Land Base Research Articles

The efficacy of land versus water exercise program on body composition in obese patients with knee osteoarthritis

Obesity and Osteoarthritis (OA) can affect each other and make a reciprocal causal chain with negative feedback that caused by physical inactivity. Water-based (WB) and land-based (LB) exercises are effective to improve body composition and physical activities. The aim of this study was to compare the effects of both exercise programs on body composition in obese patients with knee OA. A single-blind randomized controlled trial was done involving 33 men and women aged 40–80 years old with BMI ≥ 25 kg/m 2 and knee OA grade 2 and 3 based on Kellgren-Lawrence grading scale. Subjects were randomly divided into LB ( n = 18) and WB group ( n = 15) with aerobic and knee-strengthening exercises for 8 weeks. Body weight (BW), body mass index (BMI), and waist circumference (WC) were measured before and after the program. Data will be analyzed using SPSS 20.0 with independet t test, Wilcoxon and Mann Whitney test if necessary. Participants who performed the LB exercise program showed significant improvement in BW (mean, 0.22 ± 0.92; P = 0.025), BMI (median, 0.36 (0.68–2.88); P = 0.040), and WC (mean, 2.13 ± 3.66; P = 0.024). While there was no significant improvement of body composition in WB group. However, when both groups were compared, BMI was the only variable that was significantly different ( P = 0.048), with subjects of LB group showing better result than the WB group. Land-based exercise program was more effective to improve body composition in obese patients with knee OA due to the effect of gravity that improved muscle strengthening without buoyancy such as in the water. Warm water temperature gives relaxation effect that increases appetite. We suggest longer period of research and greater number of participants to better show a significant improvement for WC and BW variables.

Fitness-Related Benefits

PURPOSE: To compare fitness-related benefits between land-based (LAND) versus aqua-based (AQUA) courses. METHODS: Informed consent was received from 154 volunteers (N = 76 LAND; N = 78 AQUA) who were asked to exercise within each respective course 2 days per week, 50-min per day, for 15 weeks. Pre- and post-fitness assessments obtained were body composition, muscular endurance, muscular strength, cardiorespiratory endurance, and flexibility. RESULTS: Mixed ANOVA was used to investigate mean differences between pre- and post-fitness assessments and between groups. There was a main effect (p = 0.003) and interaction (p = <0.001) for body composition in which, overall, participants decreased percent body fat, however, paired t-test revealed that LAND (20.4% ± 7.3% to 19.0% ± 7.4%) had a significant reduction in mean percent body fat while AQUA did not (20.1% ± 8.7% to 20.2% ± 8.9%). A main effect for both muscular strength (p = <0.001) and muscular endurance (p = <0.04) was revealed, but no interactions, therefore, both groups improved on aforementioned variables. Lastly, no significant main effect or interaction for neither cardiorespiratory endurance nor flexibility assessments were revealed. CONCLUSIONS: Individuals participating in land-based courses displayed greater decreases in percent body fat when compared to aqua-based courses, whereas both land- and aqua-based displayed improvements in muscular strength and muscular endurance. There were no changes in cardiorespiratory endurance and flexibility within both groups.

Effectiveness of Aquatic Exercises in Women With Rheumatoid Arthritis: A Randomized, Controlled, 16-Week Intervention-The HydRA Trial.

The purpose of this study was to compare the effectiveness of land-based (LB) and water-based (WB) aerobic exercises in women with rheumatoid arthritis (RA). A total of 133 women with RA were included in this randomized, blinded, prospective, 16-week controlled trial. The subjects were randomized into 3 groups: WB (n = 33), LB (n = 33), and control (n = 34). Muscle strength (MS) was measured using an isokinetic dynamometer. Disease activity (DAS-28) and functional ability (health assessment questionnaire) were measured by an expert rheumatologist. Total body densitometry was used to assess body composition. The intervention was performed 3 times per week, and all groups were evaluated at baseline and after 8 and 16 weeks. Compliance, concomitant medications, and adverse events were recorded. The data were analyzed by intention to treat. P < 0.05 was set as significant. Of the 133 patients recruited, 100 were randomized and 82 completed the study. In the first evaluation, the 3 groups were matched to age, body composition, functional capacity, MS, and concomitant medications. After 16 weeks, there were no significant changes of knee MS neither body composition among the groups. However, there was a significant improvement in disease activity and functional ability in the WB after 8 and 16 weeks. Aquatic exercises provided significant improvement in disease activity, pain, and functional capacity.

Effects of two different exercise programs on gait parameters in individuals with Parkinson's disease: A pilot study

To date, little attempt has been made to compare or evaluate the effects of different physical exercise programs on gait disorders in people with Parkinson's disease (PD). This pilot study is aimed at obtaining preliminary data of the effects of two different exercise programs on gait parameters in people with PD by means of a biomechanical three-dimensional motion analysis. Twenty-five individuals with idiopathic PD participated either in a land-based (LB) or in a LB plus water-based (LWB) exercise program for 16 weeks. The efficacy of both exercise programs was quantified by means of a biomechanical gait analysis from which spatiotemporal and sagittal plane kinetic (gait speed, stride length, cadence, stride time, simple support time, double support time) and kinematic (angles of the hip, knee, and ankle joints) variables were recorded. Once the intervention ended, significant changes were observed in stride length and single/double support time variables in all the patients. The intergroup analysis revealed the existence of significant differences only in the gait Speed and hip Angle parameters. Few significant improvements in the amplitude of lower limb joints were found. These results suggest that land-based and land-plus-water-based exercise programs can be considered as a useful physical rehabilitation alternative, both equally capable of improving gait impairment on Parkinson's disease.

The Effect of Aquatic and Land-Based Training on the Metabolic Cost of Walking and Motor Performance in Children with Cerebral Palsy: A Pilot Study

Aim. To evaluate the effects of aquatic (AQ) compared to a land-based (LB) intervention programs on metabolic cost of walking (MCW), gross motor function and locomotor performance in children with cerebral palsy (CP). Methods. Eleven children with spastic diplegic CP completed this study, six in the AQ (5.2 ± 1.45 yrs) and five in the LB group (4.1 ± 1.33 yrs). MCW derived from Oxygen uptake (VO2) measured with a Cosmed K4 device and walking speed at steady state. Additional measures included the 10-m test, Gross Motor Function Measure (GMFM), and Pediatric Evaluation Developmental Inventory (PEDI). Non-parametric statistics were used to analyze change in each group. Results. The AQ group significantly decreased MCW (Z=−2.2; P&lt;.05) and increased steady state walking speed (Z=−2.2; P&lt;.05). Both groups significantly increased 10-m walking speed (Z=−2.2; P&lt;.03, and Z=−2.02; P&lt;.05, resp.). The LB group exhibited moderate to large effect sizes in 10-m self-selected and fast walking speeds (Cohen's d=1.07 and 0.73, resp.). Conclusion. Our findings suggest that Both AQ and LB programs were effective in improving 10-m speed, while the AQ training also improved the MCW of walking at steady state in children with spastic diplegic CP.

Land-Based Versus Water-Based Exercise Program in Elderly with Knee Osteoarthritis

Osteoarthritis (OA) is a chronic-degenerative disorder that frequently affects the knee joint. OA prevalence increases with aging causing pain, stiffness and it is responsible for a higher incidence of disability than any other chronic disease in elderly. Patients with knee OA frequently report pain and problems with daily living activities, and present greater difficulty in performing physical and functional activities. Aerobic exercise, such as walking, has been studied in numerous trials, and the aquatic environment, due to their physical characteristics, is widely used for this practice in individuals with knee OA compared to walking on the soil. PURPOSE: To investigate the effect of land-based (LB) and water-based (WB) exercise training on pain, functional and physical capacity, and quality of life of elderly women with knee OA. Method: 16 elderly women with knee OA confirmed by clinical and radiographic examination underwent assessments of functional performance, by six-minute walk test (6MWT) and stair test (ST), and physical capacity, determined by maximal progressive treadmill test to determine peak oxygen consumption (VO2peak) and anaerobic threshold (AT). OA symptoms were assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and quality of life by Medical Outcomes Study 36 - Item Short Form Health Survey (SF-36). All parameters were reevaluated after 12 weeks of aerobic training in LB and WB. The aerobic training consisted of walking, for 30-55 minutes, at 72-82% of estimated maximal heart rate, 3 times/week. RESULTS: Adherence to exercise in both, LB and WB training was 92%. No significant difference was found in functional and physical performance tests, WOMAC and SF-36 between LB and WB group. However, significant improvements were observed on all evaluated parameters on both groups after training: reduction on self-report pain, increased performance in 6MWT and ST, augment in VO2peak and VO2 corresponding to AT, and improvement of quality of life. CONCLUSIONS: The walking training on LB and WB group improved the functional and physical capacities, reduced self reported pain and improved life quality of elderly women with knee OA but no differences were observed between WB and LB exercise training. Support by: CNPq, CAPES, FAPEMIG, Brazil.

Comparison Of Underwater And Land-based Treadmill Running

Deep water (DW) running with a buoyancy device is popular with sports medicine physicians, physical therapists, and coaches as a part of rehabilitation. Research has found that muscle recruitment and lower extremity kinematics for DW running is different from land-based (LB) running. Running on an underwater (UW) treadmill allows the athlete to reproduce the pattern of limb movement used during LB running. Specially designed shoes have been developed to enhance a runner's kinesthetic perception and mimic LB running. PURPOSE: To compare metabolic and cardiovascular responses during two submaximal UW treadmill trials (barefoot and with specially designed shoes) and LB treadmill running. METHODS: Trained male triathletes (n=13) served as participants (mean ± sd age, ht and wt = 34.3±9.7 years, 182.1±6.2 cm, 79.5±1 kg). Each completed 3 30-min treadmill trials at a workload to elicit 70% max VO2 (established via each respective mode) running on an UW treadmill wearing water running shoes, running on an UW treadmill barefoot, and running on a LB treadmill. VO2 and VCO2 were measured continuously. HR was recorded every minute. RPE was assessed every 2 minutes. Descriptive statistics and repeated measures ANOVA were performed. RESULTS: There were no differences among trials for HR, RER and RPE (p=0.07, 0.56 and 0.14, respectively). There was a difference in VO2 and VCO2 between the barefoot UW trials and LB trials (VO2= 36.4±7.9 and 40.8±4.6 ml.kg.min, respectively, p= 0.01; VCO2 = 34.5±7.7 and 38.3±4.9 ml.kg.min, respectively, p=0.02). These values were not significantly different from UW trials with shoes (VO2 = 39.1±5.6 and VCO2 = 37.2±5.4 ml.kg.min). UW treadmill speed, jet resistance and water temperature were not different between UW trials (p = 0.45, 0.17 and 0.77, respectively). CONCLUSIONS: These findings suggest that UW treadmill running wearing specially designed shoes produces similar metabolic responses as LB running.

Comparison of Maximal Oxygen Consumption During Underwater Treadmill Running and Land-Based Treadmill Running

Underwater (UW) running has emerged as a low load bearing form of supplementary training for cardiovascular fitness, as a way to promote recovery from strenuous exercise while maintaining aerobic fitness, and as a way to prevent injury. Prior studies have reported conflicting results as to whether UW treadmill running elicits similar cardiorespiratory responses to land-based (LB) running. PURPOSE: To compare maximal oxygen consumption (max VO2) during 2 UW treadmill trials (one barefoot and one wearing specially designed underwater running shoes) and a LB treadmill trial to exhaustion. METHODS: Experienced male triathletes (n=14) (mean (sd) age, ht and wt = 35.1±9.8 yrs, 182.1±6.1 cm, and 78.7±11.3 kg, respectively) completed max VO2 trials for each of 3 conditions: running on an UW treadmill with water running shoes, running on an UW treadmill barefoot, and running on a LB treadmill. For UW treadmill trials, participants started at a pre-determined moderately-vigorous pace. Speed was increased 0.5 mph each minute for the first 4 minutes and thereafter jet resistance was increased 10% each minute to exhaustion. For LB treadmill trials, participants began at a predetermined moderately-vigorous pace. Grade was increased 2% every 2 minutes to exhaustion. Descriptive statistics and repeated measures ANOVA were calculated. RESULTS: There was no difference in max VO2 among the trials (max VO2 (ml.kg.min) = 53.0±7.0 for the LB trial, 51.8±8.7 for the UW barefoot trial and 53.2±6.8 for the UW shoe trial, p=0.584). RPE, and RER were not significantly different among the trials (p=, 0.698, and 0.075, respectively). For the UW trials, speed, jet resistance, and water temperature were not significantly different between trials (p=0.678, 0.336, and 0.672, respectively). Maximal HR was significantly greater for the LB trial than for the UW trials (HR = 185.1±13.4 for the LB trial, 172.5±12.8 for the UW shoe trial and 172.8±9.7 for the UW barefoot trial, p=.004). CONCLUSIONS: Maximal aerobic capacity can be accurately assessed on an UW treadmill with less cardiovascular strain.

HEART RATE AND VO2 RESPONSES TO INCREMENTAL EXERCISE WITH LAND AND AQUATIC CYCLING

Hydrostatic pressures enhance venous return to the heart during aquatic exercise, thus increasing stroke volume and reducing heart rate (HR). The current standard in aquatic therapy is to subtract 17 beats from the land-based (LB) HR to achieve an equivalent intensity for warm water (WW) exercise. PURPOSE The purpose of this study was to compare HR (bpm) and VO2 (ml/kg/min) responses to incremental exercise with LB and WW cycling using the 17 beat standard. METHODS Nine healthy subjects (5 males, 4 females, 21 ± 3 yrs) completed an LB graded maximal bicycle test and on a separate day a WW (33.3°C) bicycle test to assess HR and VO2 responses. The LB protocol followed an incremental increase in workload starting at 60% age predicted maximal HR with a 10% increase at each stage (I-V) leading to volitional fatigue. The WW test followed the same protocol with a 17 beat subtraction from LB HR at each stage. RESULTS All subjects met the criteria for volitional fatigue on each exercise test. As expected, peak HR was significantly lower for the WW test as compared to the LB test (185 ± 9.5 vs. 193 ± 7, p < 0.05). Peak VO2 was not significantly different between tests (41.7 ± 10 vs. 41.3 ± 7.1, p > 0.05). The submaximal (SM) HR values (p < 0.05) were significantly lower in water at each exercise stage. The SM VO2 values were also significantly lower in water than on land at each stage: I (13.7 ± 5.5 vs. 19.9 ± 3.9, p < 0.05), II (21.7 ± 5.6 vs. 25.2 ± 5.5, p < 0.05), III (25.2 ± 7.9 vs. 29.8 ± 6.0, p < 0.05) and IV (33.0 ± 5.7 vs. 38.0 ± 8.2, p < 0.05). CONCLUSIONS Despite the difference in peak HR's, peak VO2 values were equivalent. However, the WW values for both HR and VO2 at SM levels were significantly lower than the LB values. The WW HR was lower due to the implementation of the 17 beat subtraction from the LB HR. The observed differences in VO2 at SM levels suggests that the 17 beat land to water HR reduction may not be accurately depicting the same relative exercise intensity between LB and WW exercise.

Effects of pool-based and land-based aerobic exercise on women with fibromyalgia/chronic widespread muscle pain.

To examine the effects of pool-based (PE) and land-based (LE) exercise programs on patients with fibromyalgia. The outcomes were assessed by the Fibromyalgia Impact Questionnaire, the Arthritis Self-Efficacy Scale, and tests of physical capacity. Eighteen subjects in the PE group and 16 in the LE group performed a structured exercise program. After 20 weeks, greater improvement in grip strength was seen in the LE group compared with the PE group (P < 0.05). Statistically significant improvements were seen in both groups in cardiovascular capacity, walking time, and daytime fatigue. In the PE group improvements were also found in number of days of feeling good, self-reported physical impairment, pain, anxiety, and depression. The results were mainly unchanged at 6 months followup. Physical capacity can be increased by exercise, even when the exercise is performed in a warm-water pool. PE programs may have some additional effects on symptoms.

ECG Response to Water and Land Based Exercise in Patients with Cardiovascular

The purpose of this study was to compare the ECG response during land, based (LB) and. water based (WB) exercise rehabilitation of cardiac patients. Thirty-seven patients (JOURNAL/jcrh/04.02/00008483-199001000-00001/ENTITY_OV0335/v/2017-08-08T011905Z/r/image-png age = 55.6 ± 5.0 yrs; 19 Myocardial Infarction; 4 Coronary Bypass Surgery; 5 Angina; 5 Silent Ischemia; 4 Other) completed a maximal exercise test (GXT) (X HRmax= 132 ± 23 bpm; JOURNAL/jcrh/04.02/00008483-199001000-00001/ENTITY_OV0335/v/2017-08-08T011905Z/r/image-png BPmax = 170/85 ± 21/19 mmHg;JOURNAL/jcrh/04.02/00008483-199001000-00001/ENTITY_OV0335/v/2017-08-08T011905Z/r/image-png functional capacity = 9 Mets) and participated in both the LB and WB exercise programs. Both LB and WB were designed to use varying arm and leg exercises eliciting a heart rate response of 70–85% of attained HR max for 40–50 minutes, excluding warm-up and cool down. The ECG was continuously monitored by telemetry during LB and WB, and evaluated for arrhythmias and ST changes. The mean exercise HR was 98 ± 15 bpm and 104 ±17 bpm during LB and swimming WB respectively, which was not significantly different (P > 0.05). Significant ST segment depression was present in 14 subjects during the GXT (38%) and in seven subjects (19%) during both LB and WB (Chi-Square = 4.7; P > 0.05). Ectopy was present in nine (24%) subjects during the GXT and in 14 (38%) and two (5%) subjects during LB and WB respectively (Chi-Square = 11.3; P