Abstract
Objective
To investigate the effectiveness of aquatic exercise in improving lower limb strength
in people with musculoskeletal conditions.
Data Sources
A systematic search used 5 databases, including MEDLINE, CINAHL, Embase, SPORTDiscus,
and The Cochrane Library.
Study Selection
Randomized controlled trials evaluating aquatic exercise with a resistance training
component for adults with musculoskeletal conditions compared with no intervention
or land-based exercise were identified. Fifteen studies from the initial yield of
1214 met these criteria.
Data Extraction
Data related to participant demographics, study design, and methods, interventions,
and outcomes, including numerical means and SDs, were extracted independently by 2
reviewers.
Data Synthesis
Nine of the 15 studies were of high quality, scoring at least 6 on the Physiotherapy
Evidence Database Scale. Limited consideration of the prescription of resistance in
the aquatic exercise and application of resistance training principles existed. Low-
or very low–quality evidence indicates there was no difference in average effect between
aquatic exercise and no exercise in improving hip abductor strength (standardized
mean difference [SMD], .28; 95% confidence interval [CI], −.04 to .59), knee extensor
strength (SMD, .18; 95% CI, −.03 to .40), knee flexor strength (SMD, .13; 95% CI,
−.20 to .45), or lower limb endurance (SMD, .35; 95% CI, −.06 to .77). Low-quality
evidence indicates no difference in average effect between aquatic and land exercise
for knee extensor (SMD, −.24; 95% CI, −.49 to .02) or flexor strength (SMD, −.15;
95% CI, −.53 to .22).
Conclusions
It is likely that the inadequate application of resistance in water is a significant
contributor to the limited effectiveness of aquatic exercise interventions in improving
hip and knee muscle strength in people with musculoskeletal conditions. Future research
is needed to quantify resistance with aquatic exercises and to determine if using
opportunities for greater resistance in aquatic rehabilitation and appropriate resistance
training principles can be more effective in improving muscle strength.
Keywords
List of abbreviations:
CI (confidence interval), RM (repetition maximum), SMD (standardized mean difference)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 22, 2016
Footnotes
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
