Fresh Water Aquatic Training in Patients with Upright Posture Maintaining Disorders

The use of the fresh water aquatic training course, as a more gentle training method, may allow patients to ensure effective restoration of muscle functions responsible for maintaining an upright body position. A more accurate control of the course results can be performed using a virtual analysis carried out using the «Habilect» system that allows to determine the body parts attitude. Aim. To study the effect of training in fresh water using the Habilect system based on the Microsoft Kinect infrared sensor (video stabilometry) on motor functions that contribute to maintaining an upright body posture in patients with mild gait disturbances. Material and methods. An open descriptive study was conducted including 12 patients (7 men, 5 women), aged 40 to 62 years, with upright posture maintaining disorders, which correspond to the functional diagnosis encoded by the ICF «Gait Stereotype Functions» B770.1 – mild violations (5–24%). A group of subjects (n = 12), in addition to basic therapy and training with an exercise therapy instructor, underwent aquatic training in fresh water for two weeks (30 minutes, 6 days a week). Assessment methods: the research was carried out using the Habilect gait video analysis system before and after the rehabilitation course. The χ2 test was used to assess the significance of differences between groups of qualitative variables. When analyzing quantitative variables, the Shapiro-Wilk’s (W) test was performed. For abnormal distribution, the data is in Me format [Q25-Q75]. The Wilcoxon T-test was used to assess the significance of differences in quantitative variables of the two studied groups. The processing of the obtained research results was carried out using the Statistica for Windows, v. 8.0 (StatSoft Inc., USA) and Microsoft Excel (Microsoft, USA). The significance of the differences was considered established at p <0.05. Result and discussion. When examining the amplitude of body deflection along the X-axis before training, they were 3.25 cm [-98 cm; 93.9 cm], after – -9.96 cm [-100.92 cm; -81.96 cm], on the Y-axis before training – -29.01 cm [-29.01 cm; 13.76 cm], after –-30.59 cm [-30.59 cm; 31.09 cm], on the Z-axis before training – 388.1 cm [369.22 cm; 393.39 cm], after training – 380.96 cm [377.98cm, 400.05 cm], deviation of the body movement vector before training 16.45 cm [7.46 cm; 338.67 cm], after training – 324.7 cm [324.7 cm; 342.56 cm]. When examining the amplitude of head deflection along the X-axis before training, they were -0.92 cm [-1.24 cm; -0.92 cm], after – 1.5 cm [-10.19 cm; 2.38 cm], Y-axis before training – 125.33 cm [61.13 cm; 128.94 cm], after – 107.42 cm [52.49 cm; 107.42 cm], along the Z-axis before training – -8.59 cm [-8.97 cm; -5.33 cm], after training – -14.89 cm [-14.89 cm, -3.45cm]. When calculating the increase in deviation (deviations of the main body axes from the initial value) using the Wilcoxon T-test revealed statistically significant deviations in the X-axis (an increase of 306.5%, p = 0.0504), the Z-axis (an increase of 112.68%, p =0.0225) and the Body Angle parameter (an increase of 1973.86% p = 0.0323). When calculating the increase in the deviation of the head axes from the initial value using the Wilcoxon T-test, statistically significant deviations were revealed along the X axis (increase of 163.04%, p = 0.0280), the Y axis (increase of 85.71%, p = 0.0199) and the parameter Z (an increase of 173.34% p = 0.0292). The study revealed a decrease in the body axes deviations amplitude in all 3 planes, which indicates an improvement in the work of all brain parts that are responsible for the coordination of motor functions and their vegetative support, an improvement in functional interaction within individual muscle chains. The reduction in the head and neck muscles in compensatory balancing participation during walking and maintaining a vertical body posture mainly due to the muscles of the lower extremities and pelvis contributes to the prevention of arterial and venous circulation disorders in the head and neck and makes training not only more effective, but also safer. Conclusion. Due to the decrease in the amplitude of deviations along all three axes (Z, Y, X), the course of aquatic training contributes to the correction of upright posture maintaining disorders, a statistically significant decrease in the amplitude of head and neck movements.

The effect of aquatic training on static and semi-dynamic balance of patients with chronic ischemic stroke: A randomized clinical trial

Objectives: This study aims to investigate the effect of six-week aquatic exercise on the static and semi-dynamic balance of male patients with chronic ischemic stroke (CIS). Patients and methods: This randomized clinical trial (RCT) included a total of 36 male CIS patients (mean age 60.2±6.7 years; range, 40 to 70 years) between January 2015 and January 2017. The patients were randomly divided into three groups consisting of 12 patients in each group: (i) exercising in shallow water, (ii) exercising in deep water, and (iii) control group. Training sessions were held three days a week for six weeks, and the control group did not participate in these sessions. The balance of the patients was checked using the Biodex balance system in two stages. Results: There was no significant difference between the two intervention groups (shallow and deep) in terms of the balance assessment post-test (p>0.05), yet there was a statistically significant difference between the two intervention groups (shallow and deep) with the control group in terms of the semi-dynamic balance (total) score, (p<0.05); the semi-dynamic balance (total) of the two intervention groups (shallow and deep) was higher than that of the control group (p<0.05). Conclusion: Our study results indicate that exercise in both depths is a suitable solution to improve balance, particularly semi-dynamic balance (total) in male CIS patients. Accordingly, aquatic training has a positive effect on balance in male stroke patients and we can prescribe this protocol as a useful remedy for these patients.

Aquatic Training after Joint Immobilization in Rats Promotes Adaptations in Myotendinous Junctions

The myotendinous junction (MTJ) is the muscle-tendon interface and constitutes an integrated mechanical unit to force transmission. Joint immobilization promotes muscle atrophy via disuse, while physical exercise can be used as an adaptative stimulus. In this study, we aimed to investigate the components of the MTJ and their adaptations and the associated elements triggered with aquatic training after joint immobilization. Forty-four male Wistar rats were divided into sedentary (SD), aquatic training (AT), immobilization (IM), and immobilization/aquatic training (IMAT) groups. The samples were processed to measure fiber area, nuclear fractal dimension, MTJ nuclear density, identification of telocytes, sarcomeres, and MTJ perimeter length. In the AT group, the maintenance of ultrastructure and elements in the MTJ region were observed; the IM group presented muscle atrophy effects with reduced MTJ perimeter; the IMAT group demonstrated that aquatic training after joint immobilization promotes benefits in the muscle fiber area and fractal dimension, in the MTJ region shows longer sarcomeres and MTJ perimeter. We identified the presence of telocytes in the MTJ region in all experimental groups. We concluded that aquatic training is an effective rehabilitation method after joint immobilization due to reduced muscle atrophy and regeneration effects on MTJ in rats.

Impact of COVID-19 on Swimming Training: Practical Recommendations during Home Confinement/Isolation

The COVID-19 pandemic has had severe effects on communities globally, leading to significant restrictions on all aspects of society, including in sports. Several significant decisions were made to postpone or cancel major swimming events by FINA (Fédération Internationale de Natation). Swimmers were no longer allowed to continue their usual training in swimming pools and were confined to their homes. These unusual circumstances may represent a good opportunity to strengthen different areas of swimmer preparation and potentially enhance performance when resuming regular aquatic training. We searched major databases for relevant information, and the present article provides practical information on home-based training for swimmers of all ages. The COVID-19 crisis and its consequences on the swimming community have created a myriad of challenges for swimmers around the world, including maintaining their fitness level and preparing to return optimally and safely to pool training and competitions. Unfortunately, the mental consequences that might arise after the pandemic may also have an impact. We strongly recommend encouraging the swimmers to consider quarantine as an opportunity for development in specific areas of preparation and learn how to best cope with this special situation of self-isolation and/or “physical distancing” for their mental health and in case a similar situation is faced again in the future.

The Effect of Aqua-trainings are in Fresh Water in Patients with Hypertension on the Microcirculation

Walking in water (Aquatic Physiotherapy) is a simple, reproducible and affordable method. Warm pool water reduces peripheral vascular resistance. Purpose of the study was to assess the effect of dosed physical activity in a fresh water on the microcirculation of patients with arterial hypertension (AH) when applied externally. Materials and methods. The study included 14 subjects (7 men, 7 women) aged 18 to 70, with AH stage I. The patients were administered aqua training course in the form of walking in a fresh water for the 30 minutes duration, the course of treatment included 10 procedures, the water temperature in the pool was 30–32C. Before and after the end of the intervention, several parameters were monitored, including the assessment of microcirculation using laser Doppler flowmetry. Results: In patients receiving aqua training in a fresh water, there was a significant decrease of arterio-venular bypass grafting by 25.0%from the initial (Wilcoxon T-test = 310.0; p = 0.004) and an increase in the muscle component of microcirculation regulation (Wilcoxon T-test = 399.0; p <0.05), which indicates an improvement in microcirculation under the influence of aqua training. The optimal duration of training in fresh water was found to be equal to five days, after which the indicators characterizing microcirculation remain at the plateau level, without significantly changing. Significantly more often, the positive effect of aqua training was achieved in the group of patients with microcirculation disorders of the type of venous stasis (χ2 = 10.6; p <0.001). Conclusion. Laser Doppler flowmetry screening may be useful method to select patients with AH in a greatest need of aquatic training.

Effects of 2 Models of Aquatic Exercise Training on Cardiorespiratory Responses of Patients With Type 2 Diabetes: The Diabetes and Aquatic Training Study—A Randomized Controlled Trial

Background: There are a lack of clinical trials with suitable methodological quality that compare aquatic exercise training types in type 2 diabetes (T2D) treatment. This study aimed to compare the effects of aerobic and combined aquatic training on cardiorespiratory outcomes in patients with T2D. Methods: Untrained patients with T2D were randomized to receive an aerobic aquatic training, a combined aquatic training, or a procedure control in 3 weekly sessions for 15 weeks. The sessions were 50 minutes long. The intensities were from 85% to 100% of heart rate of anaerobic threshold and at maximal velocity for aerobic and resistance parts, respectively. Resting heart rate, peak oxygen uptake (VO2peak), and oxygen uptake corresponding to second ventilatory threshold and its relation with VO2peak were evaluated. Results: Participants were 59.0 (8.2) years old and 51% women. Intervention groups increased in VO2peak (aerobic aquatic training group: 4.48 mL·kg−1·min−1, P = .004; combined aquatic training group: 5.27 mL·kg−1·min−1; P = .006) and oxygen uptake corresponding to second ventilatory threshold, whereas the control group presented an increase in oxygen uptake corresponding to second ventilatory threshold and minimal change in VO2peak. Conclusions: Aerobic and combined aquatic exercise interventions improve the cardiorespiratory fitness of patients with T2D.