Aquatic versus land-based exercise for cardiorespiratory endurance and quality of life in obese patients with knee osteoarthritis: a randomized controlled trial
AbstractBackground: 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.
Flier J, Maratos S. Biology of obesity . In: Fauci SA, Braunwald E, Kasper DI, Hauser SL, Longo DL, Jameson JL, et al, editors Harrison's principles of internal medicine. 17th ed. USA: McGraw to Hill; 2008. 462–8. p.
Riskesdas. Riset Kesehatan Dasar. Badan Penelitian Dan Pengembangan Kesehatan Kementrian Kesehatan RI. 2013. p. 223–30. Indonesian.
Sitik T, Stiskal D, Foye P, Nadler R, Wyss J, Heslop S. Osteoarthritis. In: Frontera WR, editor. DeLisa's physical medicine and rehabilitation: principles and practice. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2010. 781–809 p.
Messier SP. Diet and exercise for obese adults with knee osteoarthritis. Clin Geriatr Med. 2010;26(3):461–77.
Boidin M, Lapierre G, Paquette Tanir L, Nigam A, Juneau M, Guilbeault V, et al. Effect of aquatic interval training with Mediterranean diet counseling in obese patients: results of a preliminary study. Ann Phys Rehabil Med. 2015;58(5):269–75.
Nagle EF, Robertson RJ, Jakicic JJ, Otto AD, Ranalli JR, Chiapetta LB. Effects of aquatic exercise and walking in sedentary obese women undergoing a behavioral weight-loss intervention. Int J Aquatic Res Educ. 2007;1:43–56. https://doi.org/10.25035/ijare.01.01.05
Vinod Kumar KC, Regima SE, Vikranth GR. Effectiveness of land based endurance training versus aquatic based endurance training on improving endurance in normal individuals. Int J Physiother. 2015;2(3):466–71. https://doi.org/10.15621/ijphy/2015/v2i3/67016
de Mattos F, Leite N, Pitta A, Bento PC. Effects of aquatic exercise on muscle strength and functional performance of individuals with osteoarthritis: a systematic review. Rev Bras Reumatol Engl Ed. 2016;56(6):530–42. https://doi.org/10.1016/j.rbre.2016.09.003
Semanik PA, Chang RW, Dunlop DD. Aerobic activity in prevention and symptom control of osteoarthritis. PM R. 2012;4(5):S37–44. https://doi.org/10.1016/j.pmrj.2012.02.015
Larose J, King J, Brosseau L, Wells GA, Reid R, Maetzel A, et al. The effect of walking on cardiorespiratory fitness in adults with knee osteoarthritis. Appl Physiol Nutr Metab. 2013;38(8):886–91. https://doi.org/10.1139/apnm-2012-0487
Pescatello LS, Arena R, Riebe D, Thompson DP. ACSM's guidelines for exercise testing and prescription. 9th ed. China: Wolters Kluwer; 2014. p. 72–86.
Borg E, Borg G, Larsson K, Letzter M, Sundblad BM. An index for breathlessness and leg fatigue. Scand J Med Sci Sports. 2010;20(4):644–50. https://doi.org/10.1111/j.1600-0838.2009.00985.x
Alnahdi AH, Zeni JA, Snyder-Mackler L. Muscle impairments in patients with knee osteoarthritis. Sports Health. 2012;4(4):284–92. https://doi.org/10.1177/1941738112445726
Lieber DC, Lieber RL, Adams WC. Effects of run-training and swim-training at similar absolute intensities on treadmill VO2max. Med Sci Sports Exerc. 1989;21(6):655–61. https://doi.org/10.1249/00005768-198912000-00005
Wilber RL, Moffatt RJ, Scott BE, Lee DT, Cucuzzo NA. Influence of water run training on the maintenance of aerobic performance. Med Sci Sports Exerc. 1996;28(8):1056–62. https://doi.org/10.1097/00005768-199608000-00017
Taunton JE, Rhodes EC, Wolski LA, Donelly M, Warren J, Elliot J et al. Effects of land-based and water-based fitness programs on the cardiovascular fitness, strength and flexibility of women aged 65–75 years. Gerontology. 1996;42(4):204–10. https://doi.org/10.1159/000213794
Bocalini DS, Serra AJ, Murad N, Levy RF. Water- versus land-based exercise effects on physical fitness in older women. Geriatr Gerontol Int. 2008;8(4):265–71. https://doi.org/10.1111/j.1447-0594.2008.00485.x
Wouters EJ, Van Nunen AM, Geenen R, Kolotkin RL, Vingerhoets AJ. Effects of aquajogging in obese adults: a pilot study. J Obes. 2010;2010:231074. https://doi.org/10.1155/2010/231074
Skurvydas A, Kamandulis S, Stanislovaitis A, Streckis V, Mamkus G, Drazdauskas A. Leg immersion in warm water, stretch-shortening exercise, and exercise-induced muscle damage. J Athl Train. 2008;43(6):592–9. https://doi.org/10.4085/1062-6050-43.6.592
Lund H, Weile U, Christensen R, Rostock B, Downey A, Bartels EM, et al. A randomized controlled trial of aquatic and land-based exercise in patients with knee osteoarthritis. J Rehabil Med. 2008;40(2):137–44. https://doi.org/10.2340/16501977-0134
Lim JY, Tchai E, Jang SN. Effectiveness of aquatic exercise for obese patients with knee osteoarthritis: a randomized controlled trial. PM R. 2010;2(8):723–31. https://doi.org/10.1016/j.pmrj.2010.04.004
Burholt V, Nash P. Short form 36 (SF-36) health survey questionnaire: normative data for Wales. J Public Health. 2011;33(4):587–603. https://doi.org/10.1093/pubmed/fdr006
Suomi R, Collier D. Effects of arthritis exercise programs on functional fitness and perceived activities of daily living measures in older adults with arthritis. Arch Phys Med Rehabil 2003;84(11):1589–94. https://doi.org/10.1053/S0003-9993(03)00278-8
Kao MJ, Wu MP, Tsai MW, Chang WW, Wu SF. The effectiveness of a self-management program on quality of life for knee osteoarthritis (OA) patients. Arch Gerontol Geriatr. 2012;54(2):317–24. https://doi.org/10.1016/j.archger.2011.05.018
Bartels EM, Lund H, Hagen KB, Dagfinrud H, Christensen R, Danneskiold-Samsøe B. Aquatic exercise for the treatment of knee and hip osteoarthritis. In: The Cochrane Collaboration, editor. Cochrane Database of Systematic Reviews [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2007 [cited 2018 Jun 26]. Available from: http://doi.wiley.com/10.1002/14651858.CD005523.pub2
Copyright (c) 2018 Tirza Z. Tamin, Natalia Loekito
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.