Heywood (2018) Force during functional exercises on land and in water in older adults with and without knee osteoarthritis; Implications for rehabilitation

Exploring Exercise Mediums for Knee Osteoarthritis
Knee osteoarthritis is a debilitating condition, with exercise being a cornerstone of management. This study investigates the impact of aquatic and land-based exercises, focusing on closed kinetic chain and plyometric exercises believed to mitigate joint load while mimicking functional activities. The study’s novelty lies in examining vertical ground reaction forces during exercises like squats, calf raises, and jumps among older adults, with and without knee osteoarthritis, in water versus on land.

Methodological Insights
The research involved 41 participants, divided into healthy individuals and those with knee osteoarthritis, performing various exercises at different speeds and depths in water and on land. Vertical ground reaction forces and pain levels were measured, revealing significantly greater forces on land compared to water, particularly at chest depth. Notably, the force patterns during slow-speed squats in water differed markedly from those on land, suggesting a unique loading environment in aquatic settings.

Aquatic Exercise: A Pain-Reducing, Functional Approach
One of the critical findings was the lower pain ratings for exercises performed in water, highlighting aquatic therapy’s potential for pain-sensitive individuals like those with knee osteoarthritis. The study underscores aquatic exercises’ role in neuromotor training or low-load, high-velocity training, particularly at maximal speeds, which could address power deficits with minimal pain.

Clinical Implications and Future Directions
The research provides valuable insights for clinicians in tailoring rehabilitation programs, emphasizing the importance of exercise speed and medium in achieving specific therapeutic goals. Aquatic therapy, with its inherent lower load and reduced pain, offers a viable option for enhancing functional mobility and quality of life in individuals with knee osteoarthritis. Further research is needed to explore the long-term benefits and optimal protocols for aquatic versus land-based exercises in managing knee osteoarthritis.

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