PNHS Aquatic Activity 2024

Arianne P. Verhagen PT, MSc, PhD, ... Sita M.A. Bierma-Zeinstra PT, MSc, PhDProf, in Best Practice & Research Clinical Rheumatology, 2012
Aquatic exercise
Aquatic exercises (water-based exercises, aquatic therapy or hydrotherapy), are exercises that are performed in the water. The Chartered Society of Physiotherapists defined aquatic exercises as a therapy program using the properties of water, designed by a suitably qualified physiotherapist, to improve function, ideally in a purpose-built and suitably heated pool [7]. If the clinical decision is to use aquatic exercise as the treatment modality, certain aspects of the intervention should be considered such as: fluid mechanics, temperature, type of exercise (with intensity, frequency and duration), the professional's experience and costs.
Aquatic exercises are frequently used to maintain or improve function for people with musculoskeletal disorders, especially arthritis [8]. Exercise in water is a popular treatment for many patients with musculoskeletal conditions [9]. Aquatic exercise is growing in popularity within the fitness industry and has been a popular way of keeping fit for years, particularly for people with musculoskeletal disorders or those recovering from injury. Water offers natural resistance, which helps strengthen the muscles. The effects of water resistance, for instance drag forces, may increase energy expenditure and decrease mechanical loads on lower extremity joints [10]. The buoyancy of water reduces pressure on the bones, joints and muscles facilitating movement, and may block nociception by acting on thermal receptors and mechanoreceptors, thus influencing spinal segmental mechanisms [11]. Apart from various specific techniques, simple exercises such as general body movements and walking in water might be beneficial because water's natural buoyancy allows many body movements by providing a type of body weight support [12].
In addition to the standard benefits of any exercise such as increased muscle strength, improved aerobic and cardiovascular capacity, the use of water exercise may reduce the risk of muscle or joint injury [13]. The mitigation of gravity by flotation reduces joint stress when stretching, and can allow a greater range of motion and makes aquatic exercises safe for individuals who are able to keep their heads out of water, including the elderly. Aquatic exercise greatly reduces the risk of injury; when they are performed in a low impact manner however, not as many calories are burned as would be with some weight baring activities. When aquatic activities performed at the same pace as many land-based activities they in general expend more energy due to the increased resistance of water, the speed with which movements can be performed is greatly reduced [13]. Due to the inherent resistance of water, to obtain a similar physiological response the travel or transportation speed of movement in water must be approximately half of the speed of movement of land-based exercises. To maintain a constant speed, it is necessary to generate a pulse to overcome the resistance provided in response to drag force on the body [14].
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