Abstract

(1) Background: Squatting is one of the common closed-kinetic chain (CKC) exercises for knee rehabilitation. Some patients cannot perform squatting exercises on land occasionally due to knee pain. Several studies had suggested that lower limb muscle activities are lower in water than on land while performing CKC exercises. The purpose of this study is to investigate the surface electromyography (sEMG) activities of Rectus femoris (RF) and Biceps femoris (BF) muscles when doing a squatting exercise in water and on land. (2) Methods: This was a cross-sectional experimental study. A total of 20 healthy participants (10 males, 10 females) were recruited by convenience sampling. The sEMG of RF and BF muscles in water and on land were collected and the knee motions were videotaped. Participants were instructed to perform closed kinetic-chain back squatting exercises at a specific speed (30 beats per minute) in water and on land at angular speed of 45°/s. Eight repetitions of the squatting exercise (0–90° knee flexion) were performed. The mean percentage maximal voluntary contraction (%MVC) between two muscles was compared in two conditions. The %MVC of RF and BF muscles at different specific knee flexion angles (30°, 60° and 90° knee flexion) was also identified. (3) Result: Muscle activities of RF (p = 0.01) and BF (p < 0.01) muscles were significantly lower in water than on land. The %MVC of RF and BF muscles was found to be 15.01% and 10.68% lower in water than on land respectively. For different knee angle phases, the differences in %MVC between land and water had significant difference for both RF muscles and BF muscles. (4) Conclusion: This study found a difference of mean percentage MVC of RF and BF muscles between land and water in different phases of squatting. The water medium reduced the two muscles’ activities to a similar extent. The result showed that the aquatic environment allows an individual to perform squatting with less muscle activation which may serve as an alternative knee exercise option for patients who encounter difficulty in land squatting due to lower limb muscle weakness or a high level of knee pain.

Highlights

  • Aquatic exercises are recommended during the initial phase of a musculoskeletal rehabilitation program, as the specific properties of water allow early exercises for patients who are unable to exercise successfully on land [1,2,3,4,5]

  • (4) Conclusion: This study found a difference of mean percentage Maximal Voluntary Contractions (MVC) of Rectus femoris (RF) and Biceps femoris (BF) muscles between land and water in different phases of squatting

  • The result showed that the aquatic environment allows an individual to perform squatting with less muscle activation which may serve as an alternative knee exercise option for patients who encounter difficulty in land squatting due to lower limb muscle weakness or a high level of knee pain

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Summary

Introduction

Aquatic exercises are recommended during the initial phase of a musculoskeletal rehabilitation program, as the specific properties of water allow early exercises for patients who are unable to exercise successfully on land [1,2,3,4,5]. Several studies have suggested the unique physical properties of water, including buoyancy, hydrostatic pressure and thermodynamics, could induce different physiological and biomechanical responses of the body during exercises [6,7,8]. Res. Public Health 2019, 16, 4562; doi:10.3390/ijerph16224562 www.mdpi.com/journal/ijerph

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