Land-based Exercise Research Articles

Effect of aquatic versus land based exercise programs on physical performance in severely burned patients: a randomized controlled trial.

[Purpose] To compare the effect of an aquatic-based versus a land-based exercise regimen on the physical performance of severely burned patients. [Subjects and Methods] Forty patients suffering from severe burn (total body surface area more than 30%) were recruited from several outpatient clinics in Greater Cairo. Their ages ranged between 20 to 40 years and were randomly assigned into two equal groups: group (A), which received an aquatic based exercise program, and group (B), which received a land-based exercise program. The exercise program, which took place in 12 consecutive weeks, consisted of flexibility, endurance, and lower and upper body training. Physical performance was assessed using 30 seconds chair stand test, stair climb test, 30 meter fast paced walk test, time up and go test, 6-minute walk test and a VO2max evaluation. [Results] Significantly increase in the 30 second chair stand, 6-minute walk, 30 meter fast paced walk, stair climb, and VO2 max tests and significantly decrease in the time up and go test in group A (aquatic based exercise) compared with group B (a land-based exercise) at the post treatment. [Conclusion] Twelve-week program of an aquatic program yields improvement in both physical performance and VO2 max in patients with severe burns.

Exercise training programs and detraining in older women

The aim of the study was to evaluate the effects of exercise training programs and detraining. Fifty one aged women participated in two supervised exercise programs: a group of land-based exercise and a group of land-based exercise plus aquatic exercise, both being evaluated at the baseline after nine months of intervention and three months of detraining. After intervention, both groups had decreased blood pressure and improved resistance of the lower and upper limbs. After a detraining period, both groups showed significant increase in blood pressure while resistance of lower and upper limbs, agility and aerobic capacity had a significant decrease.

Exercise for haemophilia.

Haemophilia is a bleeding disorder associated with haemorrhaging into joints and muscles. Exercise is often used to aid recovery after bleeds, and to improve joint function in the presence of arthropathy. Our objective was to systematically review the available evidence on the safety and effectiveness of exercise for people with haemophilia. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register and electronic databases PubMed, OVID-Embase, and CINAHL. We hand searched abstracts from congresses of the World Federation of Hemophilia and the European Hematology Association, trial registries and the reference lists of relevant articles.Date of the last search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register: 14 December 2016. Randomized or quasi-randomized controlled studies comparing any exercise intervention considered relevant in haemophilia management including supervised, unsupervised, aquatic, strengthening, aerobic or cardiovascular, stretching, proprioceptive and balance training exercise programs in males of any age with haemophilia A or B of any severity (those with co-morbidities were not excluded). Two authors reviewed the identified abstracts to determine their eligibility. For studies meeting the inclusion criteria, full articles were obtained. The two authors extracted data and assessed the risk of bias. Any disagreements were resolved by discussion. The authors contacted study investigators to obtain any missing data. Eight studies were included, which represented 233 males with all severities of haemophilia A and B, ranging in age from eight years to 49 years. Study duration ranged from four to 12 weeks. Exercise interventions varied greatly and included resistance exercises, isometric exercises, bicycle ergometry, treadmill walking and hydrotherapy; therefore, comparison between studies was difficult.None of the studies measured or reported adverse effects from the interventions. None of the studies reported outcomes regarding bleed frequency, quality of life or aerobic activity. Overall risk of bias across all studies was assessed as unclear.Very few studies provided sufficient information for comparison. None of the studies reported data that favoured the control group. One study reported that six weeks of resistance training improved joint health status (Colorado score) compared to controls. The addition of pulsed electromagnetic fields also improved ankle scores compared to exercises alone, but this was not seen in the elbows or knees.Two studies reported statistically significant improvements in pain intensity after exercise interventions compared to controls. Hydrotherapy exercises produced significant decreases in pain compared to controls and land-based exercise groups.Two studies found improvement in joint motion in the exercise group compared to controls. One study compared land- and water-based exercises; there was no difference in the range of motion between the two groups; however, the water-based exercise group did show improvement over the control group.One study, comparing joint traction and proprioceptive neuromuscular facilitation for the elbow to a control group, showed no differences in biceps girth or strength after 12 weeks of intervention.Some studies reported comparisons between interventions. In one study, treadmill training significantly improved balance in children compared to bicycle ergometry. Another study added partial weight bearing exercises to quadriceps exercises and showed improved walking tolerance.Four studies evaluated quadriceps or hamstring strength (or both). The addition of bicycle ergometry and exercises with weights was more effective than static exercises and treadmill walking for strengthening knee flexors and extensors. Partial weight-bearing exercises through range were more effective than static and short arc exercises for improving knee extensor strength. The addition of treadmill walking to ultrasound, stretching and strengthening exercises showed increased peak torque of knee flexors and extensors and decrease in knee effusion.The results should be interpreted with caution due to the quality of evidence (GRADE) as outlined in the summary of findings tables, which demonstrates that all but one of the outcomes assessed were rated as low or very low due to the small sample sizes and potential bias. These results must be considered with caution. There is a lack of confidence in the results due to the small number of included studies and the inability to pool the results due to the heterogeneity of outcome measures. Most exercise interventions produced improvement in one or more of the measured outcomes including pain, range of motion, strength and walking tolerance. Hydrotherapy may be more effective than land exercises for pain relief in adults. Functional exercises such as treadmill walking and partial weight bearing exercises seem to be more effective than static or short arc exercises for improving muscle strength. These findings are consistent with the many non-controlled intervention reports in the haemophilia literature. No adverse effects were reported as a result of any of the interventions. However, some groups used prophylactic factor prior to exercise and other groups studied only subjects with moderate haemophilia. Therefore, the safety of these techniques for persons with severe haemophilia remains unclear.

Effects of 8-week swimming training on carotid arterial stiffness and hemodynamics in young overweight adults.

BackgroundExercise has been found to either reduce or increase arterial stiffness. Land-based exercise modalities have been documented as effective physical therapies to decrease arterial stiffness. However, these land-based exercise modalities may not be suitable for overweight individuals, in terms of risks of joint injury. The purpose of this study was to determine the effects of 8-week swimming training and 4-week detraining on carotid arterial stiffness and hemodynamics in young overweight adults.MethodsTwenty young male adults who were overweight were recruited and engaged in 8-week of swimming training and 4-week detraining. Five individuals withdrew due to lack of interest and failure to follow the training protocol. Body Fat Percentage (BFP) and carotid hemodynamic variables were measured on a resting day at the following intervals: baseline, 4 weeks, 8 weeks after swimming training and 4 weeks after detraining. A repeated analysis of variance (ANOVA) was used to assess the differences between baseline and each measurement. When significant differences were detected, Tukey’s test for post hoc comparisons was used.ResultsEight-week swimming training at moderate intensity decreased BFP, including the trunk and four extremities. Additionally, the BFP of the right and left lower extremities continued to decrease in these overweight adults 4 weeks after ceasing training. Carotid arterial stiffness decreased, while there were no significant changes in arterial diameters. Blood flow velocity, flow rate, maximal and mean wall shear stress increased, while systolic blood pressure and peripheral resistance decreased. No significant differences existed in minimal wall shear stress and oscillatory shear stress.ConclusionsEight-week swimming training at moderate intensity exhibited beneficial effects on systolic blood pressure, arterial stiffness and blood supply to the brain in overweight adults. Moreover, maximal and mean wall shear stress increased after training. It is worth noting that these changes in hemodynamics did not last 4 weeks. Therefore, further studies are still warranted to clarify the underlying relationship between improvements in arterial stiffness and alterations in wall shear stress.

The effect of water-based exercises on balance in persons post-stroke: a randomized controlled trial

Objective: Water-based exercises have been used in the rehabilitation of people with stroke, but little is known about the impact of this treatment on balance. This study examined the effect of water-based exercises compared to land-based exercises on the balance of people with sub-acute stroke. Methods: In this single-blind randomized controlled study, 32 patients with first-time stroke discharged from inpatient rehabilitation at West Park Healthcare Centre were recruited. Participants were randomized into W (water-based + land; n = 17) or L (land only; n = 15) exercise groups. Both groups attended therapy two times per week for six weeks. Initial and progression protocols for the water-based exercises (a combination of balance, stretching, and strengthening and endurance training) and land therapy (balance, strength, transfer, gait, and stair training) were devised. Outcomes included the Berg Balance Score, Community Balance and Mobility Score, Timed Up and Go Test, and 2 Minute Walk Test. Results: Baseline characteristics of groups W and L were similar in age, side of stroke, time since stroke, and wait time between inpatient discharge and outpatient therapy on all four outcomes. Pooled change scores from all outcomes showed that significantly greater number of patients in the W-group showed improvement post-training compared to the L-group (p < 0.05). More patients in W-group showed change scores exceeding the published minimal detectable change scores. Discussion: A combination of water- and land-based exercises has potential for improving balance. The results of this study extend the work showing benefit of water-based exercise in chronic and less-impaired stroke groups to patients with sub-acute stroke.

Effects of aquatic exercise on muscle strength and functional performance of individuals with osteoarthritis: a systematic review

Water-based exercises are recommended for people with osteoarthritis (OA), due to the beneficial effects on physical function, quality of life and symptom reduction. However, the effects on muscle strength are still controversial. The aim of this review was to assess and compare the effects of aquatic exercise programs on muscle strength and physical function in people with OA. A systematic search was performed at Pubmed, Scopus and Web of Science databases. Clinical trials with interventions involving aquatic exercises for individuals with OA were included. The methodological quality of the studies was evaluated using the PEDro scale. 296 studies were found and twelve were selected: six studies comparing water-based exercises with land-based exercise, and six comparing water-based exercise groups with the control group. Exercise programs included muscle strengthening, aerobic, balance, flexibility and stretching exercises. Duration of the program, weekly frequency, intensity and progression varied between studies. Beneficial effects of aquatic exercise were found on physical function. However, only two of five studies that assessed muscle strength observed positive effect of aquatic exercise. Although it is difficult to compare studies and establish guidelines for the standardized protocol formulation, it was observed that water-based exercises can be effective on improving physical function and increasing muscle strength, since they are well-structured, with exercise intensity and overload controlled.

Elite sprint swimming performance is enhanced by completion of additional warm-up activities

ABSTRACTThis study investigated the effect of completing additional warm-up strategies in the transition phase between the pool warm up and the start of a race on elite sprint swimming performance. Twenty-five elite swimmers (12 men, 20 ± 3 years; 13 women, 20 ± 2 years, performance standard ~807 FINA2014 points) completed a standardised pool warm up followed by a 30-min transition phase and a 100-m freestyle time trial. During the transition phase, swimmers wore a tracksuit jacket with integrated heating elements and performed a dry land-based exercise routine (Combo), or a conventional tracksuit and remained seated (Control). Start (1.5% ± 1.0%, P = 0.02; mean ± 90% confidence limits) and 100-m time trial (0.8% ± 0.4%, P < 0.01) performances were improved in Combo. Core temperature declined less (−0.2°C ± 0.1°C versus −0.5°C ± 0.1°C, P = 0.02) during the transition phase and total local (trapezius) haemoglobin concentration was greater before the time trial in Combo (81 µM ± 25 µM versus 30 µM ± 18 µM, P < 0.01; mean ± standard deviation) than in Control. Combining swimmers traditional pool warm up with passive heating via heated jackets and completion of dry land-based exercises in the transition phase improves elite sprint swimming performance by ~0.8%.

Effects of Aquatic Exercise on Muscle Strength in Young and Elderly Adults: A Systematic Review and Meta-Analysis of Randomized Trials.

Prado, AKG, Reichert, T, Conceição, MO, Delevatti, RS, Kanitz, AC, and Kruel, LFM. Effects of aquatic exercise on muscle strength in young and elderly adults: a systematic review and meta-analysis of randomized trials. J Strength Cond Res 36(5): 1468-1483, 2022-The effects of training in an aquatic environment on muscular strength are still contradictory in the literature. The aim was to conduct a systematic review and meta-analysis of randomized studies about muscle strength responses after a program of aquatic exercise. A systematic review followed the Cochrane and PRISMA recommendations. The search was performed between December 2015 and January 2016. There were no language restrictions, and PubMed, SCOPUS, Scielo, Cochrane, and PEDro databases were consulted. An analysis of eligibility of the studies was performed by 2 independent authors. The data extraction followed standard criteria, and an evaluation of methodological quality was performed. The statistical analysis was conducted in the Review Manager 5.1 software. The statistical heterogeneity was assessed by means of Cochran's Q test and by the inconsistency test (I2). The search found 2,563 articles, 27 were included, totaling a total n of 1,006 subjects. The analysis of the risk of bias demonstrated a lack of clarity of the randomization process, allocation concealment, blinding assessment, intention to treat analysis, and calculation of the sample in 70% or more of the studies analyzed. Meta-analysis demonstrated a significant increase in handgrip strength, in isometric peak torque (PT) of knee unilateral extension and flexion, and isokinetic PT (60°·s-1) of knee unilateral extension. Sensitivity analyses demonstrated that the positive effects of training in an aquatic environment may be dependent on factors such as age, velocity of movement, and use of device. Land-based and aquatic exercises seem to lead to similar muscle strength gains. Aquatic exercise should be recommended as a strategy to improve muscle strength, but new studies with better methodological quality should be conducted.

Effect of water- versus land-based exercise training as a component of a multidisciplinary intervention program for overweight and obese adolescents

To compare water- versus land-based exercise programs, as part of a multidisciplinary intervention, on physical fitness and health-related quality of life in overweight and obese adolescents. A total of 151 overweight and obese adolescents (age: 13.2±1.8years) were divided into: 1) a water-based intervention (WB; n=28); 2) a land-based intervention (LB; n=57); and 3) a control group (CG; n=66). Anthropometric measures, body composition, flexibility, abdominal strength/endurance, cardiorespiratory fitness and health-related quality of life were assessed prior and by the end of a 16-week intervention. Both the water- and land-based interventions were part of a multidisciplinary program focusing on behavioral changes. Fat Mass (%) was significantly reduced in both intervention groups and a higher progression was observed in the WB group (−9.8±7.2% versus −6.1±6.2%; p<0.05 for pre-to-post changes within-groups). However, LB increased more abdominal strength than WB (69.6±165.8% versus 53.4±83.4%; p<0.05) and significantly increased social (19.7±88.8%), psychosocial (5.1±15.1%) and total score (6.3±14.8%), which was observed in neither WB nor CG. The intervention groups did not change body weight (WB: −1.7±5.3%; LB: 0.1±3.4%; p>0.05 for both groups) and increased (p<0.05) fat-free mass (WB: 4.6±4.0%; LB: 4.4±4.1%), VO2max (WB: 9.3±7.8%; LB: 11.0±13.4%), and physical dimension of quality of life (WB: 9.2±17.2%; LB: 8.9±18.0%) differently of what was observed in CG. The physical dimension improvement observed in the land-based and water-based samples was associated with decreased percentage fat mass (r=0.282 and 0.229; p<0.05). We suggest water- and land-based physical exercises within a multidisciplinary program promote similar improvements in body composition, physical fitness and health-related quality of life in overweight and obese adolescents.

Treadmill training combined with water and land-based exercise programs: Effects on Parkinson's disease patients.

There is a need for studies about the effects of treadmill training (TT) on Parkinson's disease (PD) patients when combined with other exercise training modalities. To identify the effects of a multicomponent rehabilitation program on the illness impact, quality of life and fitness level in Parkinson's disease. Participants were assigned to two exercise groups: water and land-based exercise (WL) or water and land-based exercise plus treadmill training (TWL). The water and land-based exercise group performed one water-based exercise and one land-based exercise session per week for 15 weeks. Participants in the water and land-based exercise plus treadmill training added two sessions of treadmill training to this schedule. The Senior Fitness Test (SFT) was used to assess the sample's fitness level. Participants in the water and land-based exercise Group experienced significant benefits in the disease impact (UPDRS t = 3.083; p = 0.029) and quality of life (PDQ-39 t = 2.942; p = 0.036). The addition of treadmill training did not have any significant effect on these variables. Both programs showed similar effects on the fitness components evaluated. Adding treadmill training to a combination of water and land-based exercise programs may have limited effects on quality of life and the impact on the disease.

Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercise in the management of hip osteoarthritis*

Objectives: The primary objective is to identify effective land-based therapeutic exercise interventions and provide evidence-based recommendations for managing hip osteoarthritis. A secondary objective is to develop an Ottawa Panel evidence-based clinical practice guideline for hip osteoarthritis. Methods: The search strategy and modified selection criteria from a Cochrane review were used. Studies included hip osteoarthritis patients in comparative controlled trials with therapeutic exercise interventions. An Expert Panel arrived at a Delphi survey consensus to endorse the recommendations. The Ottawa Panel hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) considered the study design (level I: randomized controlled trial and level II: controlled clinical trial), statistical significance (p < 0.5), and clinical importance (⩾15% improvement). Results: Four high-quality studies were included, which demonstrated that variations of strength training, stretching, and flexibility exercises are generally effective for improving the management of hip osteoarthritis. Strength training exercises displayed the greatest improvements for pain (Grade A), disability (Grades A and C+), physical function (Grade A), stiffness (Grade A), and range of motion (Grade A) within a short time period (8–24 weeks). Stretching also greatly improved physical function (Grade A), and flexibility exercises improved pain (Grade A), range of motion (Grade A), physical function (Grade A), and stiffness (Grade C+). Conclusion: The Ottawa Panel recommends land-based therapeutic exercise, notably strength training, for management of hip osteoarthritis in reducing pain, stiffness and self-reported disability, and improving physical function and range of motion.

The effect of aquatic exercise on physical functioning in the older adult: a systematic review with meta-analysis.

ageing and sedentary behaviour cause negative changes in the neuromuscular systems of healthy older adults resulting in a decrease in physical functioning. Exercising in water (aquatic exercise, AE) has been shown to be effective at improving physical functioning in this population; however, no systematic review with meta-analysis has been published. to investigate the effect of AE on physical functioning in healthy older adults compared to control or land-based exercise (LE) through a systematic review with meta-analysis of randomised controlled trials. Medline, Embase, Cinahl, PEDro, SPORTDiscus, Web of Science, Cochrane Library, published before 31st December 2015. in total, 28 studies met the inclusion criteria and were included in the systematic review;24 studies with 1,456 subjects (89% female) and with mean age 66.4 years were included in the meta-analysis. data were extracted and checked for accuracy by three independent reviewers. size of treatment effect was measured using the standardised mean difference with 95% confidence intervals (CIs). compared to control interventions, AE had a moderate positive effect on physical functioning 0.70 [95% CI 0.48 to 0.92]. Compared to LE, AE had a small positive effect on physical functioning 0.39 [0.12 to 0.66]. there is a high risk of bias and low methodological quality in the studies particularly when comparing AE to LE with possible over estimation of the benefit of AE. AE may improve physical functioning in healthy older people and is at least as effective as LE.

Glycemic reductions following water- and land-based exercise in patients with type 2 diabetes mellitus

PurposeTo assess the acute glucose responses to the first sessions of three mesocycles of water- and land-based aerobic exercise. MethodsThe water-based exercise group (WBE, n = 14; 54.1 ± 9.1 years) performed deep water walking and/or running, while the land-based exercise group (LBE, n = 11; 60.1 ± 7.3 years) performed walking and/or running on athletic track. In the first mesocycle, patients trained at 85–90% of their anaerobic threshold (AT) for 35 min, progressing to 90–95% of the AT in the second mesocycle, and 95–100% of the AT in the last mesocycle. Capillary glucose was assessed before and immediately after the first session of each mesocycle. ResultsThere was glycemic reduction (p < 0.001) in all sessions, with relative reductions of 19%, 29% and 24% for the WBE and 24%, 29% and 27% for the LBE in the mesocycles 1, 2 and 3, respectively. There were no found differences between groups and between mesocycles. ConclusionsThe acute response of blood glucose to aerobic training between 85 and 100% of the heart rate of AT is effective and independent of the environment in which it is performed. Clinical trial reg. no. NCT01956357, clinicaltrials.gov.

Postexercise Hypotension after Heart Transplant

Heart transplant recipients (HTx) have a high prevalence of hypertension. Although exercise training promotes blood pressure (BP) reduction in HTx, the effects of a single exercise bout are unknown. Thus, we analyzed the acute effects of heated water-based exercise (HEx) versus land-based exercise (LEx) on ambulatory BP (ABP) in HTx. Eighteen (six females) clinically stable HTx (time since surgery = 5.0 ± 0.7 yr) age 45.7 ± 2.7 yr underwent 30 min of HEx (walking inside the pool), LEx (walking on a treadmill), and nonexercise control (CON) intervention in random order (2-5 d between interventions). HEx and LEx intensity was set at 11-13 in the 6-20 RPE scale. Twenty-four-hour (24-h) ABP monitoring was performed after each intervention. No significant differences between interventions were found in 24-h and nighttime BP. However, daytime diastolic BP was significantly lower after HEx than CON (-4 ± 1.6 mm Hg, P = 0.03), and daytime diastolic BP tended to be lower after LEx than CON (-2.3 ± 1.1 mm Hg, P = 0.052). Hourly analysis showed that systolic and diastolic BP values were lower after HEx (average reductions of 6.6 to 12.3 mm Hg, P < 0.01) and LEx (average reductions of 5 to 8.3 mm Hg, P < 0.05) than after CON in several hours. No significant differences between HEx and LEx were found in any ABP data. HEx and LEx promoted similar reductions in ABP of heart transplant recipients, which suggests that they may be a tool to counteract hypertension in this high-risk population.

The impact of hydrotherapy on a patient’s perceived well-being: a critical review of the literature

Background: Physiotherapists commonly use hydrotherapy as a treatment approach for various types of conditions. As hydrotherapy utilizes the hydrodynamic properties of water to promote relaxation and decrease pain perception, previous research has suggested that hydrotherapy may help to decrease the health burden of musculoskeletal (MSK) conditions. The aim of this review was to critically examine literature investigating (a) the benefits of hydrotherapy on reducing pain and disability associated with chronic MSK conditions, and (b) report on literature findings regarding the perceived benefit of hydrotherapy on the well-being of adults with chronic MSK conditions.Methods: Select electronic databases were searched to identify relevant articles. Studies meeting the inclusion criteria were critically analyzed using the Downs and Black protocol with agreement between raters assessed via Kappa analysis.Results: Nine original articles addressing the benefits of hydrotherapy on adult populations with chronic MSK conditions were analyzed. The mean critical appraisal score was 73% (κ = 0.87) with the evidence suggesting that hydrotherapy had a positive effect on pain, quality of life, condition-related disability and functional exercise capacity. It was also noted that following hydrotherapy, the perceived benefit of well-being was superior to land-based exercise protocols in cases where water temperature was within a thermoneutral range (33.5–35.5 °C).Conclusion: Hydrotherapy helps to reduce the health burden of MSK conditions. Improvements in the perception of well-being are likely to occur following hydrotherapy that is conducted in water within the thermoneutral range.

A comparative study of the effects of trunk exercise program in aquatic and land-based therapy on gait in hemiplegic stroke patients.

[Purpose] The purpose of this study was to compare the effects of aquatic and land-based trunk exercise program on gait in stroke patients. [Subjects and Methods] The subjects were 28 hemiplegic stroke patients (20 males, 8 females). The subjects performed a trunk exercise program for a total of four weeks. [Results] Walking speed and cycle, stance phase and stride length of the affected side, and the symmetry index of the stance phase significantly improved after the aquatic and land-based trunk exercise program. [Conclusion] These results suggest that the aquatic and land-based trunk exercise program may help improve gait performance ability after stroke.

Effects of exercise and manual therapy on pain associated with hip osteoarthritis: a systematic review and meta-analysis

AimTo explore the effects of exercise (water-based or land-based) and/or manual therapies on pain in adults with clinically and/or radiographically diagnosed hip osteoarthritis (OA).MethodsA systematic review and meta-analysis was performed,...

The Effects of Water-Based Exercise on Muscle activity and Gait Ability in Stroke Patients

Purpose: This study attempts to determine the effects of water-based exercise performed on stroke patients in their muscle activity of lower extremity and gait ability tests. Methods: The subjects were 20 stroke patients, who were randomly divided into a water-based exercise group and a land-based exercise group, each including 10 patients. Both exercises were performed 3 days per week, for 40 minutes a day, for a period of eight weeks. Results: The water-based exercise group showed a greater increase in muscle activity of lower extremity compared to the land-based exercise group. The water-based exercise group showed a greater increase in gait ability than the land-based group, showing a significant difference and better efficiency of water-based exercise when compared to land-based exercise. Conclusion: From the result of this study, we found that water-based exercises are more effective in improving muscle activity of lower extremity and gait ability. The patient is considered to be used by itself to involve the treatment and the risk of falling from the lowered state into the treatment method for the intensive treatment of stroke patients to be useful in improving the strength and ability to walk.

Effects of Swimming and Cycling Exercise Intervention on Vascular Function in Patients With Osteoarthritis

Swimming exercise is an ideal and excellent form of exercise for patients with osteoarthritis (OA). However, there is no scientific evidence that regular swimming reduces vascular dysfunction and inflammation and elicits similar benefits compared with land-based exercises such as cycling in terms of reducing vascular dysfunction and inflammation in patients with OA. Forty-eight middle-aged and older patients with OA were randomly assigned to swimming or cycling training groups. Cycling training was included as a non-weight-bearing land-based comparison group. After 12 weeks of supervised exercise training, central arterial stiffness, as determined by carotid-femoral pulse wave velocity, and carotid artery stiffness, through simultaneous ultrasound and applanation tonometry, decreased significantly after both swimming and cycling training. Vascular endothelial function, as determined by brachial flow-mediated dilation, increased significantly after swimming but not after cycling training. Both swimming and cycling interventions reduced interleukin-6 levels, whereas no changes were observed in other inflammatory markers. In conclusion, these results indicate that regular swimming exercise can exert similar or even superior effects on vascular function and inflammatory markers compared with land-based cycling exercise in patients with OA who often has an increased risk of developing cardiovascular disease.

Adjunctive therapies in addition to land-based exercise therapy for osteoarthritis of the hip or knee

Adjunctive therapies in addition to land-based exercise therapy for osteoarthritis of the hip or knee