Dear Ratan

I am not an expert in the area. I know aquatic is better for people with arthritis since body weight will not work on the joints. Here are a few references that may be useful.

1. Batterham, S. I., Heywood, S., & Keating, J. L. (2011). Systematic review and meta-analysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes. BMC musculoskeletal disorders, 12(1), 123.

2. Douris, P., Southard, V., Varga, C., Schauss, W., Gennaro, C., & Reiss, A. (2003). The effect of land and aquatic exercise on balance scores in older adults. Journal of Geriatric Physical Therapy, 26(1), 3-6.

3. http://portjeffersonphysicaltherapy.com/JGPT-douris.pdf

4. http://physther.net/content/74/8/710.full.pdf

5. Bartels, E. M., Lund, H., Hagen, K. B., Dagfinrud, H., Christensen, R., & Danneskiold-Samsøe, B. (2007). Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database Syst Rev, 4.

The advantage is that water bears the weight; it is good for those with joint pains even the elderly, with supervision. But the disadvantage is that not everyone can afford or has access to swimming pools etc.

'A luxury car, he points out, could cost the owner more than RM 300,000, while the cost of installing a pool might only be a third of the price.'

http://www.thestar.com.my/Story/?file=%2F2012%2F11%2F10%2Fmetrobiz%2F12294258&sec=metrobiz

I do like water exercises my dear@Ratan! Major issue of your question is comparing the water and land-based exercises. Here is a good article about:"Water- versus land-based exercise in elderly subjects: effects on physical performance and body composition"

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762608/

From my experience, and cooperation with experts in this area, it is great therapy to many chronic diseases. It is now called hydrotherapy exercise. In addition, it is fantastic recreation for stress relief.

@ Hashem, I agree with you... Yes aquatic exercise is therapeutically known as hydrotherapy...

Aquqtic exercises are very good for every person at every age. I KNOW IT FROM MY OWN EPERIENCE THAT THEY IMPROVE STAMINA AND FLEXIBILITY AND HELP ACHiNG JOINTS. I PREFER THEM TO "earthly" exercises.

Swimming is the best way for someone with knee issues to increase lung capacity. It is very difficult and also a very safe way to exercise your body. It does not create stress on the ligaments. Since my accident I have not been able to do much but walk, so the lake would provide a way to exercise without creating injury to my knee. It can also be very relaxing. It can be used for anxiety reduction also.

Susan

I recently looked into the evidence for aquatic exercise for patients with fibromyalgia (FM), a patient group with longstanding aches and pains in most of their body. We concluded that there is evidence of moderate quality that aquatic exercise is effective to reduce pain and disability and increase health-related quality of life in patients with FM. However, we found no difference in our systematic review of landbased exercise vs. aquatic exercise. Nevertheless, clinical and patient experience indicate that acquatic exercise is a gentler, non-weightbearing type of exercise which protects joints better than land-based exercise, and has similar effects. Also, the relaxing or invigourating effects on physical and mental wellbeing are important. European guidelines recommend aquatic exercise for patients with FM (Carville et al 2008).

Our conclusions on aquatic exercise were based primarily on two systematic reviews: Verhagen 2012 and Langhorst 2009.The conclusions can most likely also be applied for patients with widespread pain of which FM is a subgroup.

Hope this helps.

Swimming is considered to be the best form of exercise. It has many reasons, that many have pointed it out above.

The effect of bouyancy gives weightlessness which reduces te impact on the joints and thus ideal for people with joint diseases. It can be ideal for athelets too, if in case of lower limb injury while other forms of exercse s/a running or cycling can be tormenting; aquatic exercises can help them maintain fitness untill their recovery.

However it has disadvantages too. Aquatic exercise may require a coach, a clean pool, optimal water temperature in different seasons and other measure to avoid accidents (drowning).

Despite of few disadvantages swimming and other forms of aquatic exercises can be recreational as well as good workout program.

Dear all, many of you are supporting aquatic excercise according to your experience which will help in management of musculoskeletal problems. And thanks for contributing to the question...

Regards

Dear Taiar, i agree with you, Archimedes' principle make it happen for all of us...

Aquatic exercise is advantageous over land-based for the following main reasons:

* Minimum joint stress and soft tissue strain: Water’s buoyancy virtually eliminates the effects of gravity supporting 90 percent of the body’s weight => reduced joint forces and greater flexibility (water acts as a cushion for the body’s weight-bearing joints, reducing stress on muscles, tendons and ligaments). Excellent for conditions such as OA, RA, cardio-pulmo and musculoskeletal injury rehabilitation and so forth.

* No resistance apparatus required (for basic strength training): Water can provide full-body resistance which is proportional to the effort exerted against it and speed of movement (water resistance is between 4 and 42 times greater than that of air medium).

* Pascal’s law: The hydrostatic pressure of water pushes equally on all body surfaces and helps the heart circulate blood by aiding venous return => lower blood-pressure and heart rates (about 10-15 beats lower than land-based).

* Luke-warm water: Helps relieving muscle spasms and induces local and general relaxation => reduced pain and fatigue, increased flexibility, enhanced mood and well being.

Disadvantage: problems associated with finances and resources

PS. Lectured on the topic recently for postgraduate physiotherapy students

@ Gourav, Good points, I agree with you...

@ Ratan, I agree to the above answers supporting the aquatic exercises.

Here is the systemic review comparing the aquatic verses land based exercises... Have a look...

http://www.biomedcentral.com/1471-2474/12/123

Dear Ratan

As several researcher have pointed out the major advantage of aquatic exercise vs. land based exercises is that you lack the high forces associated with ground contact e.g. the shock-wave to the skeleton and high eccentric muscle action during running. My knowledge in this area is mainly based on deep-water running using flotation west in well trained athletes. From a performance perspective the major physiological differences when comparing deep-water running to normal land based running is that:

1) Both stroke volume and cardiac output is elevated during water immersion (this is because of the hydrostatic compression of tissues and capillaries).

2) Peak values for VO2, Minute ventilation and heart rate is decreased during maximal deep water exercise

3) Blood lactate concentration at a given sub maximal VO2 is higher during water immersion

Taken together this means that at a given exercise level the cardio-vascular response (VO2, HR etc.) will be lower when compared to land based running, and at the same time the subject will expectance higher levels of blood lactate (i.e. faster muscle fatigue). Thus land based running generally provides a better physiological stimulus in well trained athletes compared to deep-water running. However, despite these disadvantages deep-water running might be used both as a recovery session and as an extra high intensity session (if the athlete in injury prone) and of cause during injury rehabilitation. There are several reports showing that a well-designed deep-water running program might maintain (but not increase…) aerobic performance in well trained endurance athletes for up to 6 weeks. See Thomas Reilly et al 2003 J sports sciences for review.

Best wishes

//Peter Edholm

Peter@Thanks a lot for a real lecture - very educative as well as informal. I've learned a lot.

Multiple studies have shown improvement in physical fitness, quality of life, overall wellbeing, reduction in pain amongst patients of chronic musculoskeletal pain. Hydrotherapy is also used traditionally in most ancient civilizations as a wellness measure. We do have references for Roman baths, Russian bath, the community bath centers in Harappa and Mohanjodar etc. Hippocrates also used hydrotherapy for treatment of various illnesses.