Cited by 92Musculoskeletal pain and rehabilitationCardiovascular and exercise physiologySports Performance and Training

The DOI matches its Crossref record; 77 of the 77 references it cites were found in a registry or an index.

Effectiveness of Aquatic Exercise in Improving Lower Limb Strength in Musculoskeletal Conditions: A Systematic Review and Meta-Analysis

Heywood, Sophie, McClelland, Jodie, Mentiplay, Benjamin, Geigle, Paula, Rahmann, Ann, Clark, Ross·2017·Archives of Physical Medicine and Rehabilitation

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.

Overview

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Crossref · 10.1016/j.apmr.2016.08.472

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77 of 77 references verified0 citation errors · 0 not checkable

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Research works printed but not linked: 2

  1. Gulick, 2007, Comparison of aquatic and land plyometric training on strength, power and agility, Journal of Aquatic Physical Therapy, 15, 11
  2. Hillman, 1987, The resistance to motion through water of hydrotherapy table-tennis bats, Physiotherapy, 73, 570

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Metadata

Authors
Heywood, S., McClelland, J., Mentiplay, B., Geigle, P., Rahmann, A., & Clark, R.
Affiliations
  • Australian Catholic University (AU)
  • La Trobe University (AU)
  • University of Maryland, Baltimore (US)
  • University of the Sunshine Coast (AU)
Corresponding author
Heywood, Sophie
Venue
Archives of Physical Medicine and Rehabilitation
Publisher
Elsevier BV
Published
2017-01
Volume
98
Issue
1
Pages
173-186
ISSN
0003-9993 (ISSN-L)
OpenAlex
W2521795822
Cited by
87
References
75
Citations by year
2026: 2 · 2025: 14 · 2024: 7 · 2023: 8 · 2022: 11 · 2021: 15 · 2020: 5 · 2019: 15 · 2018: 8 · 2017: 2
FWCI
1.11
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Physical Medicine and Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
  • Research Bank (Australian Catholic University) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
Keywords
aquatic exercise, lower limb muscle strength, hip abductor strength, quadriceps strength, hamstring strength, musculoskeletal disorders
MeSH terms
Hamstring Muscles, Humans, Musculoskeletal Diseases, Water, Exercise, Randomized Controlled Trials as Topic, Lower Extremity, Quadriceps Muscle, Muscle Strength, Resistance Training

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