Underwater Treadmill Exercise Research Articles

A study using a canine hydrotherapy treadmill at five different conditions to kinematically assess range of motion of the thoracolumbar spine in dogs

Incline treadmill and underwater treadmill (UWTM) exercises are common canine rehabilitation modalities , which are often used in isolation in dogs recovering from spinal surgery. Early use of an incline during UWTM exercise may have the potential to improve rehabilitation outcomes in dogs, but, it is hypothesised that dorsoventral movement of the spine may be excessive meaning it is unsuitable in some circumstances. The purpose of this study was to identify changes in canine spinal kinematics in dogs when using a dry treadmill at different angles of incline compared to an underwater treadmill using the same inclines. Eight dogs were encouraged to walk on a dry, horizontal, underwater treadmill as well as under the same conditions with both a 10% and 20% incline. This was then repeated at a 10% and 20% incline with the addition of water to hock level. Data were collected using reflective anatomical markers placed at the occipital protuberance, T1, T13, L3, L7 and sacral apex, captured by a high-speed camera facing the lateral aspect of the treadmill. Dorsoventral motion of the spine as well as flexion, extension and range of motion (ROM) of T1, T13, L3 and L7 were recorded. We found significant differences in dorsoventral spinal ROM at T1, L3 and L7, but no significant differences in T13 ROM. No significant differences were found in flexion and extension of any of the joints assessed when comparing dry conditions to the use of water (P>0.05). The lack of significant differences in joint flexion and extension at T1, T13, L3 and L7 indicates the potential safe use of combining underwater treadmill and incline exercise in canine rehabilitation. However, a lack of uniformity in results makes distinguishing any patterns of significance difficult. More research is needed to establish the effects of these exercises in additional planes of motion before a treatment protocol can be established.

Design of an Underwater Treadmill System for rehabilitation of older obese adults: a pre-post study

BackgroundPatients with knee osteoarthritis (OA) who are obese have problems performing land-based exercises. The reduced joint stress associated with aquatic exercise may benefit these patients. This study aimed to develop an underwater treadmill (UTM) machine that is affordable and suitable for use in developing countries, and to evaluate its efficacy in decreasing pain and increasing functional improvement.MethodsClinical testing of the UTM machine was performed in an outpatient setting at Siriraj Hospital during January–June 2017. Patients with knee OA, aged 50–85 years, numerical rating scale (NRS) ≥5/10, and body mass index (BMI) ≥25 kg/m 2 were recruited. The UTM exercise protocol was 30 min/session, 3 days/week, for 4 weeks. The main outcomes were NRS pain score, 6-min walk distance (6MWD), quadriceps strength (QS) and body weight. Those outcomes were evaluated at baseline and at week 4.ResultsThe UTM was constructed with safety, ergonomically designed and user-friendly control panel with push button for emergency stopping. Thirty patients were included for clinical testing. The mean age was 62.8 years, and almost all were female. The mean BMI was 28.9 kg/m 2. Most patients (65.0%) developed bilateral knee OA, used pain medication (56.7%), and engaged in regular knee exercise (73.3%). Of the 30 enrolled patients, 6 withdrew. All of the remaining 24 patients attended all 12 sessions. The mean difference between baseline and the end of the study was − 2.3 (95% CI: − 3.0, − 1.5; p < 0.001) for NRS pain; 34.9 m (95% CI: 14.1, 55.8; p = 0.002) for 6MWD; and, 1.8 kg (95% CI, 1.1, 2.6; p < 0.001) for QS. Concerning adverse events, 4 patients (15.4%) developed muscle pain, 2 patients (7.7%) had joint pain, and 1 patient (3.9%) withdrew due to severe knee pain. Two-thirds of patients described themselves as being ‘very satisfied’ with UTM exercise, and approximately 90% of participants rated their symptoms as ‘improved’ or ‘much improved’.Conclusions4-week exercise with UTM can significantly improve NRS pain, 6MWD, and QS. UTM could be an alternative treatment for patients with knee OA who are obese due to small size, durability, and ecofriendly design as an exercise modality.

Workload and kinematics of horses during underwater treadmill exercise

Workload and kinematics of horses during underwater treadmill exercise

Is four-week underwater treadmill exercise regimen compared to home exercise efficacious for pain relief and functional improvement in obese patients with knee osteoarthritis? A randomized controlled trial

Objective: To investigate the efficacy of a four-week underwater treadmill exercise regimen compared to a home exercise regimen relative to pain relief and functional improvement in obese patients with knee osteoarthritis. Design: Single-blind randomized controlled trial. Setting: Outpatient. Participants: Eighty primary knee osteoarthritis with pain ⩾5/10 and body mass index ⩾25 kg/m2. Interventions: Daily quadriceps exercise at home for 30 minutes (control group) or underwater treadmill exercise (study group) for 30 minutes/day, three times/week for four weeks. Main outcomes: Pain score, six-minute walking distance, quadriceps strength, and body weight were evaluated at baseline and after four weeks. Adverse events, global assessment, and satisfaction index were assessed at the end of study. Results: All outcomes in both groups were significantly improved at the end of the study, except for body weight. The mean difference (95% confidence interval (CI)) in outcomes between groups were −0.53 (−1.31, 0.26) for pain; 10.81 (−11.9, 33.53) meters for 6-minute walking distance; 0.67 (−0.10, 1.44) kilograms for quadriceps strength; and 0.01 (−0.66, 0.68) kilograms for body weight. No significant differences were observed between groups, for the per protocol analysis or the intention-to-treat analysis. Participants in the study group evaluated significantly better global improvement and higher patient satisfaction than those in control group (13 (39.4%) vs. 4 (10.8%); P = 0.014 and 23 (69.7%) vs. 16 (43.2%); P = 0.021, respectively). Conclusion: Exercise using an underwater treadmill was found to be as efficacious as home exercise for relieving pain and improving function in obese people with mild to moderate knee osteoarthritis.

Effect of water depth on limb kinematics of the domestic dog (Canis lupus familiaris) during underwater treadmill exercise

Canine hydrotherapy is an increasingly popular modality for the rehabilitation of dogs; however, little evidence exists to support the use of current hydrotherapy protocols. Before data can be meaningfully collected from pathological animals, biomechanical data for healthy animals is required. Kinematic analysis was utilised to observe the effect of increasing water depth on the stride parameters (including duty factor) of dogs exercising on a canine hydrotherapy treadmill. During two sessions, eight clinically sound adult dogs walked on the underwater treadmill at four different water depths (dry, mid-tarsal, between the lateral malleolus and the lateral epicondyle, and between the lateral epicondyle and greater trochanter). Reflective kinematic markers were placed onto anatomical limb landmarks and a video camera was used to record foot contacts at 60 Hz. Data were digitised using video analysis software and stride length, stride frequency and duty factor were subsequently calculated. Data were analysed using the Friedman Test and Wilcoxon post hoc pairwise tests to identify differences between conditions. There was a significant effect of water depth on duty factor (P&lt;0.0005). Hind limb duty factor differed significantly from fore limb duty factor (P&lt;0.0005), except at the depth between the lateral malleolus and the lateral epicondyle where no significant difference was observed. There was a significant effect of water depth on both stride frequency (P&lt;0.0005) and stride length (P&lt;0.0005). In summary, water depth has a significant impact on the stride parameters of dogs exercising on the canine hydrotherapy treadmill and as such is an important consideration when designing underwater treadmill based rehabilitation programs.

Cardiovascular response during submaximal underwater treadmill exercise in stroke patients.

ObjectiveTo evaluate the cardiovascular response during head-out water immersion, underwater treadmill gait, and land treadmill gait in stroke patients.MethodsTen stroke patients were recruited for underwater and land treadmill gait sessions. Each session was 40 minutes long; 5 minutes for standing rest on land, 5 minutes for standing rest in water or on treadmill, 20 minutes for treadmill walking in water or on land, 5 minutes for standing rest in water or on treadmill, and 5 minutes for standing rest on land. Blood pressure (BP) and heart rate (HR) were measured during each session. In order to estimate the cardiovascular workload and myocardial oxygen demand, the rate pressure product (RPP) value was calculated by multiplying systolic BP (SBP) by HR.ResultsSBP, DBP, mean BP (mBP), and RPP decreased significantly after water immersion, but HR was unchanged. During underwater and land treadmill gait, SBP, mBP, DBP, RPP, and HR increased. However, the mean maximum increases in BP, HR and RPP of underwater treadmill walking were significantly lower than that of land treadmill walking.ConclusionStroke patients showed different cardiovascular responses during water immersion and underwater gait as opposed to standing and treadmill-walking on land. Water immersion and aquatic treadmill gait may reduce the workload of the cardiovascular system. This study suggested that underwater treadmill may be a safe and useful option for cardiovascular fitness and early ambulation in stroke rehabilitation.

Effect of underwater treadmill exercise on postural sway in horses with experimentally induced carpal joint osteoarthritis

To evaluate the effect of underwater treadmill exercise on static postural sway in horses with experimentally induced carpal joint osteoarthritis under various stance conditions. 16 horses. On day 0, osteoarthritis was induced arthroscopically in 1 randomly selected middle carpal joint of each horse. Beginning on day 15, horses were assigned to either underwater or overground (without water) treadmill exercise at the same speed, frequency, and duration. Two serial force platforms were used to collect postural sway data from each horse on study days -7, 14, 42, and 70. Horses were made to stand stationary on the force platforms under 3 stance conditions: normal square stance, base-narrow placement of the thoracic limbs, and removal of visual cues (blindfolded) during a normal square stance. The mean of 3 consecutive, 10-second trials in each condition was calculated and used for analysis. Displacement of the center of pressure differed significantly depending on the stance condition. Among horses exercised on the underwater treadmill, postural stability in both the base-narrow and blindfolded stance conditions improved, compared with findings for horses exercised on the overground treadmill. Horses exercised on the overground treadmill were only successful at maintaining a stable center of pressure during the normal square stance position. Variations in stance position had profound effects on the mechanics of standing balance in horses with experimentally induced carpal joint osteoarthritis. Underwater treadmill exercise significantly improved the horses' postural stability, which is fundamental in providing evidence-based support for equine aquatic exercise.

A Review of Biophysical Differences between Aquatic and Land-Based Exercise

Four of the most popular modes of aquatic exercise are deep-water (DW) exercise, shallow water (SW) exercise, water calisthenics (WC), and underwater treadmill (UT) exercise. The mechanical requirements of each aquatic exercise mode may elicit different physiological and biomechanical responses. The purpose of this descriptive literature review was to evaluate some biophysical differences between aquatic and land-based exercises. The biophysical variables included oxygen consumption (VO2), heart rate (HR), rating of perceived exertion (RPE), stride length, stride frequency, pain, and measures of functional gain. Based on the studies reviewed, when compared to similar land-based exercises, VO2 and HR maximum values were lower during DW and SW exercise, but, depending on water depth and exercise performed, may be greater during WC and UT exercise. RPE during DW exercise was generally similar to land exercise during max effort. Stride frequency tended to be lower for all four aquatic exercises, relative to on-land counterparts. Pain levels tended to be similar between WC and land exercise, yet may decrease after UT exercise.

VO&lt;SUB&gt;2&lt;/SUB&gt; Prediction and Cardiorespiratory Responses During Underwater Treadmill Exercise

VO&lt;SUB&gt;2&lt;/SUB&gt; Prediction and Cardiorespiratory Responses During Underwater Treadmill Exercise

VO2 Prediction and Cardiorespiratory Responses During Underwater Treadmill Exercise

We compared cardiorespiratory responses to exercise on an underwater treadmill (UTM) and land treadmill (LTM) and derived an equation to estimate oxygen consumption (VO2) during UTM exercise. Fifty-five men and women completed one LTM and five UTM exercise sessions on separate days. The UTM sessions consisted of chest-deep immersion, with 0, 25, 50, 75, and 100% water-jet resistance. All session treadmill velocities increased every 3 min from 53.6 to 187.8 m·min-1. Cardiorespiratory responses were similar between LTM and UTM when jet resistance for UTM was ≥ 50%. Using multiple regression analysis, weight-relative VO2 could be estimated as: VO2 (mLO2·kg-1·min-1) = 0.19248 · height (cm) + 0.17422 · jet resistance (% max) + 0.14092 · velocity (m·min-1) - 0.12794 · weight (kg) - 27.82849, R2= .82. Our data indicate that similar LTM and UTM cardiorespiratory responses are achievable, and we provide a reasonable estimate of UTM VO2.

Underwater Treadmill Training in High School Cross Country Runners

Underwater treadmill exercise (UTM) is emerging as an innovative method of athlete rehabilitation but there has been little research on its injury prevention and performance enhancement. The low-impact nature of UTM has been suggested to expedite injury recovery while providing a cardiovascular training effect similar to dry-land exercise. PURPOSE: To assess overuse symptoms and injury rate of a UTM exercise intervention on a high school cross country team. We hypothesized that the UTM would decrease the orthopedic problems in these young athletes who are susceptible to a high rate of overuse symptoms. METHODS: 16 subjects (16 ± 2 yr) exercised on a HydroWorx™ UTM in groups of 2-4 runners for 30-45 minutes, 1-2 times per week for 10 weeks in place of a dry-land practice. UTM was submerged to the level of the xyphoid process. Runners began with a 6 to 10 minute dynamic warm-up at an RPE of 1-2 / 10. Workouts then emphasized either low intensity (avg UTM speed 148 m/min, 25% flow from horizontal jets, RPE 3-6) or speed (avg speed 188 m/min, 70% jet flow, RPE 5-10). Daily questionnaires regarding injuries, discomfort, flexibility, and performance were administered before dry land and UTM practices. Race times were gathered and follow-up surveys were completed at the conclusion of the season. RESULTS: For the season there were two injuries (one male and one female) resulting in one missed meet each and thus a rate of 1.8 injuries/1000 athletic exposures (AE). There were five minor orthopedic complaints (shin splints and hip pain) not serious enough to miss meets but resulting in missed practices. This injury rate was a great improvement over the previous season as well as historical controls (which suggest a rate of 17/1000 AE). As well as could be compared to the previous year, race times were not consistently faster. CONCLUSION: The young runners were enthusiastic about the UTM experience. Quotes supporting our observed reduction in overuse symptoms included: "easier on your knees," "it's better than sprinting outside all the time" and from the coach "they like it a lot, otherwise they would not come." With our small sample size we cannot say for sure that the benefits observed were only due to the UTM. Future research, including any measurable performance benefits, would need to be done on a larger sample over several seasons.

Health Benefits Of Underwater Treadmill Exercise For Active Adults

Health Benefits Of Underwater Treadmill Exercise For Active Adults

Underwater Treadmill Exercise as a Potential Treatment for Adults With Osteoarthritis

This study examined the acute effects of underwater and land treadmill exercise on oxygen consumption (VO2), perceived pain, and mobility. Nineteen participants diagnosed with osteoarthritis performed three consecutive exercise sessions for each mode of exercise. VO2 and perceived pain were recorded during each exercise session and Timed Up & Go (TUG) scores were measured before and after each intervention. VO2 values were not different between conditions during moderate intensities, but were 37% greater during low intensity exercise on land than in water (p = 0.001). Perceived pain and TUG scores were 140% and 240% greater, respectively, for land than underwater treadmill exercise (p = 0.01). Patients diagnosed with OA may walk on an underwater treadmill at a moderate intensity with less pain and equivalent energy expenditures compared to walking on a land based treadmill. Unexpectedly, OA patients displayed greater mobility and balance after underwater than land treadmill exercise when assessed with the TUG.

Underwater treadmill training in adults with incomplete spinal cord injuries

Gravity. We spend our lives fighting it . One day it will win, as it always does. Until then, much of what we call quality of life is based on our ability to resist the effects of gravity and to be functionally mobile at home, at school, at work, and in our community. For those with physic al disabilities, the challenge is greater and the stakes are higher. To counter the loss of mobility , strength, and endurance that often accompanies a disabling condition, a variety of interventions has been studied to improve physical fitness and reduce the weight-bearing challenges associated with walking. Several of these systems involve supporting a portion of a person's body weight with a harness during overground walking or land-based treadmill exercise [1]. This editorial describes an innovative method to unload body weight that allows a person with a gait impairment to walk on a treadmill submerged in a water tank (see Underwater Treadmill Training Videos 1 and 2). UNDERWATER TREADMILL Our interest in this unique therapeutic approach follows earlier studies that examined the evolution of gait in nondisabled youth and documented the influence of growth and maturation on the energy cost of walking. This research effort compared the aerobic demands of walking in nondisabled youth and children with cerebral palsy (CP). Results indicated that locomotor energy use was much higher in youth with CP [2]. Realizing that higher ambulatory energy use could help explain the fatigue often experienced by children with CP during extended walking bouts, training interventions to improve locomotor efficiency in this population were investigated. One such intervention was the implementation of an aquatics-based treadmill walking program to reduce the energy cost of walking and increase overall fitness and mobility in youth with CP. Because aquatic exercise is less damaging to joint integrity , it can be an effective alternative to land-based exercise programs in persons with lower-limb joint weakness and balance problems. Gait training can also be performed in a very controlled setting with an underwater treadmill because speed, water depth, and water temperature can be easily manipulated and reproduced. Other advantages of underwater treadmill exercise include the similarity of muscle activity and gait patterns used in land walking, minimization of postural distortions, greater weight-bearing support for deconditioned individuals, increased leg strength gained by overcoming water resistance and turbulence, and decreased pain levels. The preliminary findings from this research in ambulatory youth with CP suggest that a number of fitness a nd mobility variables can be improved following an underwater treadmill training program incorporating the gradual, systematic, and overlapping manipulation of water height, gait speed, and walking duration. UNDERWATER TREADMILL WITH SPINAL CORD INJURIES Based on these initial findings we explored the possibility of applying this therapeutic regimen to individuals experiencing a greater degree of mobility impairment. After much dicussion, we decided to document the impact of underwater treadmill training in adults with incomplete spinal cord injuries (SCIs). Because impairments associated with SCI are often considered permanent and ireparable, even slight improvements in physical function are noteworthy. We chose to train adults with SCI to differentiate their responses from those of children with neural impairment, who exhibit nervous systems that are still somewhat plastic and whose ability to recover from injury is more dynamic than adults. In addition, SCIs are stable and do not progressively worsen like diseases such as cancer or multiple sclerosis. Accordingly, factors that could potentially confound the interpretation of study findings are often not present. Because individuals with SCI typically experience some degree of injury resolution during the initial healing period, we enrolled participants whose injuries were more than a year old and unlikely to improve without some type of clinical intervention. …

The cardio-respiratory response to underwater treadmill exercise in the American lobster

The cardio-respiratory response to underwater treadmill exercise in the American lobster