Therapeutic Effect of an Underwater Exercise Program for Patients with Peripheral Arterial Disease

Al-Jazzar, Mohammad; Aly, Farag A.; Al‐Omran, Mohammed; Alghadir, Ahmad H.; Berika, Mohamed

doi:10.1589/jpts.24.687

Cited by 5 publications

(6 citation statements)

References 28 publications

(22 reference statements)

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“…We have also previously demonstrated that swim training has beneficial effects on body composition, BP, arterial stiffness, muscular strength, and cardiorespiratory health in postmenopausal women with stage 2 hypertension (76). Additionally, warm water immersion (~28 -30°C) has been shown to reduce pain (2,45), improve blood flow (2,10), and decrease joint loading and stress on the lower-extremity musculature (10,56). In fact, it has been suggested that water immersion alone improves blood flow and BP in patients with PAD (64) and water immersion heat therapy may improve exercise tolerance in patients with PAD (1).…”

Section: Introductionmentioning

confidence: 94%

“…Participants in the AQ group participated in an aquatic walking exercise-training program for 12 wk, 4 days/ wk, for 60 min/day (Table 1), and this was adapted from previous literature for older individuals and patients with PAD (2,47). Sessions were conducted in waist-to-chest-deep water (28 -30°C) in a group setting (2). Participants were allowed to use flotation devices as needed for safety purposes.…”

Section: Participantsmentioning

confidence: 99%

“…The main exercises were performed for a total of 40 min. The first 10 min of main exercises included simple movement patterns such as hip flexion-extension, hip abduction-adduction, and knee flexion-extension (2). The next 30 min of the main exercise session consisted of water walking exercises (forward, backward, and lateral; 2).…”

Section: Participantsmentioning

confidence: 99%

See 2 more Smart Citations

Impacts of aquatic walking on arterial stiffness, exercise tolerance, and physical function in patients with peripheral artery disease: a randomized clinical trial

Park

Kwak

Pekas

2019

Journal of Applied Physiology

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Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with attenuated vascular function, cardiorespiratory capacity, physical function, and muscular strength. It is essential to combat these negative effects on health by incorporating lifestyle interventions to slow disease progression, such as exercise. We sought to examine the effects of aquatic walking exercise on cardiovascular function, cardiorespiratory capacity [maximal volume of oxygen consumption (V̇o2max)], exercise tolerance [6-min walking distance (6MWD)], physical function, muscular strength, and body composition in patients with PAD. Patients with PAD ( n = 72) were recruited and randomly assigned to a 12-wk aquatic walking training group (AQ, n = 35) or a control group (CON, n = 37). The AQ group performed walking and leg exercises in waist-to-chest-deep water. Leg arterial stiffness [femoral-to-ankle pulse wave velocity (legPWV)], heart rate (HR), blood pressure (BP), ankle-to-brachial index (ABI), V̇o2max, 6MWD, physical function, muscular strength, body composition, resting metabolic rate (RMR), and flexibility were measured before and after 12 wk. There were significant group × time interactions ( P < 0.05) after 12 wk for legPWV and HR, which significantly decreased ( P < 0.05) in AQ, and V̇o2max, 6MWD, physical function, and muscular strength, which significantly increased ( P < 0.05) in AQ, compared with no changes in CON. There were no significant differences ( P > 0.05) for BP, ABI, RMR, or flexibility after 12 wk. Interestingly, there was relatively high adherence (84%) to the aquatic walking exercise program in this population. These results suggest that aquatic walking exercise is an effective therapy to reduce arterial stiffness and resting HR and improve cardiorespiratory capacity, exercise tolerance, physical function, and muscular strength in patients with PAD.NEW & NOTEWORTHY The results of this study reveal for the first time that aquatic walking exercise can decrease arterial stiffness and improve exercise tolerance, cardiorespiratory capacity, and muscular strength in patients with peripheral artery disease (PAD). Aquatic walking exercise training demonstrates relatively high exercise adherence in this population. Aquatic walking exercise training may be a useful therapeutic intervention for improving physical function in patients with PAD.

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Section: Introductionmentioning

confidence: 94%

Section: Participantsmentioning

confidence: 99%

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Impacts of aquatic walking on arterial stiffness, exercise tolerance, and physical function in patients with peripheral artery disease: a randomized clinical trial

Park

Kwak

Pekas

2019

Journal of Applied Physiology

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“…Underwater treadmill gait training utilizes water buoyancy to run a gait training session with alleviated weight. The training method is similar to the on-ground weight support treadmill gait training 2 , 3 ) . Underwater treadmill training itself is a complete work-out, by which subjects can practice walking; therefore, it is one of the gait training methods that can be normally used 2 , 3 ) .…”

Section: Introductionmentioning

confidence: 99%

“…The training method is similar to the on-ground weight support treadmill gait training 2 , 3 ) . Underwater treadmill training itself is a complete work-out, by which subjects can practice walking; therefore, it is one of the gait training methods that can be normally used 2 , 3 ) . Most studies of gait training were of on-ground techniques and few studies have focused on underwater treadmill training.…”

Section: Introductionmentioning

confidence: 99%

Underwater treadmill training and gait ability in the normal adult

Kim

Lee

2017

J Phys Ther Sci

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[Purpose] Our working hypothesis is that underwater treadmill training improves normal people’s gait ability. [Subjects and Methods] Twenty-five healthy subjects with no orthopedic history of lower extremity were recruited. Gait training is performed using an underwater treadmill (HydroTrack® Underwater Treadmill System, Conray, Inc., Phoenix, AZ, USA), for twenty minutes per session, five sessions a week for four weeks. The water temperature was set at about 33 °C and the depth was fixed to reach between the subjects’ xiphoid process and the navel. [Results] After the intervention, step length, velocity, and cadence increased significantly. [Conclusion] This study conducted underwater treadmill training with normal people, with positive effects on gait ability.

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Effects of heated water-based versus land-based exercise training on vascular function in individuals with peripheral artery disease

Park

Wong

Son

et al. 2020

Journal of Applied Physiology

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Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with poor vascular function, walking impairment, and reduced quality of life. Land-based exercise therapy (LBET) is frequently recommended to improve walking and reduce symptoms. Recently, evidence has suggested that heated-water exercise therapy (HWET) is an effective intervention for PAD. However, the efficacy of LBET versus HWET in PAD patients had not been elucidated. Therefore, we sought to compare effects of LBET with HWET on cardiovascular function, exercise tolerance, physical function, and body composition in PAD patients. PAD patients ( n = 53) were recruited and randomly assigned to a LBET group ( n = 25) or HWET group ( n = 28). The LBET group performed treadmill walking, whereas the HWET group performed walking in heated water for 12 wk. Leg (legPWV) and brachial-to-ankle arterial stiffness (baPWV), blood pressure (BP), ankle-brachial index (ABI), 6-min walking distance (6MWD), claudication onset time (COT), physical function, and body composition were assessed before and after 12 wk. There were significant group-by-time interactions ( P < 0.05) for legPWV, BP, 6MWD, COT, body composition, and resting metabolic rate (RMR). Both groups significantly reduced ( P < 0.05) legPWV, BP, and body fat percentage, and HWET measures were significantly lower than LBET measures. Both groups significantly increased 6MWD, COT, and RMR, and HWET group measures were significantly greater than LBET measures. A time effect was noted for baPWV reduction in both groups ( P < 0.05). These results suggest that both LBET and HWET improve cardiovascular function, exercise tolerance, and body composition, and HWET showed considerably greater improvements compared with LBET in patients with PAD. NEW & NOTEWORTHY The results of this study reveal for the first time that although land-based exercise therapy is effective for reducing arterial stiffness and blood pressure in patients with peripheral artery disease (PAD), heated-water exercise therapy demonstrates greater benefits on vascular function. The greater improvements in muscular strength, time to onset of claudication, and exercise tolerance after heated-water exercise therapy may have clinical implications for improving quality of life in patients with PAD. The heated-water exercise therapy intervention demonstrated relatively higher exercise training adherence (∼88%) compared with the land-based exercise intervention (∼81%).

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Therapeutic Effect of an Underwater Exercise Program for Patients with Peripheral Arterial Disease

Cited by 5 publications

References 28 publications

Impacts of aquatic walking on arterial stiffness, exercise tolerance, and physical function in patients with peripheral artery disease: a randomized clinical trial

Impacts of aquatic walking on arterial stiffness, exercise tolerance, and physical function in patients with peripheral artery disease: a randomized clinical trial

Underwater treadmill training and gait ability in the normal adult

Effects of heated water-based versus land-based exercise training on vascular function in individuals with peripheral artery disease

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