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Deep Water Running (DWR) is a form of aquatic aerobic exercise simulating the running patterns adopted on dry land. Little is known on the effectiveness of DWR despite gaining popularity. The objective of this study is to systematically review the effects of DWR on cardiorespiratory fitness, physical function, and quality of life in healthy and clinical populations. A systematic search was completed using six databases, including SPORTDiscus, MEDLINE, CINAHL, AMED, Embase, and The Cochrane Library, up to February 2022. Eleven studies evaluating the effectiveness of DWR on cardiorespiratory fitness (CRF), physical function, or quality of life (QoL), compared with no interventions (or standard treatment) or land-based trainings were identified. Data relevant to the review questions were extracted by two independent reviewers when means and standard deviations were reported, and standardized mean differences were calculated. A quality assessment was conducted using selected items from the Downs and Black checklist. A total of 11 clinical trials (7 randomized controlled trials) with a total of 287 participants were included. Meta-analyses were not completed due to the high level of clinical and statistical heterogeneity between studies. Compared with land-based training, DWR showed similar effects on CRF with limited studies reporting outcomes of physical function and QoL compared with the no-exercise control group. DWR appears to be comparable to land-based training for improving CRF. The aquatic environment may provide some advantages for off-loaded exercise at high intensity in populations that are weak, injured or in pain, but more studies are required.

Background and Purpose: Parkinson disease (PD) has effects on an individual's balance, and Ai Chi can be used to improve balance and gait performance. The aim of this study was to investigate the effectiveness of Ai Chi in improving the balance and gait of individuals with idiopathic PD. Method: Ten individuals with PD at Hoehn and Yahr stages 1-3 were included in this 6-week study. Participants underwent a structured Ai Chi program (1 hour per session, twice weekly) for 6 weeks (12 sessions in total). Balance was assessed at baseline and week 6 using the Timed Up and Go (TUG) test, the Five Times Sit-to-Stand (FTSTS) test, the Four Square Step Test (FSST), the Ten Meter Walk Test (10MWT), and the Sensory Organization Test (SOT). Gait parameters were measured by inertial measurement units and videotaping for 2-dimentional motion analysis. Surface electromyography was used for measuring muscle activity during gait in the bilateral rectus femoris, biceps femoris, gastrocnemius, and tibialis anterior. Results: In a pre- and postintervention comparison, significant improvements were observed in the FTSTS, FSST, and TUG scores as well as in the composite, vision, and vestibular scores in the 10MWT and SOT (P < .005). The results indicated improvement in balance. As for the gait analysis, no significant differences were observed in spatiotemporal parameters, including speed, cadence, step length, stride length, step duration, stride duration, swing-phase duration, stance-phase duration, and double support duration. Insignificant changes in the percentage maximum voluntary contraction of all the muscles examined were found, while a significant decrease in maximum voluntary contraction was identified in the left biceps femoris. Conclusions: The Ai Chi program produced a significant improvement in balance in individuals with PD, with insignificant results shown in gait. Ai Chi is an appropriate intervention to improve balance in individuals with PD.

Background The accuracy of measurement of cardiometabolic functions of individuals is crucial. The objective of this study was to compare the validity and reliability of the PNOE in measuring cardiometabolic outcomes in the expired air of healthy individuals, during a treadmill walking protocol. Methods A total of 21 subjects (15 male, 6 females) aged 22.76 ± 3.85 years took part in this study. Oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory exchange ratio (RER), metabolic equivalent (MET), ventilatory threshold (VT), energy expenditure (EE) was measured by PNOE and COSMED K5 portable systems during a four-stage incremental protocol on a treadmill. Test-retest reliability was tested on separate days with trail repetition. Validity was evaluated by Bland-Altman plots, intraclass correlation coefficients (ICC) and mean percentage difference. Results ICC found in VCO2 is in the good range (0.75–0.90). ICC of RER from level 1–3 and VT of level 2–4 fall in good to excellent reliability. No specific pattern seen on VO2, VCO2 and EE on the changes of CV upon speeds variations. Pearson’s correlation coefficient was moderately high (r = 0.60–0.79) between metabolic variables measured by PNOE and K5 systems. All subjects, except few more cases in VT, lie within the upper and lower 95% confidence intervals acceptance range of the Bland Altman plots. Conclusion PNOE system is a valid and reliable measure for cardiometabolic outcomes and is as comparable to COSMED K5 system.

Aquatic treadmill running is a partial weight-bearing exercise for rehabilitation. The purpose of this study was to investigate the surface electromyography activities of the rectus femoris, tibialis anterior, biceps femoris and medial head of gastrocnemius, and gait kinematics during aquatic treadmill running in water levels at waist, mid-thigh and mid-shin and on land. Seventeen healthy subjects (9 males and 8 females) were recruited by convenience sampling. Participants performed 2-min aquatic treadmill running at a specific speed for each water depth. The test speed was selected based upon the speed that elicited 110 steps per min. The surface electromyography data of lower limb muscles and the joint angles at three different water depths and on land were collected to evaluate the muscle activity and gait kinematics using a waterproofed surface electromyography system and inertial measurement unit for each muscle. Results showed that rectus femoris electromyography was different between depths during the swing and stance phases. Likewise, biceps femoris and tibialis anterior electromyography were different between depths for the swing phase. However, it was not the case for gastrocnemius electromyography. Peak flexion angles in both left and right hips were different between depths. A significant increase in a stance/swing ratio was observed with rising water depths. Water depth influenced muscle activity as well as kinematics. Aquatic treadmill running in the mid-thigh level should be further evaluated for its effectiveness, training value and applicability.