Head-Out Water-Based Protocols to Assess Cardiorespiratory Fitness—Systematic Review

Abstract

The aquatic environment offers cardiorespiratory training and testing options particularly for individuals unable to adequately train or test on land because of weight bearing, pain or disability concerns. No systematic review exists describing cardiorespiratory fitness protocols used in an aquatic environment. This review investigated the different head-out water-based protocols used to assess cardiorespiratory fitness. Our comprehensive, systematic review included 41 studies with each included paper methodological quality assessed using the statistical review of general papers checklist. Diverse protocols arose with three major categories identified: conducted in shallow water, deep water, and using special equipment. Thirty-seven articles presented data for peak/maximal oxygen consumption (VO2peak/VO2max). Twenty-eight of 37 studies predefined criteria for reaching a valid VO2peak/VO2max with shallow water exercise demonstrating 20.6 to 57.2 mL/kg/min; deep water running 20.32 to 48.4 mL/kg/min; and underwater treadmill and cycling 28.64 to 62.2 mL/kg/min. No single, accepted head-out water-based protocol for evaluating cardiorespiratory fitness arose. For clinical use three cardiorespiratory fitness testing concepts ensued: water temperature of 28–30 °C with difference of maximum 1 °C between testing participants and/or testing sessions; water depth adapted for participant aquatic experiences and abilities; and intensity increment of 10–15 metronome beats per minute.

Effects of Aquatic versus Land High-Intensity Interval Training on Acute Cardiometabolic and Perceptive Responses in Healthy Young Women

“…This mechanism promotes a reduction in HR because of stimulation of the carotid and aortic receptors, which is likely to be directly proportional to the immersion depth [ 9 ]. Therefore extra caution should be taken when using the HR values obtained on land to regulate exercise in water, since exercise intensity was one of the variables for aquatic exercise prescription [ 37 ].…”

Wearable technologies for monitoring aquatic exercises: A systematic review

“… 2 Systematic reviews of aquatic motion analysis have focused on specific dysfunctions or conditions, such as neurological diseases, 1 , 2 fibromyalgia, 3 asthma, 4 spinal cord injury, 5 , 6 haemophilia 7 and stroke 8 – 10 . Additional reviews have also investigated the physiological effects of water, 11 evaluated the use of aquatic exercise for healthy subjects 12 , 13 and for glycaemia 14 and studied the biophysical differences between aquatic and land-based treatments. 15 The presence of water generally constrains the application of classical investigative tools for motion analysis, including motion capture and electromyography.…”

Energy Consumption of Water Running and Cycling at Four Exercise Intensities

“…However, water's properties, such as temperature, buoyancy, hydrostatic pressure, specific gravity, and drag, affect every participant differently based on limb length, body composition, and fat deposition, making it difficult to accurately assess the various components of a water-exercise protocol [2]. Biomechanical and physiological assessments are more difficult in the water than on land; for example, video analyses are greatly hindered by the water refraction and by the water turbulence disturbances [16,17]. Methods that measure perceived effort and the pleasantness of exercise can be used to modulate or refine the prescribed exercise's intensity, but the accuracy of this approach is insufficient for it to be utilised as a primary method of exercise prescription [12].…”