water exercise demonstrating 20.6 to 57.2 mL/kg/min; deep water running 20.32 to 48.4 mL/kg/min; and underwater treadmill and cycling 28.64 to 62.2 mL/kg/min. No single, accepted head-out water-based protocol for evaluating cardiorespiratory fitness arose. For clinical use three cardiorespiratory fitness testing concepts ensued: water temperature of 28–30 °C with difference of maximum 1 °C between testing participants and/or testing sessions; water depth adapted for participant aquatic experiences and abilities; and intensity increment of 10–15 metronome beats per minute.
Highlights
Cardiorespiratory fitness (CRF) is a health-related component of physical fitness defined as the ability of the circulatory, respiratory, and muscular systems to supply oxygen during sustained physical activity [1]
With difference of maximum 1 ◦ C between testing participants and/or testing sessions; water depth adapted for participant aquatic experiences and abilities; and intensity increment of 10–15 metronome beats per minute
We divided them into three groups: protocols conducted in shallow water, deep water, and others that used special equipment like underwater treadmill or bicycle
Summary
Cardiorespiratory fitness (CRF) is a health-related component of physical fitness defined as the ability of the circulatory, respiratory, and muscular systems to supply oxygen during sustained physical activity [1]. It is increasingly important to monitor and systematically evaluate cardiorespiratory fitness in persons with disability or chronic disease in clinical rehabilitation and beyond [4,5,6]. Monitoring changes in cardiorespiratory fitness may indicate training and rehabilitation program effectiveness, as well as the development of a physically active lifestyle [7]. The head-out aquatic exercises are an important therapeutic component for individuals with physical limitations [8,9], as well as an element of a primary health prevention system, [10,11,12] and elite athlete sport performance conditioning [13,14,15,16,17]. Regular testing of the individuals participating in an aquatic therapy program with standardized cardiorespiratory protocols may give practitioners valuable information for establishing exercise guidelines, monitoring progress and making adjustments in both
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