Aquatic versus land-based exercise for cardiorespiratory endurance and quality of life in obese patients with knee osteoarthritis: a randomized controlled trial

Abstract

Background: Obesity with knee osteoarthritis (OA) is related to chronic pain causing physical inactivity that leads to decreased cardiorespiratory endurance and quality of life. Aquatic and land-based exercises are effective in improving physical activity. The aim of this study is to compare between aquatic and land-based exercise to improve cardiorespiratory endurance and quality of life in obese patients with knee osteoarthritis.Methods: A single-blind, randomized, controlled trial was conducted on thirty three obese patients with knee OA who visited Obesity Clinic of Medical Rehabilitation Cipto Mangunkusumo Hospital, from October 2016 to January 2017, subjects were divided into aquatic or land-based exercise group. Aerobic and knee-strengthening exercises were given. Cardiorespiratory endurance was assessed using the Borg Scale, whereas both the BORG CR-10 and SF-36 questionnaires were used to assess quality of life.Results: After intervention, there were significant improvements in the land-based exercise group in the rating of perceived exertion (p=0.02), role limitations due to physical health (p=0.024), role limitations due to emotional problems (p=0.041), energy/fatigue (p=0.016), and the decline in pain (p=0.049) parameters. While in the aquatic exercise, there were significant improvements in leg fatigue (p=0.016), energy/fatigue (p=0.025), emotional well-being (p<0.001), and general health (p=0.045) parameters. Despite this, there were no significant differences between two groups regarding cardiorespiratory endurance and quality of life.Conclusion: This study found that patients could start aquatic exercise to reduce leg fatigue and enhanced general health and energy. After that, exercise could be continued in land-based settings to improve cardiorespiratory endurance and quality of life.

Effect of exercise training on psychological outcomes in adults with overweight or obesity: A systematic review and meta‐analysis

“…Eight original studies included subjects with comorbidities: metabolic syndrome 35 or diabetes. 36 , 37 , 38 , 39 , 40 , 41 , 42 …”

“…Thirteen studies involved an aerobic‐only exercise program, eight studies comprised a resistance‐only exercise program, and six studies involved a combined aerobic plus resistance exercise program. A few studies included water exercise, 42 , 43 , 44 , 45 pilates, 46 and multicomponent programs also involving balance or flexibility exercises. 47 , 48 Twenty‐four studies involved a passive control, two studies combined exercise with diet and involved a diet‐only control, and two studies were comparative, involving two different exercise groups.…”

“…Eight original studies included subjects with comorbidities: metabolic syndrome 35 or diabetes. [36][37][38][39][40][41][42] Interventions delivered ranged from 6 to 76 weeks (median, 12 weeks) and most were supervised (65%). Thirteen studies involved an aerobic-only exercise program, eight studies comprised a resistance-only exercise program, and six studies involved a combined aerobic plus resistance exercise program.…”

Efficacy of the WATERinMOTION Aquatics Exercise Programme on the Body Weight and Composition of Sedentary Older Women with Overweight/Obesity

“…Any type of exercise that leads to calorie-burning increases the likelihood of alterations in body composition. Water aerobics does this with internal resistance to water viscosity and creates pressure in any movement (Tamin & Loekito, 2018). Thus, the moderate weight loss experienced during the WA-TERinMOTION aquatic exercise was most likely induced by a lack of compensatory increase in calorie intake to match energy expenditure during training.…”

“…Raffaelli et al (2010) found that aquatic exercise compared to land-based exercise led to noticeable rises in physical activity. Aquatic exercise is defined as a low-impact activity that occurs in water (Sanders et al, 2016), which, due to greater resistance than air, increases heart rate and energy flow and includes movements of the whole body (Tamin & Loekito, 2018).…”