Comparing the effects of aquatic exercises with or without high intensity on the functional status, muscular endurance, and performance of patients with chronic low back pain

Aquatic high-intensity interval training (HIIT) may be similarly effective to land-based HIIT in improving exercise capacity in people with chronic conditions: a systematic review and meta-analysis

“…A total of 868 participants are included in this review. The main characteristics of the included studies are listed in table 1.The studies included 325 participants with musculoskeletal conditions, including chronic low back pain, knee osteoarthritis and fibromyalgia44 61–65; 188 participants with respiratory conditions, including chronic obstructive pulmonary disease and asthma60 66–68; 146 participants with cardiovascular conditions, including mild arterial hypertension, and peripheral artery disease46 69; 127 participants with metabolic conditions, including dyslipidaemia, diabetes type 2, polycystic ovary syndrome and obesity43 45 70; and 82 participants with neurological conditions, including chronic motor incomplete spinal cord injury, multiple sclerosis and chronic stroke 71–73. A total of 74% of the participants were female (n=640).…”

“…A total of 74% of the participants were female (n=640). In six of the studies participants were excluded if they had comorbidities,44 61 63 67 68 72 and in four studies participants’ comorbidities were reported 45 65 66 69. Comorbidities reported were musculoskeletal (arthritis, osteoporosis, disc protrusion), cardiovascular (mild arterial hypertension, peripheral artery disease, cardiac or other vascular diseases) and metabolic conditions (obesity, diabetes mellitus, dyslipidaemia, thyroid dysfunction and insulin resistance) 45 65 66 69…”

“…Water temperature was between 26°C and 33°C in the studies, predominantly with temperatures between 28°C and 32°C 44 61 62 65 67 69 70 72 73. In three trials participants were immersed to the level of xiphoid process43 70 71 and in five trials head out of water 46 62–65. In two trials participants were immersed in levels of waist to chest 66 69…”

“…A number of trials (39%) evaluated the effect of AHIIT versus a non-intervention control group,43–45 61 67 69 73 four trials (22%) evaluated the effect of AHIIT versus LBHIIT,60 62 66 72 four trials evaluated AHIIT versus AMICT,63–65 71 and three trials were three armed and evaluated AHIIT versus LBHIIT and control,68 AHIIT versus aquatic resistance and aerobic combination training and a control group,70 and AHIIT versus aquatic moderate intensity exercise and a control group 46. The target training intensity profiles were matched in all LBHIIT and AHIIT studies60 62 66 72 and were increased in a similar way for LBHIIT and AHIIT during the exercise programme.…”

“…Seven studies (39%) had exercise capacity as primary outcome,60 61 65 70–73 11 as a secondary outcome (61%). Detailed descriptions are given in online supplemental file 3.…”