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The effectiveness of aquatic exercise in improving lower limb strength in musculoskeletal conditions: A systematic review and meta-analysis
Heywood, Sophie McClelland, Jodie A. Mentiplay, Benjamin Geigle, Paula Rahmann, Ann Clark, Ross
Heywood, Sophie
McClelland, Jodie A.
Mentiplay, Benjamin
Geigle, Paula
Rahmann, Ann
Clark, Ross
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 trainingcomponent 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 PhysiotherapyEvidence 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
hydrotherapy, muscle strength, rehabilitation, resistance training
Date
2017
Type
Journal article
Journal
Archives of Physical Medicine and Rehabilitation
Book
Volume
98
Issue
1
Page Range
173-186
Article Number
ACU Department
School of Allied Health
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled