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Medicine & Science in Sports & Exercise: Volume 36(5) Supplement May 2004
p S289-S290
Bone Density and Physical Function in Postmenopausal Women After a
12-Month Water Exercise Intervention
Littrell, Tanya R.; Snow, Christine M. FACSM
Oregon State University Bone Research Lab, Corvallis, OR.
Email: littrelt@onid.orst.edu
2015
Exercise may be the most effective strategy to reduce osteoporotic fractures in
older adults because of its potential to reduce bone loss and fall risk. It is
unclear whether water exercise is an effective strategy to reduce fracture risk in
postmenopausal women. PURPOSE: To examine the effects of a 12-month
shallow water exercise program on bone mineral density (BMD) and physical
function in postmenopausal women. METHODS: We recruited 59 women (5
years past menopause; 27 exercisers and 32 controls) and evaluated subject
characteristics (weight and age), BMD (anterior-posterior spine, total hip,
femoral neck) by dual energy x-ray absorptiometry, and physical function (leg
power, arm endurance, cardiorespiratory fitness, flexibility) at baseline and 12
months. The exercise group participated in a 45-minute shallow water exercise
class 3 times per week for 12 months, while the control group was asked to
maintain initial activity levels. RESULTS: Using ANCOVA (covariates: initial
BMD and weight) BMD difference scores at the spine, total hip, and femoral
neck were similar between exercisers and controls after the 12-month
intervention (p = 0.14-0.31). However, one-sample t-tests revealed that over the
12-months, femoral neck BMD decreased 3.0% in controls (p<0.01) but did not
change in exercisers (p = 0.98). Using ANCOVA to evaluate difference scores in
physical function, (covariates: baseline weight and age), leg power, arm
endurance, and flexibility were not different between the groups, whereas
exercisers exhibited greater cardiorespiratory fitness after 12-months of water
exercise than controls (p = 0.03). One-sample t-tests revealed that exercisers
increased leg power (+14.1%, p = 0.01) and flexibility (+11.4%, p<0.01), while
controls did not change. CONCLUSION: Maintenance of BMD in exercisers at
the femoral neck, a clinically relevant fracture location, provides preliminary
evidence that shallow water exercise may be an effective alternative to landbased exercise programs. Furthermore, we conclude that shallow water
Resumo
Se sabe que muchos nios y nias con problemas en su movilidad o en sus
desplazamientos han estado, desde no hace mucho tiempo, escolarizados con una plena
integracin social dentro de su grupo de compaeros. Los inconvenientes se han dado en
aquellos cuyas disfunciones siendo tambin de tipo motor, no les permitan realizar lo que el
resto de sus compaeros hacan en los programas de natacin y/o actividades acuticas.
An considerando que las discapacidades motoras corresponden a una extensa y compleja
variedad de situaciones, la actividad acutica se presenta como una propuesta
extraordinaria para un amplio sector de la poblacin. Las actividades acuticas pueden
incidir favorablemente en las necesidades de este colectivo. Slo si la familia y el
profesorado permiten al nio o nia desarrollar estas experiencias en un ambiente
motivador y agradable, sin miedo a que se haga dao, stos podrn realmente construirse a
s mismos.
Palabras clave: Necesidades especiales. Discapacidad fsica. Actividad acutica
adaptada. Programa adaptado.
http://www.efdeportes.com/ Revista Digital - Buenos Aires - Ao 10 - N 86 - Julio de 2005
1/1
Introduccin
Como profesionales que intervenimos en el medio acutico, son muchos los
mtodos de los que disponemos y que se pueden utilizar en el enfoque de nuestras
intervenciones. Sin embargo, el contacto directo con las familias del nio/a que
atendemos y la evolucin de los casos, nos empujan a encontrar nuevas salidas que
colaboran en el seguimiento global del mismo.
Debemos ser capaces, con nuestro asesoramiento, de transmitir a los padres el
deseo de proporcionar al nio experiencias motoras, que le hagan posible adoptar
los patrones de movimiento propios de la motricidad humana. El agua aporta
Concepto Viviente
Manejo ms que tratamiento
Manejo dentro del contexto funcional
Adaptable- Adaptativo
Calidad
Holstico
Esto produce DEFICIT DE EXPERIENCIAS SENSORIO-MOTORAS NORMALES sobre la cual se basar su desarrollo
posterior, y la adaptacin a los requerimientos del medio.
Importancia de la evaluacin
Cada persona es diferente de la otra, principio incuestionable, y presenta
problemas especficos y potenciales desiguales, por lo que requiere una evaluacin
individual para planear un programa teraputico.
La evaluacin conviene que sea analtica:
En el medio gravitacional (fuera del agua) observacin de las habilidades y
dificultades del nio. En el medio acutico se debe observar el grado de adaptacin
y familiarizacin al entorno y cmo se manifiestan las condiciones de control
postural en este medio.
1. Evaluacin de las necesidades individuales en base a las habilidades
y dificultades en el medio gravitacional (tierra).
2. Evaluacin individual referida a la etapa del aprendizaje de la
natacin en la que se encuentra.
3. Evaluar y determinar cmo se manifiestan las condiciones bsicas de
control postural en el medio acutico.
4. Establecer los componentes de movimiento a desarrollar como
preparacin para la funcin o para habilidades que est
desempeando en forma anormal, as como contrarrestar o inhibir los
patrones motores anormales que impiden o interfieren su actividad
funcional.
5. Facilitar los patrones normales de movimientos ausentes o
interferidos de acuerdo al resultado de la evaluacin inicial, en
relacin a las necesidades individuales dentro de la etapa del
aprendizaje de la natacin en la que se encuentre el nio/a.
En el agua
Estos mismos conceptos en los que se basa el desarrollo normal, pueden ser
trasladados al medio acutico, tanto en lo que se refiere al aprendizaje de la
independencia, como a la adquisicin de ajustes posturales y de movimiento
necesarios para realizar distintas actividades en este medio.
Cualquier abordaje en el medio acutico, sea cual fuera el mtodo a emplear, se debe facilitar:
Simetra
Alineamiento
Estabilidad dinmica
Control respiratorio.
Sin lugar a dudas, adquirir un buen control respiratorio condicionar la
consecucin de los dems objetivos del programa. En general, se trabaja segn el
orden de los tems para el rea correspondiente. A medida que su respiracin (sobre
todo la espiracin) se adecua al agua, se refuerza el tem (C.R.4) y el control en la
boca del agua (C.R.5). La combinacin de ambas permite sumergir la boca bajo el
agua (C.R.6). A partir de all se recomienda trabajar en actividades y estrategias,
basadas fundamentalmente en el juego, para lograr consecutivamente los tems
C.R.7 Y C.R.8.
Flotacin elemental o bsica:
Si consideramos que flotar significa no hundirse en el agua, con vas respiratorias
fuera y mantenerse un tiempo mnimo aceptable, debemos considerar que la
misma requiere de un control postural muy especfico y equilibrado, tanto en
flotacin dorsal como en flotacin ventral, un adecuado tono muscular "relajacin",
y otros factores como: la composicin corporal (grasa, msculo, y estructura sea),
posicionamiento del cuerpo, superficie de contacto con el agua (volumen
sumergido), capacidad pulmonar, densidad del agua, y otros aspectos de
autocontrol tales como la relajacin, seguridad en s mismo, reconocimiento del
cuerpo en el agua (kinestsico motor) y control de la respiracin.
Desplazamiento bsico.
Comienza a trabajarse especficamente el desplazamiento en el agua cuando es
capaz de mantenerse en la barra o manguitos. Al inicio debe perseguirse cualquier
tipo de desplazamiento en funcin de las posibilidades de cada usuario; segn qu
refleje a nivel motor.
Los objetivos de trabajo en el Programa de Nivel Intermedio, respecto al
desplazamiento, se estructuran siguiendo la secuencia de los tems H.P.4 al H.P.9.
Bibliografa
Buscar
revista digital Ao 10 N 86 | Buenos Aires, Julio
2005
1997-2005 Derechos reservados
1. Introduccin al Aquagym
Esta actividad acutica surgi antes de Cristo; Hipcrates utilizaba baos de
contraste (agua caliente y fra) en el tratamiento de enfermedades (460 a. C).
Los romanos utilizaban el agua con la finalidad recreativa y curativas, existen 4
tipos de baos:
1. Fridigarium: Bao fro utilizado para fines recreativos.
2. Tepidarium: Bao con agua templada, en ambiente con aire
caliente.
3. Caldarium: Bao caliente.
4. Sudatorium: Un sitio saturado de aire hmedo caliente con el
objetivo de producir la sudoracin.
Los griegos utilizaban las caminatas en el agua.
estiramientos
relajacin inducida, etc.
Hay dos factores que, tericamente, aplican carga adicional a este sistema de
"bombeamiento" cuando alguien ejecuta un ejercicio de pie dentro del agua. El
primero es que los riones siguen necesitando de sangre, mismo durante la
realizacin del ejercicio. (La hormona antidiurtica, que normalmente reduce la
actividad renal durante el ejercicio en seco, no funciona en situaciones de
inmersin). El segundo factor se relaciona con la temperatura: el corazn puede
ser afectado si la piscina estuviera fra, o demasiado caliente.
Una piscina caliente causa vasodilatacin, lo que aplica demanda adicional al
corazn, ya que en esta situacin, la sangre no estar siendo desviada nicamente
de la piel hacia los msculos que estn trabajando, creando por tanto, una mayor
demanda de oxgeno. Una piscina muy fra puede causar vasoconstricin, con un
aumento concomitante de la presin sangunea. Todo esto viene referido cuando
hablamos de temperaturas por encima de 30 C y por debajo de los 20 C
respectivamente.
sigue
Medicine & Science in Sports & Exercise: Volume 35(5) Supplement 1 May
2003 p S33
COMPARISON OF PHYSICAL ACTIVITY ENJOYMENT DURING AQUATIC
EXERCISE IN OVERWEIGHT WOMEN
Otto, A D.1; Nagle, E F.1; Jakicic, J M. FACSM1; Robertson, R J. FACSM1; Aaron,
D A.1; Pcsolyar, M J.1; Hindes, K M.1
1
email: ayotto@pitt.edu
Non-weight bearing activity is commonly recommended as a form of exercise
for overweight individuals. However, enjoyment and attendance for this type of
activity has not been examined.
PURPOSE
To compare physical activity enjoyment and attendance in overweight women
participating in aquatic plus walking (AW) or walking only (W) exercise groups.
METHODS
Forty-four sedentary, overweight women (age: 40.3 6.8 y; BMI: 34.9 3.8
kg/m2) undergoing a 16-week standard behavioral weight loss program (SBT)
were randomly assigned to AW or W. The AW group was prescribed 2
supervised aquatic classes while the W group was prescribed 2 supervised
walks a week. In addition, all subjects were instructed to complete 3
unsupervised, home-based walking sessions per week. Type and minutes of
activity were recorded in a weekly diary. Physical activity enjoyment
(Kendzierski and DeCarlo, 1991) was assessed at completion of this study.
RESULTS
Thirty-three subjects completed the study. Enjoyment scores were significantly
different (p 0.05) between the AW (115.6 14.3) and the W (103.6 14.5)
group. Attendance (AW = 67 22%, W = 57 17%) and total physical activity
minutes for the 16 weeks (AW = 2937.6 1459.5, W = 2414.8 1518.3) did not
differ significantly between the 2 groups. Spearman Rank Order correlation
coefficients showed significant correlations between enjoyment scores and total
activity sessions attended (r = 0.50, p 0.05) in the AW group but not the W
group.
CONCLUSIONS
These short-term results suggest that AW is an acceptable, alternative activity
for overweight, sedentary women undergoing SBT. Comparisons of AW and W
should be further investigated to examine if these results translate into better
long-term exercise adherence and/or weight loss. Supported by NIH grant
5P30DK4620410
2003The American College of Sports Medicine
Medicine & Science in Sports & Exercise: Volume 37(5) Supplement May 2005
p S307
Effect Of Aquatic Aerobic Exercise, On Glycemia In People With Type 2
Diabetes: 1604 Board #59 9:30 AM - 11:00 AM
De Leon, Lidia G.; Muoz, Maria J.; Gonzalez, Laura A.; Alvarado, Juan D.
University of Chihuahua, Chihuahua, Chih., Mexico.
Email: gdeleon@uach.mx
Incidence and prevalence of Type 2 Diabetes Mellitus (DM) have increased all
over the world and in some places they have reached pandemic proportions.
Obesity and sedentary lifestyles have been the major recognized risk factors
leading to Type 2 DM. Although the scienti.c evidence for overall benefits of
regular exercise is extensive, the dose-response relationship and the effects of
exercise intensity on people with diabetes are not clearly understood.
PURPOSE
To determine the impact of aquatic aerobic exercise, on glycemia of sedentary
adults with Type 2 Diabetes Mellitus.
METHODS
Fifteen subjects, 8 women and 7 men with 6 years or less of Type 2 DM were
asked to perform a 6-week aquatic exercise protocol, at 40%, 50% and 60% of
their heart rate reserve capacity. Capillary glycemia before and after each single
exercise session was measured. Fasting blood glucose was determined every
two weeks throughout the study. Descriptive statistics, student's t and ANOVA
for repeated measures at a p < 0.05 significance level were used.
RESULTS
All patients showed normalized levels of blood glucose after each exercise
session. Capillary glycemia mean values for all of them were 27% lower after
the exercise session than before (137.6 41.4 mg% and 100.4 21.5 mg%,
respectively, p < 0.01). Post exercise glycemia was lower in the male group
than in the female group (95.2 23.2 mg% and 104.6 19.1 mg% respectively;
p < 0.01), nevertheless, men had higher capillary glycemia before the exercise
sessions than women (143.6 42.7 mg% and 132.6 39.7 mg%, respectively;
p < 0.05). This meant a reduction in glycemia of 33.7% and 21.1% in men and
women respectively (p < 0.01). Fasting blood glucose was lower at the end of
the 6-week exercise program in both groups: 140.7 6.9 and 109.2 6.6 mg/dl,
Mean Std Error before and after the exercise program respectively (p < 0.05).
However the univariate repeated measures analysis in the women group
revealed higher fasting venous glycemia before the program than after the 40%,
50% and 60% workload intensities (138.9 4.5, 111,8 4.1, 106.8 4.1 and
104.9 4.5 mg%, Mean Std Error, respectively; p < 0.01). No significant
differences were found on fasting venous glycemia in the male group (140.9
8.7, 132.0 7.9, 115.9 7.9 and 114.1 7.9 mg%, Mean Std Error,
respectively).
CONCLUSION
The 6-week aquatic exercise protocol contributed to normalize the blood
glucose in both men and women with Type 2 DM, every exercised day. Fasting
venous glycemia revealed a better response in women, who got lower values
after the first workload intensity of the exercise program.
Acknowledgements - This research was supported by CONACyT Government
of Mexico, grant 9702009.
fmur , enquanto nos outros stios analisados no houve diferena significativa. No houve diferena significativa
entre as participantes de musculao e praticantes de hidroginstica em nenhum dos stios avaliados. Assim, esses
resultados sugerem que tanto a musculao , como j havia sido preconizado por vrios estudos, quanto a
hidroginstica (talvez surpreendendo muitos profissionais da Educao Fsica cticos com relao aos benefcios
das atividades aquticas para indivduos osteoporticos), mostraram ser positivas para uma maior DMO em
relao populao sedentria.
Takeshima (2002), em estudo feito no Japo com pessoas entre 60 e 75 anos de idade que praticaram a
Hidroginstica por 12 semanas , em sesses de 70 minutos , 3 vezes por semana, verificou um aumento do
VO2mx. e da flexibilidade, alm de relevante incremento da fora em todos os praticantes. Lopez e Silva (2002),
estudaram os efeitos da Hidroginstica na Osteoporose .Em 1 ano de trabalho , com freqncia de 3 vezes por
semana, alunas de 60 a 77 anos que faziam reposio hormonal tiveram diminuio do IMC (ndice de Massa
Corporal) e da gordura corporal, alm do aumento do peso magro e da flexibilidade , sendo que 70% das alunas
melhoraram a DMO da coluna lombar e 60% do fmur.
Segundo Wysong (2003),os exerccios aquticos melhoram o equilbrio em mulheres no perodo psmenopausa, e podem indiretamente ajudar a impedir quedas, de acordo com um estudo apresentado no II
Encontro Anual da Sociedade Americana para a pesquisa do osso e seus minerais. Nesse trabalho, 73 mulheres
foram divididas em trs grupos: praticantes de hidroginstica, praticantes de ginstica localizada e grupo controle.
Ao fim do estudo, ambos os sujeitos dos grupos que fizeram atividades fsicas obtiveram ganhos de fora, correo
da postura, melhora do equilbrio, da marcha e da execuo das atividades cotidianas. Contudo, as mulheres
treinadas na gua, apresentaram maiores nveis de equilbrio lateral, o que pode ajudar muito na preveno de
quedas .
De acordo com Clark (2003), em um recente estudo conduzido por um conjunto de pesquisadores (GOLDSTEIN,
SIMKIN, EPOSTEIN, PERITZ, HARUSH) no Instituto Wingate de Israel, um grupo de mulheres no perodo psmenopausa se exercitou tanto na gua quanto fora dela. O impacto vertical dos exerccios aquticos mostrou ser
bastante significativo no aumento da DMO mensurada nos pr e ps-testes.Alm do mais, o grupo de mulheres que
se exercitou na gua apresentou um aumento relevante da DMO (1%) quando comparado ao grupo exercitado fora
da gua (0,17%).
A revista "Prevention Magazine" (1994, p.19-20; apud CLARK,2003), relatou os resultados de um estudo feito
no Japo, envolvendo 35 mulheres na fase ps - menopausa, que participaram de um programa de Hidroginstica.
Elas se exercitaram apenas uma vez por semana , por 45 minutos. Dentro de um ano ,esse programa de exerccios
no somente paralisou a perda de massa ssea , como tambm aumentou discretamente a densidade mineral
ssea da coluna das participantes.
CONCLUSO:
Tendo em vista todos os trabalhos cientficos relatados acima, conclumos que a Hidroginstica uma atividade
fsica capaz de proporcionar a seus praticantes um aumento do condicionamento cardiopulmonar, da fora
muscular , da flexibilidade e equilbrio, alm de propiciar uma sobrecarga no tecido sseo suficiente para estimular
algum grau de osteognese , j que os exerccios realizados em piscina rasa ( entre 1,20 e 1,40 m de
profundidade) ainda oferecem impacto durante os saltitos realizados nesse meio.Logo, essa atividade, se
planejada para esse fim, pode contemplar todos os itens preconizados pelo ACSM com relao prescrio de
atividade fsica para idosos, ou seja, coordenao, equilbrio, flexibilidade e fora muscular.
A Hidroginstica pode no ser a atividade fsica que mais osteognese promove, porm, rene uma srie de
outros fatores tais como segurana, ludicidade do meio, ausncia de espelhos, adaptabilidade aos diferentes nveis
de alunos, possibilidade de ganhos de fora pela ao da resistncia da gua e, portanto, a que mais atrai a
populao da terceira idade. Assim, deve ser sugerida ao portador de Osteoporose, dentre outras atividades
fsicas, como uma modalidade que s vir a contribuir para a melhoria da qualidade de sua vida.
importante, contudo , que os profissionais da Educao Fsica tenham o bom senso para no prescrever a
Hidroginstica como a melhor modalidade para todas as valncias fsicas do individuo .Para o portador de
Osteoporose, j foi ressaltada a importncia de atividades com pesos livres , como a ginstica e a musculao. Se
um idoso no se sente apto a iniciar com o trabalho dessas atividades neuromusculares antigravitacionais, a
Hidroginstica poderia servir como meio preparatrio at que se atingisse um condicionamento melhor para ,
ento , iniciar-se um programa de musculao, por exemplo. Outra opo ainda melhor seria intercalar as
atividades antigravitacionais com a Hidroginstica, para que o praticante obtivesse os efeitos de ambas.
Finalmente, se o indivduo no rene condies fsicas ou psicolgicas para a realizao das atividades em terra,
ou ainda, se simplesmente s gosta do trabalho na gua, j est claro que podemos oferecer a ele importantes
benefcios que sero eficazes na luta contra a Osteoporose e decisivos na melhora de sua qualidade de vida.
REFERNCIAS:
BALSAMO, S. A Influncia da Musculao e da Hidroginstica na Densidade Mineral ssea. Braslia: UCB, 2002 . 93
p.
CLARK, J. Older adult exercise techniques. Exercise for older adults. ACE's guide for fitness professionals.
American Council on Exercise. Human Kinetics, p.128-81, 1998.
CLARK,C. Osteoporosis and the Benefits of Water Exercise. BFY Sports & Fitness, 2003. Disponvel em : URL:
http://www.bfysportsnfitness.com/owaterex.html.
COLEGIO AMERICANO DE MEDICINA DESPORTIVA. Osteoporose e Exerccio. Med. Sci. Sports Exerc, Vol 27, n 4,
Benefcios da Hidroginstica
Vrios estudos de adaptao ao treinamento em gua profunda e pouco
profunda relatam significativas melhoras do condicionamento cardiovascular
nos praticantes de hidroginstica (Baretta1993,Hoegrer et al.1993,Michaud et
al.1992, Ruoti,Troup & Berger1994,Sanders 1993,Stevenson et al.1998)
Um estudo de Hoeger et al . (1993) comparou dois grupos ( A e B ) , o primeiro
composto por praticantes de Hidroginstica e o segundo por indivduos que faziam um
treinamento aerbio em terra, sendo que ambos treinamentos tinham a mesma
intensidade .Observou-se que os treinados na gua obtiveram uma reduo de 2% na
taxa de gordura corporal enquanto que os treinados em terra reduziram seu percentual
de gordura apenas em 1.1%.A dieta dos indivduos no foi controlada.
Diversos estudos (Hoeger et al.1993,Miss 1998, Ruoti et al.1994,Baretta 1993)
indicaram significantes incrementos de fora e resistncia muscular nas reas
controladas.Resulta de particular interesse o aumento da forca abdominal notificado por
Sanders(1993), dado que seu programa no utilizou nenhum exerccio potencialmente
abdominal.A melhora se atribuiu as tcnicas de alinhamento postural dinmico e vertical
.
Medicine & Science in Sports & Exercise: Volume 35(5) Supplement 1 May
2003 p S19
BONE MINERAL DENSITY: RELATIONSHIP TO LEG POWER AND
CARDIORESPIRATORY FITNESS IN POSTMENOPAUSAL WOMEN
Littrell, T R.1; Snow, C M. FACSM1
1
Desta forma, trabalhando com planejamento srio e seguindo o rendimento dos alunos
com avaliao fsica rotineira e criteriosa, fica fcil mostrar aos praticantes de
hidroginstica dados concretos sobre os benefcios desta atividade em suas vidas.
Medicine & Science in Sports & Exercise: Volume 31(5) Supplement May 1999
p S154
SUBMAXIMAL EXERCISE ON LAND AND IN WATER WITH AND WITHOUT
HAND-HELD WEIGHTS: COMPARATIVE EXERCISE PHYSIOLOGY
LeMura, L M FACSM; Klebez, J; Rushton, D; Adreacci, J; Presper, S; von
Duvillard, S P FACSM
Bloomsburg University, PA, University of North Dakota, Grand Forks, ND
Abstract 651
The purpose of this study was to compare the metabolic and physiologic
responses of submaximal exercise on land and in water with and without .90 kg
(2.0 pounds) hand-held weights. Eight women (X age = 19.8 1.6 yrs)
completed a maximal graded exercise test (GXT) and four submaximal exercise
tests: 1) on land with hand-held weights; 2) on land without hand-held weights;
3) in neck-depth water with hand-held weights and 4) in neck-depth water
without hand-held weights. Analyses of heart rate (HR), oxygen consumption
(VO2), ventilation (VE), respiratory exchange ratio (RER), blood lactate (BLa -)
and rating of perceived exertion (RPE) were conducted in all tests. A 2 X 2
(Environment X Weights) analysis of variance (ANOVA) revealed significantly
lower HR and VO2 responses during water exercise, and the addition of the
hand-held weights in the water significantly increased the HR at 21 minutes of
exercise. The addition of the weights in the water did not increase the
resistance or "drag" in the water, as indicated by the non significant changes in
the water with weights versus water without weights conditions. Responses for
VE and BLa- produced significantly higher responses on land with weights. The
lowest values for RPE were generated during water exercise. These data
indicate that water exercise is a suitable mode of activity for those who are
elderly, overweight or suffer from orthopedic injury while reducing the effort
perception of the exercise.
Supported by a Research and Disciplinary Grant of Bloomsburg University
Section Description
American College of Sports Medicine; 46th Annual Meeting; Washington State;
Convention & Trade Center; June 2-5, 1999
The abstracts contained herein were prepared by the authors and then printed
by photo-offset without correction. The accuracy, form of citation, designation,
nomenclature, and the like, all remain the responsibility of the author. Readers
should note that the appearance of an abstract does not imply future publication
of a regular scientific manuscript.
C-29 POSTER CARDIOPUL EXER EVALUATION
1999 Lippincott Williams & Wilkins, Inc.
LAFI - D I
ETRE
EFEITEFEITOSOSFISIOLGICOSDDAAIMERSOEDO
EXERCCIONAGUGUA
FTIMA A. CAROMANO*
MRIO ROBERTO F. THEMUDO FILHO**
JULIANA MONTEIRO CANDELORO***
Endereo para correspondncia:
* Profa Dra Ftima Caromano.
** Fisioterapeutas.
LAFI REACOM (Laboratrio de Fisioterapia e Reatividade Comportamental).
Rua Cipotnea, n 51, Cidade Universitria da USP, Campus So Paulo.
Curso de Fisioterapia da FMUSP, So Paulo / SP CEP: 05360-000.
LAFI - D I
ETRE
Efeitos fisiolgicos da imerso e do exerccio na gua
1. Respostas fisiolgicas decorrentes da imerso
1a. Respostas cardiovasculares durante a imerso
No que diz respeito s respostas cardiocirculatrias imerso, temos duas situaes diferentes a
considerar:
1. Como vrios autores demonstraram, imediatamente aps a imerso, como conseqncia da ao da
presso hidrosttica,
700 ml de sangue so deslocados dos membros inferiores para regio do trax, causado um aumento no
retorno venolinftico, e
ocasionando um aumento de 60,0 % do volume central. A presso intratorcica aumenta de 0,4 mmHg
para 3,4 mmHg e a presso
no trio direito aumenta de 14,0 mmHg para 18,0 mmHg. A presso venosa central aumenta de 2,0 a 4,0
mmHg para 3,0 a 16,0
mmHg, sendo que a presso arterial pulmonar aumenta de 5,0 mmHg no solo para 22,0 mmHg em
imerso. O dbito cardaco
(volume sangneo x a freqncia cardaca) aumenta de 30,0 % a 32,0% associados a uma diminuio de
aproximadamente 10
batimentos por minuto ou de 4,0 % a 5,0 % da freqncia cardaca em bipedestao no solo (DENISON
et al., 1972; HALL et al.,
1990; GREENLEAF, 1984, BOOKSPAN, 2000; BECKER & COLE, 1997).
2. Parte das alteraes cardiocirculatrias decorrentes da imerso so atribudas ao reflexo de mergulho,
que inclui
bradicardia, vasoconstrio perifrica e desvio de sangue para rgos vitais. O reflexo de mergulho ocorre
em situaes
significativamente diferentes como, molhar a face, imergir o corpo com a cabea fora da gua e imerso
total com apnia. Nos
homens conseqncia da interao e competio de vrios fatores mecnicos e neurais (RUOTI et al.,
1997).
pode ser igual, maior ou menor na gua que na terra, dependendo da atividade, profundidade de imerso e
velocidade do movimento
(CURETON, 2000, CRAIG & DVORAK, 1969).
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Algumas atividades fsicas merecem ser discutidas em detalhes.
Ciclismo - COSTILL (1971) observou que exerccios com bicicleta, com o sujeito em imerso at o
pescoo, a 50
revolues por minuto, em gua a 25oC, exigiu de 33% a 42% mais energia do que o exerccio com
bicicleta mesma taxa de
trabalho em terra com o ar a 24oC. CRAIG e DVORAK (1968) realizaram experimentos similares a 30oC
e 35oC e no encontraram
diferena no dispndio energtico e respostas cardiorespiratrias.
Caminhada, trote e corrida - EVANS et al. (1978) estudaram o dispndio de energia durante a caminhada
em duas
velocidades e durante o trote em trs velocidades, percorrendo uma piscina a 31oC, com gua pela cintura.
A capitao de oxignio
foi maior nas duas atividades, em todas as velocidades, do que o mesmo exerccio realizado em esteira
ergomtrica. Foi necessria
de metade a um tero da velocidade para caminhar ou trotar na piscina no mesmo nvel de gasto
energtico. Dos vrios estudos
produzidos nessa linha de pesquisa, pode-se concluir que, quanto maior a imerso menor o gasto
energtico nas atividades de
caminhar e trotar, e que, este gasto varia em funo descarga de peso e resistncia oferecida pela gua
(CURETON, 2000).
BISHOP et al. (1989) compararam as respostas fisiolgicas corrida em imerso, com cada participante
utilizando um
colete de flutuao, com as respostas corrida em uma esteira rolante no mesmo nvel percebido de
esforo. Os participantes
exercitaram-se a uma intensidade preferida para uma corrida de treinamento de 45 minutos. Os graus de
esforo percebido (GEP)
no diferiram nos dois modos de exerccio. O consumo de oxignio mdio foi de 1,97 l/min e 2,68 l/min e
a freqncia cardaca
mxima de 122 bpm e 157 bpm respectivamente. Os autores concluram que o custo metablico da
corrida em imerso, com um
colete de flutuao, a uma intensidade preferida de esforo, menor que a corrida na esteira ergomtrica.
HITCHIE & HOPKINS (1991) compararam o dispndio de energia durante a corrida em imerso sem um
aparelho de
flutuao e a corrida em esteira durante 30 minutos, em ritmo intenso, com corredores treinados. O
consumo de oxignio mdio,
expresso em relao ao peso corporal foi de 49 ml/Kg/min durante a corrida na gua e de 53 ml/Kg/min
durante a corrida na esteira.
Os autores concluram que a intensidade se mostrou suficiente para melhorar o consumo de oxignio
sendo, portanto, uma forma
eficaz de treinamento.
2c. Circulao
A resposta cardiovascular ao exerccio na gua diferente daquele em terra. A freqncia cardaca tende a
permanecer
inalterada em repouso e durante exerccios de baixa intensidade, mas diminui nos nveis de intensidade
mais altos de exerccio
submximo e mximo, em comparao com exerccios em terra (SHEDAHL et al., 1987).
A relao da freqncia cardaca e do gasto energtico durante o exerccio na gua com relao ao
exerccio na terra de
particular importncia, porque a freqncia cardaca comumente utilizada para descrever e regular a
intensidade metablica do
exerccio. comum observar que a freqncia cardaca, s vezes, mais durante exerccios na gua em
comparao com seu
similar no solo. Esta resposta em parte dependente da temperatura da gua. Durante exerccio de leve a
moderada intensidade, em
imerso com a cabea fora da gua, em temperatura termoneutra (31oC a 33oC), a freqncia cardaca no
diferente daquela
durante o mesmo exerccio em terra no mesmo nvel de gasto energtico (CONNELLY et al., 1990).
A profundidade da gua tambm afeta a freqncia cardaca durante o exerccio ereto, sendo que, durante
o exerccio
aerbico na gua, a freqncia cardaca de 8 a11 bpm mais baixa com gua na altura do trax do que
com gua pela cintura
plvica (CURETON, 2000).
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2d. Ventilao
Apesar das alteraes que ocorrem a partir da imerso, a ventilao em repouso, o volume corrente e a
freqncia
respiratria ficam inalterados (SHEDAHL et al., 1987).
Durante exerccios submximos a ventilao a mesma que durante exerccios em terra no mesmo nvel
de gasto energtico.
Diferentes temperaturas de gua (18oC a 33oC) tm pouco efeito (MOORE e col., 1970). Durante
exerccios em nveis mximos de
esforo, comparados com exerccios em terra, exceto para bicicleta, tendem a serem inferiores, embora a
porcentagem de saturao
de hemoglobina com oxignio sejam semelhantes.
SHEDAHL et al. (1982) constataram que mulheres obesas que pedalaram em bicicleta a 405 da capitao
mxima de
oxignio, no tiveram nenhuma alterao da temperatura retal durante 90 minutos de atividade em gua a
20oC, 24oC e 28oC.
Mulheres magras tiveram uma queda progressiva na temperatura retal nas duas temperaturas mais baixas
e nenhuma alterao na
temperatura mais alta. O tremor elevou o gasto energtico das mulheres magras nas duas temperaturas
mais baixas.
a temperatura central (retal), respectivamente, do grupo que treinou em gua quente foram, em mdia,
27bpm e 15oC mais altos
do que o grupo que treinou em gua fria. A captao mxima de oxignio aumentou em 13% para ambos
os grupos. O treinamento
aumentou a capacidade oxidativa do msculo a um grau semelhante em ambos os grupos, e o volume
sangneo no se alterou
significativamente em qualquer dos grupos. Os resultados do estudo sugerem que as temperaturas cutnea
e central do corpo no
afetam a adaptao metablica e cardiovascular do treinamento na gua. A alterao no volume
plasmtico e sangneo pode Ter
ocorrido em razo da supresso da liberao de vasopressina, renina e aldosterona durante o exerccio na
gua. Como as freqncias
cardacas dos dois grupos durante o treinamento diferiram por mais de 25 bpm, os resultados do estudo
reforam a concluso de
que as freqncias cardacas de treinamento so um mau indicador das adaptaes metablicas ao
treinamento. Uma desvantagem
do treinamento em gua fresca que ele no melhora a tolerncia ao calor.
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LIEBER et al. (1989), MICHAUD & BRENNAN (1992) e BRENNAN & MICHAUD (1992) estudaram
os efeitos de
treinamento de corrida, na captao mxima de oxignio, em adultos jovens e de meia idade, sedentrios.
O treinamento de corrida
em imerso foi eficaz para aumentar e manter a captao mxima de oxignio e o desempenho em
corrida. Indivduos no treinados
que efetuaram 16 a 36 minutos de corrida com intervalos, em imerso, a 63% a 82% da freqncia
cardaca mxima, 3 dias por
semana, durante 8 semana, aumentaram a captao mxima de oxignio de corrida em esteira e na gua
em 10,7% e 19,6%
respectivamente.
Dois trabalhos avaliaram os efeitos de exerccios de calistenia na gua.
MINOR et al. (1989) estudaram os efeitos de exerccios calistnicos em imerso at o trax, em sesses
de uma hora, trs
dias por semana, por doze semanas, em pacientes com artrite reumatide ou osteoartite. Durante o
perodo de atividade a freqncia
cardaca variou de 60% a 80% da freqncia cardaca mxima. A captao mxima de oxignio aumentou
em 19% a 20%.
RUOTI et al. (1994) estudaram o efeito de um programa de exerccios na gua sobre a resistncia
muscular, a composio
corporal e a capacidade de trabalho aerbico em 12 homens e mulheres idosos. A captao mxima de
oxignio durante a caminhada
na esteira aumentou em 15%, a porcentagem de gordura corporal no alterou de forma significativa, a
freqncia cardaca em
repouso diminuiu em 7%, a freqncia cardaca durante caminhada na gua, em velocidade padro,
diminuiu em 20 % e a resistncia
dos msculos dos braos e ombros aumentaram em 11% e 35% respectivamente. Os autores
demonstraram que exerccios calistnicos
constituem um meio eficaz para melhorar a funo cardiorespiratria e a capacidade de trabalho fsico do
idoso.
Referncias bibliogrficas:
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AVELLINNI BA, SHAPIRO Y, PANDOLF KB. Cardiorespiratory physical training in water and on land. Eur J Appl Physiol.
50:255-263, 1983.
BECKER BE e COLE A. Comprehensive Aquatica Therapy. Butterworth-Heinemann, Boston, 1997.
BECKER, BE. Aspectos biofiolgicos da hidroterapia. Em: Becker EB. E Cole AJ. (eds) Terapia Aqutica Moderna, cap. 2: 17-50,
Editora Manole, So Paulo,
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BISHOP PA, FRAZIER S, SMITH J. Physiologic responses to tradmill and water running. Physician Sportsmedicine, 17: 87-94,
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BOOKSPAN, Jolie. Efeitos fisiolgicos da imerso em repouso. Em: Ruoti RG, Morris DM e Cole AJ, Reabilitao Aqutica. So
Paulo, Editora Manole,
2000.
BRENNAN DK, MICHAUD TJ, WILDER RP. Gains in aquarunning peak oxigen consumption after eight weeks of aquarun
training. Med Sci Sports Exerc.
23:S23, 1992.
BUFALINO KD, MOORE A, SLONIGER EL. Physiological and perceptual responses to bench stepping in water and in land.
Med Sci Sport Exerc. 24:
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CASSIDY SL, NIELSEN DH. Cardiorespiratory responses of healthy subjects to calisthenics performed on land versus in water.
Phys Ther., 72: 532-538,
1992.
CONNELLY TP, SHEDAHL LM, TRISTANI FE. Effect of increased central blood volume with water immersion on plasma
catecholamines during exercise.
J Apll Physiol. 23:238-241, 1990.
COSTILL DL. Energy requirements during exercise in water. J. Sports Med Phys Fitness, 11: 87-92, 1971.
CRAIG AB, DVORAK M. Comparison of exercise in air and in water of different temperatures. Med Sci Sports. 1:124-130, 1969.
CRAIG AB, DVORAK M. Thermal regulation of man exercising during water immersion. J Appl Physiol. 25:28-35, 1968.
CURETON KJ. Respostas fisiolgicas ao exerccio na gua. Em: : Ruoti RG, Morris DM e ole AJ, Reabilitao Aqutica. So
Paulo, Editora Manole, 2000.
DENISON DM, WAGNER PD, KINGABY GL e WEST JB. Cardiorespiratory responses to exercise in air and underwater. J.
Appl. Physiol. 33(4): 426-430,
1972.
EVANS BW, CURETON K.J, PURVIS JW. Metabolic and circulatory response to walking and jogging in water. Res Q., 49: 442449, 1978.
FRANGOLIAS DD, RHODES EC, BELCASTRO AN. Comparison of metabolic responses to prolonged work at tvent during
treadmill and water
immersion runing. Med Sci Sports Exerc. 26: S10, 1994.
GREENLEAF JE. Physiological responses to prolonged bed rest and fluid immersion in humans brief review. J. Appl. Physiol.:
Respirat. Environ. Exercise
Physiol. 57(3):619-633, 1984.
HALL J, BISSON D e OHARE P. The Physiology of immersion. Physioherapy, 76(9):517-521, 1990.
HITCHIE SE, HOPKINS WG. The intensity of exercise in deep water running. Int J Sports Med, 12: 27-29, 1991.
HOLMER I. Oxygen uptake during swimming in man. J Appl Physiol, 33:502-509, 1972,
LIEBER DC, LIEBER RL, ADANS WC. Effects of run training and swin training at similar absolute intensities on treadmill
VO2mx. Med Sci Sports Exerc.
21:655-661, 1989.
MICHAUD TJ, BRENNAN DK, WILDER RP. Aquarun training and changes in treadmill running maximal oxygen consuption.
Med Sci Sports Exerc.
24:S23, 1992.
MINOR MA, HEWETT J, WEBEL RR. Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and
osteoartitis. Arthritis Rheum.
32:1396-1405, 1989.
MOORE T.O., BERNAUER E.M., SETO G. Effect of immersion at different water temperatures on graded exercise performance
in man. Aerospace
Medicine. 41:1404-1408, 1970.
PENDERGAST DR, DiPRAMPERO PE, CRAIG AB. Quantitative analysis of the front crawl in men and women. J Appl
Physiol. 43:475-479, 1977.
RUOTI RG, MORRIS DM e COLE AJ. Aquatic Rehabilitation. New York, Lippincott, 1997.
RUOTI RG, TOUP JT, BERGER RA. The effects of nonswimming water exerciseon olders adults. J Orthop Sports Phys Ther.
19:140-145, 1994.
SHEDAHL LM, BUSKIRK ER, LOOMIS JL. Effects of exercise in cool water on body weight loss. Int J Obes. 6:29-42, 1982.
SHEDAHL LM, TRISTANI FE, CLIFORD PS. Effect of head out water immersion on response to exercise training. J Appl
Physiol. 60:1878-1881, 1986.
SHEDAHL LM, TRISTANI FE, CLIFORD PS. Effect of head out water immersion on cardiorespiratory response to dynamic
exercise. J Am Coll Cardiol.
10:1254-1258, 1987.
TIPTON MJ, GOLDEN F. Immesrion in cold water. Em: Harries M. (ed) Oxford textboob of Sports Medicine Oxford University
Press, 1996
YOUNG AJ, SAWKA MN, QUIGLEY MD. Role of thermal factors on aerobic capacity improvements with endurance training. J
Appl Physiol. 75:49-54,
Medicine & Science in Sports & Exercise: Volume 35(5) Supplement 1 May
2003 p S183
HEART RATE AND VO2 RESPONSES TO INCREMENTAL EXERCISE WITH
LAND AND AQUATIC CYCLING
White, J S.1; Yeater, R A.1; Liparulo, T L.1; Lowther, C G.1; Parker, J E.1;
Hornsby, J A.1; Ullrich, I H.1; Hornsby, W G. FACSM1
1
Despite the difference in peak HR's, peak VO2 values were equivalent.
However, the WW values for both HR and VO2 at SM levels were significantly
lower than the LB values. The WW HR was lower due to the implementation of
the 17 beat subtraction from the LB HR. The observed differences in VO2 at SM
levels suggests that the 17 beat land to water HR reduction may not be
accurately depicting the same relative exercise intensity between LB and WW
exercise.
2003The American College of Sports Medicine
Medicine & Science in Sports & Exercise: Volume 28(5) Supplement May 1996
p 189
STRENGTH, FLEXIBILITY, AND BODY COMPOSITION CHANGES OF
OLDER WOMEN FOLLOWING 10 WEEKS OF WATER EXERCISE 1124
Swank, S. A.*; Long, K. A.; Lee, E. J.; Poindexter, H. B.
Human Performance Dept., Rice University, Houston, TX.
The purpose of this study was to determine the effectiveness of deep water
exercise on muscle strength, flexibility, and body composition in older women.
Thirty-five sedentary women were assigned to control (CO, N=10, 57.52.3 yr)
and exercise (EX, N=25, 63.11.6 yr) groups. Volunteers were considered
sedentary if they had not exercised 3 dwk -1 during the last year. Pre and post
training, subjects completed maximal strength, Sit-and-Reach (SNR), and body
composition measurements. Strength was assessed using the 1 repetition
maximum for: bench press (BP), leg press (LP), bicep curl (BC), leg extension
(LE), tricep extension (TE), leg curl (LC), and lat pull (LAT). Subjects completed
two SNR trials with the average of the two trials recorded. Skinfolds were taken
at the tricep, subscapular, suprailiac, abdomen, and anterior thigh. Percent body
fat (%BF) was estimated from the calculated body density using the Siri
formula. Subjects performed supervised deep water exercise (DWE) 3 dwk -1 for
10 wk (compliance=85%). Following DWE, all strength and stretching exercises
were performed using only water resistance in the shallow end of the pool, with
the number of reps of sets increasing weekly. The order of strength exercises
was: hamstring curl, side leg extensions, rear kicks, front kicks, soccer kicks,
bicep curl, pectoral press, front arm raises, lateral arm raises, and tricep press.
No significant differences existed between EX and CO prior to training. After
training, EX had significantly greater (p.05) LE, LP, BP, and LAT. SNR
significantly decreased (p.05) in CO, but remained unchanged for EX. EX
significantly decreased%BF (p.05) and all skinfold measures (p.05, while CO
significantly increased%BF (p.05) and tricep skinfold measurements(p.05).
Our results suggest that deep water exercise is a viable training method for
decreasing%BF and increasing strength in older women.
Section Description
H-9 POSTER TRAINING AND PERFORMANCE
Hidroginstica e osteoporose
*Prof. de Hidroginstica da ACM-Braslia
**Prof. Fac. de Educ. Fsica. UnB
Diretor do Instituto Latino-americano de Atividade Fsica Teraputica
(ILAFiT)
(Brasil)
1/3
Introduo
As melhorias na medicina e padres gerais de vida durante o
ltimo sculo levaram a um considervel aumento na expectativa de
vida. Com o aumento da idade surgem novas doenas e da a
necessidade de preveno e retardamento das inevitveis
enfermidades. nesse contexto que entra a Educao Fsica,
integrante ativo no setor da sade, com objetivo de, atravs de
exerccios fsicos orientados e seguros, promover um bem estar fsico,
social e psicolgico a essas pessoas.
A atividade fsica torna-se uma terapia importante e necessrio
que o professor de Educao Fsica que visa a sade do aluno, se
interesse mesmo que superficialmente pelas diversas enfermidades
e, se for o caso, at mesmo redirecionar a modalidade fsica aps
uma conversa com o mdico.
Dentre as atividades fsicas mais indicadas pelos mdicos para os
idosos, notria a escolha pela hidroginstica, considerada uma
atividade segura, prazerosa e eficiente devido aos efeitos
teraputicos proporcionados pela gua no quadro das doenas
metablicas sseas.
Uma das doenas metablicas sseas de maior incidncia a
OSTEOPOROSE, onde existem autores que apiam e outros que
desaprovam a utilizao de exerccios na gua como um fator
benfico no processo de aumento de massa ssea.
Exerccios respiratrios;
Hidroginstica e osteoporose
Ao analisarem 77 mulheres ps-menopausa, no encontraram
aumento significativo na DMO (densidade mineral ssea) da espinha
aps perodo de prtica de HIDROGINSTICA (12-2). Uma pesquisa
realizada em Israel, relata aumentos significativos na DMO em
mulheres ps-menopausa aps participarem de um programa de
exerccios aquticos por 15 meses, 3 vezes por semana, tendo um
aumento maior que o grupo que realizou o exerccio em terra e que o
grupo controle (11).
So recomendveis atividades como HIDROGINSTICA, exerccios
com peso (musculao), ambos com importante efeito na reduo da
osteoporose. de suma importncia a orientao prvia de um
professor de educao fsica capacitado durante o planejamento e
prescrio para recalcular intensidade, bem como propor novos
exerccios (21).
importante adotar uma posio de equilbrio, no indicando a
hidroginstica como recurso mgico, nem contraindic-la, sendo mais
adequado associar a hidro com atividades como caminhada, ginstica
ou dana (15).
Lecturas: Educacin Fsica y Deportes http://www.efdeportes.com Ao 8 N 44
Ainda no se pode dizer qual a melhor atividade (se que existe uma
melhor) para o combate da osteoporose. Entretanto, o exerccio fsico
atua na preveno e recuperao da osteoporose. Podemos inferir
que o desenvolvimento das valncias fsicas - fora, flexibilidade,
resistncia, equilbrio, coordenao e o condicionamento
cardiorespiratrio - ir diminuir o risco de quedas. Ento a
hidroginstica pode ser classificada como uma atividade importante
no combate aos efeitos deletrios da diminuio da massa ssea
(12).
Objetivo geral
Comprovar a eficcia de um programa de exerccios aquticos
(hidroginstica) para uma amostra de portadores da sndrome
osteoportica.
Objetivos especficos
1. Avaliar as mudanas antropomtricas que acontecem na
amostra, motivo desse estudo.
2. Avaliar as transformaes que acontecem na varivel motora
da flexibilidade.
3. Verificar as modificaes na densidade mineral ssea.
Materiais e mtodos
Concluses
1. O programa de atividade fsica desenvolvido atravs de
exerccios fsicos de hidroginstica foi benfico para o grupo
estudado visto que houve uma melhora nas medidas
antropomtricas (peso, IMC, peso magro, peso gordo e
percentual de gordura).
2. Na flexibilidade constata-se uma melhora no grau de
flexibilidade nos segmentos analisados. Destacando-se a
retrao de isquiotibiais.
3. Foi constatado atravs da anlise geral dos resultados que
70% das alunas que apresentavam uma BMD reduzida na
coluna lombar no incio do programa obtiveram uma melhora
e dessa mesma amostra, em relao ao fmur, 60% delas
aumentaram a BMD.
4. A partir das concluses anteriores se aceita a hiptese a qual
expressa: programa de hidroginstica aplicada tem um efeito
positivo na amostra de portadores da sndrome osteoportica
estudada.
Recomendaes
Bibliografia
1. BANDEIRA, Francisco, MACEDO, Gesa, CALDAS, Gustavo,
GRIZ, Luiz e FARIA, Manoel. Osteoporose. Rio de Janeiro:
Medsi, 2000.
2. BRAVO, G. and al. A weight-bearing, water-based exercise
program for osteopenic women: Its impact on bone, functional
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pp.1375-1380. 1997.
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e Exerccio. Med. Sci. Sports Exerc, Vol 27, n 4, pgs. 662666, 1995
4. FOX, E.L. BOWERS R.W. & FOSS M.L. Bases fisiolgicas da
educao fsica e dos desportos. 4ed. Rio de Janeiro:
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7. KAPANDJI, I. A. Fisiologia Articular. Esquemas comentados de
mecnica humana. Tronco e coluna vertebral. So Paulo:
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8. KAPLAN, Frederick S. Preveno e Tratamento da Osteoporose.
Revista Clinical Symposia. v.47, n.1, So Paulo: Novartis, 1995.
9. KNOPLICH, Jos. Prevenindo a Osteoporose: orientaes para
evitar fraturas. So Paulo: Ibrasa, 1995.
10. KRAVITZ, L. & MAYO, J. The physiological effects of aquatic
exercice: a brief review. AEA. 1997.
11. LINDLE, J. The influence of weight-bearing water exercises on
bone density of post-menopausal women. The AKWA letter,
1994.
12. MASI, Fabrizio Di. Hidro. Propriedades Fsicas e Aspectos
Fisiolgicos. Rio de Janeiro: Sprint, 2000.
13. McARDLE, W.D, KATCH F.I. & KATCH V.L. Fisiologia do exerccio.
Energia nutrio e desempenho humano. 4ed. Rio de Janeiro:
Guanabara Koogan, 1998.
Densitometria ssea. Tabela 4: anlise qualitativa da evoluo dos diagnsticos dos casos
estudados
Nephrol
Dial
Transplant
(2003)
18:
2003 European Renal Association-European Dialysis and Transplant Association
624-625
Letter
Regular low-intensity aquatic exercise improves cardiorespiratory functional capacity and reduces proteinuria in
chronic renal failure patients
lle Pechter1, Jaak Maaroos1, Siiri Mesikepp2, Alar Veraksits1 and Mai Ots2
1
Sir,
Results from several studies indicate that patients with chronic renal failure (CRF) can
benefit from regular exercise training by improving their cardio-respiratory capacity and
quality of life [1,2]. However, there have been no studies examining the effect of
exercise on renal function in patients with moderate renal failure. Although experiments
have shown that swimming significantly lowers proteinuria and reduces
glomerulosclerosis in rats [35], human non-swimming exercise studies were not able to
confirm these findings [6]. Interestingly, studies with uraemic animals have shown that
land-based exercise did not positively affect the renal function [7,8], whereas waterbased training effectively reduced proteinuria and glomerulosclerosis, even though these
pathologies were less prominent [3,4]. Previous work has shown that aquatic immersion
favourably affects renal function by lowering plasma renin activity, decreasing renal
sympathetic nerve activity and by immediately altering cathecholamine and
prostaglandin levels [5], thereby decreasing renal vascular pressure and elevating
sodium excretion [9,10]. Several studies have validated the use of the aquatic
environment in exercise therapy [11], and have shown that water immersion per se
significantly affects blood circulation, and especially stimulates increases in renal blood
flow. The orthostatic and renal vasoconstrictive effects of land-based exercise can be
avoided by exercising in water. We therefore hypothesized that individually dosed and
well-supervised aquatic exercise training may provide an effective therapeutic
rehabilitation method for CRF patients by improving physical capacity and retarding the
progression of renal failure. The aim of the study was to determine the efficacy of lowintensity 12-week regular aquatic exercise training on cardio-respiratory endurance and
renal functional parameters in patients with CRF.
We designed a prospective study including patients (n=20) having moderate proteinuria,
with no anaemia, and with two or more cardiovascular risk factors with one of the
factors being physical inactivity. There were 12 patients with chronic
glomerulonephritis, five patients with hypertension and three with diabetes. Eleven
patients out of the 20 had mild cardiovascular problems (NYHA I-II), and all were on
antihypertensive therapy, which was not changed during the programme. There were no
dietary alterations and patients were instructed to maintain usual diet habits. The patients
were divided into two groups that were matched by age, blood pressure, body mass
index (BMI), maximal oxygen uptake and renal function: an exercising group (n=11: six
males, five females, age range 3165 years, mean age 49.53.5 years) and a control
group (n=9, six males, three females, age range 3565 years, mean age 47.93.8 years)
that remained sedentary during the study period. We measured cardio-respiratory
functional capacity, urinary protein excretion (UprotV, g/24 h), serum creatinine
(mol/l), cystatin C (CysC, mg/l), total cholesterol (mmol/l), HDL/LDL cholesterol
(mmol/l) and triglycerides (mmol/l) at baseline and at follow-up. Glomerular filtration
rate (GFR) was calculated using the CockcroftGault formula. Cardio-respiratory
functional capacity was determined using cardiopulmonary exercise testing (on
ergometric bicycle) that included measurement of peak oxygen uptake (VO2max,
ml/min/kg), oxygen pulse (ml/heartbeat/min) and peak load (W) at the ventilatory
anaerobic threshold. Intensity of training was determined individually after testing and
was 4050% of VO2max (low-intensity). The training group exercised vertically in the
pool (water temperature +2426C) two times per week for 30 min/session. The exercise
involved the joints and body and was under supervision of a trained physical therapy
specialist and rehabilitation physician. Differences between initial and final values
within groups were evaluated using two-sample paired t-test for means. P<0.05 was
accepted as statistically significant (NS, not significant). Informed consent was obtained
from all patients and the Ethics Review Committee on Human Research at the
University of Tartu approved the study protocol.
At study completion, blood pressure levels were significantly lower in the exercise
group contrasting with no change in the control group (Table 1 ). Although all of the
physical capacity parameters significantly improved in the exercising group, they
remained the same in the controls. Lipid parameters were slightly improved in
exercising patients, although the differences were not significant. In the controls, lipid
levels remained practically unchanged. BMI did not change in either group and at the
end of the study was 28.80.7 in the exercise group and 28.11.3 in controls. Renal
functional parameters of exercising patients improved during the study (Table 1 ). In
this group, 24 h proteinuria (g/24 h) diminished significantly from 1.00.3 to 0.50.3,
mean cystatin C levels decreased from 1.70.2 to 1.30.1 and serum creatinine
decreased from 161.713.7 to 154.812.4. An improvement in GFR was also detected
(60.07.4 to 67.310.1).
View this table: Table 1.
[in this window]
[in a new window]
In summary, all of the aquatic-exercising patients benefited from improved physical
functioning and showed significant decreases in proteinuria. The decreases in cystatin C
confirmed the amelioration of renal function. In contrast, renal functional parameters
worsened in sedentary controls during the study period. The decrease in proteinuria in
exercising patients was due partly to the normalizing of systemic blood pressure but was
also probably related to other well described mechanisms associated with water-based
exercise, including alterations in plasma angiotensin II and renal prostaglandin levels as
well as reductions in and renal sympathetic activity in response to immersion [11].
References
1. Oberley ET, Sadler JH, Alt PS. Renal rehabilitation: obstacles, progress, and
prospects for the future. Am J Kidney Dis2000; 35 (4 Suppl 1):S141S147[ISI]
[Medline]
1. Painter P et al. Physical functioning and health-related quality-of-life changes
with exercise training in hemodialysis patients. Am J Kidney Dis2000; 35:482
492[ISI][Medline]
Idoso diabtico:
Verifique o horrio de aplicao da insulina, sempre afira os nveis glicmicos
para saber dosar a intensidade do exerccio, tome cuidado para no ferir os
ps do aluno j que a circulao perifrica bem prejudicada no diabtico
(sugira o uso de sapatilhas, evite colocar o aluno prximo a ralos ou outra
protuberncia no cho ou parede da piscina);
Idoso obeso:
Procure trabalhar na parte mais funda da piscina na qual ele consiga por os
ps no cho; isso aliviar mais o peso sobre as articulaes e far o exerccio
mais intenso para ele, j que ter que se movimentar contra a resistncia de
uma maior quantidade de gua. Cuidado ao colocar caneleiras flutuantes, pois
o obeso, pela grande quantidade de gordura corporal (gordura menos densa
que a gua) tem muita facilidade de flutuar, e , com as caneleiras, poder
perder o equilbrio, subir as pernas e se afogar (prefira, inicialmente, trabalhar
com caneleiras flutuantes sempre com o apoio da barra na parede).
Idoso hipertenso:
Muito cuidado com as entradas e sadas na gua. Em geral, trabalha-se dentro
da gua com uma presso arterial (PA) menor do que o seria fora da gua
(pois o empuxo facilita o retorno venoso facilitando, assim, o trabalho do
corao). Porm, durante a entrada e sada da gua, a PA tende a aumentar
um pouco devido diferena de temperatura entre pele e gua (ocorre
vasoconstrico e contrao muscular, alm da diferena entre a presso da
gua e do ar). Logo, sugira o uso de rampas ou escadas para que a adaptao
ao diferente meio seja gradativa. Cuidado tambm com excessivas elevaes
de braos acima da cabea, pois isso poder contribuir para um eventual
aumento da PA. Um sintoma tpico de elevao da PA a dor de cabea,
principalmente na nuca; se o seu aluno se queixar, suspenda a aula e afira sua
PA.
Idoso Osteoportico:
Primeiramente fundamental que o Professor de Educao Fsica saiba qual o
estgio da doena no seu aluno. Para isso, vale a pena pedir que seu aluno
traga um exame de Densitometria ssea laudado por seu mdico, que lhe
informar sobre a quantidade de osso que ele j perdeu. Alm de verificar os
valores da Densitometria, preciso avaliar o risco de fratura deste sujeito , pois
uma pessoa pode ter um osso menos denso e nem por isso ter grande chances
de se fraturar, ou vice-versa. Basta ligar para o mdico do aluno e pedir a ele
uma avaliao do risco de fraturas daquele idoso. Em geral, para indivduos
bem acometidos pela osteoporose, os movimentos mais perigosos e que
propiciam fraturas so as grandes flexes de coluna alm dos movimentos de
rotao da coluna. Assim, ao pensar em uma rotina de exerccios procure
eliminar esses componentes da aula. Aps escolher exerccios seguros, inclua
sries de trabalho de fora muscular, pois um msculo mais forte exercer
maior presso no osso gerando assim um maior potencial para nova formao
ssea.
Idoso sem doena nenhuma:
Parece impossvel mas existe sim. Caso seu aluno apresente um quadro fsico
satisfatrio, voc ainda assim dever tomar alguns cuidados especficos,
indicados sempre que se trabalha com a terceira idade:
.Dar aulas com o som mais baixo e usando msicas mais melodiosas do que
com batidas fortes;
.Explicar os movimentos falando mais alto e lentamente, de frente para o aluno,
e demonstrar o exerccio mais vezes, pois geralmente as acuidades auditiva e
visual j esto diminudas e o uso da touca e o barulho da gua atrapalham
muito;
.Ter pacincia com o idoso j que seus reflexos e sua coordenao motora no
so mais to apurados;
.Deixar um tempo maior da aula destinado ao aquecimento pois muitos deles
sofrem de limitaes articulares que se beneficiam com a elevao da
temperatura.
Finalmente, trabalhe com alegria, seriedade, estude cada doena nova e cada
limitao do seu aluno, pois dessa maneira , ganha o seu aluno, que receber
um servio seguro e efetivo, e ganhamos ns profissionais, que teremos a
oportunidade de melhorar a qualidade do nosso trabalho.
LAFIREACOM
EFEITEFEITOSOSFISIOLGICOSDDAAIMERSOESU
SUAARELAOCOMA
PRIVPRIVAOAOSENSORIALEORELAXAMENT
RELAXAMENTOOEMHIDRHIDROTERAPIATERAPIA1
Mrcia Gouveia da Cunha2
Ftima Aparecida Caromano3
1. Parte integrante da dissertao de mestrado a ser defendida no Programa de PsGraduao em
Fisiopatologia Experimental da FMUSP
2. Fisioterapeuta e Mestranda do Curso de Fisiopatologia Experimental da Faculdade de
Medicina da USP
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poolterapia.com.br
turbulncia funciona como uma massagem profunda,
provocando alvio da dor. importante postular
que isto devido presso e alongamento dos tecidos
tensos e movimentos de fluidos atravs das
fscias, bem como da estimulao dos
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Referncias Bibliogrficas
1. AGOSTONI E, GURTNER G, TORRI G, RAHN
H. Respiratory mechanics during submersion and
negative- pressure breathing. J Appl Physiol. 21
(1): 251 258, 1996.
2. BECKER BE, COLE AJ. Terapia Aqutica Moderna.
Manole, So Paulo, 2000.
3. BENSON H, BEARY JF, CAROL MP. The
relaxation response. Psychiatry, 1974; 37: 37-46.
4. BOOKSPAN J. Efeitos fisiolgicos da imerso
em repouso. Em Ruoti RG, Morris DM, e Cole
AJ, Reabilitao Aqutica. So Paulo, Editora
Manole,2000.
5. CAROMANO FA, PASSARELA J, CUNHA
MG, ALVES AMB, MENDEZ FAZ. Efeitos de
um programa de atividade fsica de baixa moderada
atividade na gua, no desempenho fsico
e controle do nvel de estresse em adultos jovens.
Encaminhado para Arquivos de Sade da
UNIPAR.
6. DENISON DM, WAGNER PD, KINGABY GL
e WEST JB. Cardiorespiratory responses to
exercise in air and underwater. J. Appl.
Physiol.33(4): 426- 430,1972.
7. DULL H. Watsu: exerccios para o corpo na
gua. Summus, So Paulo, 2001.
8. FIELD T, QUINTINO O, HENTELEFF T. Job
stress reduction therapies. Alternative Ther
Health Med. 3 (4): 54-56,1997.
9. GEIGLE PR, GOULD ML, HUNT HC. Aquatic
physical therapy for balance: The interaction of
somatosensory and hydrodynamic principles. The
Journal of Aquatic Physical therapy. 5(1): 4-10, 1997.
10. GREENLEAF JE. Physiological responses to
prolonged bed rest and fluid immersion in humansbrief
Revis. Terap.
Medicine & Science in Sports & Exercise: Volume 35(5) Supplement 1 May 2003 p S19
Despite a reduced skeletal response to mechanical stimulus, older women present a greater
skeletal response variability when compared with young women.
PURPOSE
This study was designed to determine the influence of subject's individual characteristics and
exercise type on bone mineral density change (BMD) in the femoral neck and lumbar spine.
METHODS
Subjects were 36 women, 53-78 yrs, at least 1 yr postmenopausal, not taking any medication
affecting bone. Subjects were randomly assigned to a hydro-gymnastics (HG, n = 20) and step
RESULTS
Age explained 16.4% of the BMD variance on femoral neck ( = 0.405, p = 0.021). Initial
lumbar spine BMD ( = -0.367, p = 0.028) and fat-free mass ( = -0.351, p = 0.035) explained
27.3% of the BMD variance on spine. Using these predictors as covariates, ANCOVA showed
BMD group differences on spine (HG 2.8 0.6% vs. SG 0.4 0.8%, p < 0.001) but not on
femoral neck (HG -0.7 0.9% vs. SG - 0.6 1.0%, p = 0.801).
CONCLUSION
The efficacy magnitude of a specific exercise intervention for bone seems to be dependent of
some subject characteristics. After adjusting for other predictors, the HG program induced a
higher BMD on lumbar spine of postmenopausal women while femoral neck BMD was not
impacted by either program. Supported by the Portuguese Foundation for Science (Sapiens
358007/99)
2003The American College of Sports Medicine
Medicine & Science in Sports & Exercise: Volume 28(5) Supplement May 1996
p 103
MECHANICAL POWER AND ENERGY COST OF WALKING IN WATER
RELATED TO SPEED 613
Beneke, R. FACSM1; Htler, M.1; Erasmus, J.*2; Leithuser, R.*1; Hock, L.*3
1
increased (p < 0.03) and decreased (p < 0.03) with velocity. As analysis of
orthogonal regressions demonstrates, calculation of E [Jm -1] by: E = 806.7
v1.72 + (0.99 + 1.64 v) (weight - 14), [%] by: = 14 v-0.6, and Pmech [W] by: E v
100-1, enables to prescribe the metabolic (r = 0.94, p < 0.001, y = 0.94x +
74.1) and the mechanical (r = 0.87, p < 0.001, y = 0.99x + 6.4) profile of walking
related to speed in 0.6 m deep water.
Section Description
D-31 SLIDE EXERCISE EVALUATION
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MOVIMENTO NA GUA
Ftima Aparecida Caromano
Profa. Dra. do Curso de Fisioterapia da Faculdade de Medicina da USP do LAFI-REACOM
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Introduo
O somatrio de determinados movimentos,
ocorrendo concomitante e seqencialmente,
caracterizam algumas atividades que so
importantes no processo de reeducao funcional:
caminhada, corrida, salto, movimentos funcionais de
membros superiores, inferiores e tronco.
Manter o equilbrio em imerso o ponto
de partida para um movimento controlado na gua.
Compreender os mecanismos do equilbrio e as
foras que agem neste momento so importantes
para elaborar o incio de um movimento suave e
preciso. Apesar do potencial de desequilbrio ser
muito maior neste meio, varias posturas oferecem
equilbrio no meio aquoso.
O domnio do meio aqutico tambm
facilitado com auxlio dos movimentos bsicos da
natao, principalmente com crianas e idosos em
busca de reeducao funcional. Considera-se ainda
a importante influncia que os acessrios utilizados
podem exercer ao modificar as foras atuantes
durante um determinado movimento, auxiliando ou
inibindo a ocorrncia dos mesmos.
Neste contexto, o objetivo explorar o
equilbrio, o movimento e os diferentes tipos de
movimentos de um corpo imerso na gua, de acordo
com os princpios fsicos da gua e biomecnicos
do corpo imerso.
Equilbrio na gua
Prover a estabilidade do paciente dentro da
gua critico para o fisioterapeuta, pois a partir
desse passo estatele-se um vnculo de confiana [3].
Campion [4] descreve quatro posies
utilizadas com freqncia (da mais estvel para mais
instvel): bola, cubo, tringulo e basto (Fig. 1).
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menopausal women. When the monthly cycle ceases a gradual process of decline in
bone density begins that may eventually lead to fractures in the vertebrae, the neck of
the thigh bone and the wrists.
Interest in osteoporosis has risen as the disease has become more widespread and life
expectancy in the modern world has lengthened. Attempts are being made to find ways
to not only prevent the appearance of osteoporosis, but also to deal with its
accompanying symptoms.
Part of this effort has been focused in recent decades on the research of processes
affecting the buildup and breakdown of bone. Studies of the subject have revealed that
when mechanical loads higher than those of routine daily physical activity are exerted
on bones, chances improve of delaying the process of declining bone density, at times
almost to the point of preventing it altogether.
The present study will examine whether non-swimming physical activity in water can
delay the decline in bone density among post-menopausal women. Twenty-five women
aged 50 and above will undergo a weekly water-exercise training program for seven
months. Another group of women of the same age will not undergo this training and will
serve as the control group. The hypothesis is that the women who engage in physical
activity will manifest minimal or no decline in bone density at the end of the study. The
control group of non-physically active women will manifest a decline in bone density at
the conclusion of the study.
The importance of the study can be attributed mainly to its uniqueness. To date, only
three studies have been conducted that examine the effect of non-swimming physical
activity in water on bone density and their findings are far from unequivocal. The
studies under question offered a limited scope of activity and did not make use of
special equipment for water-based physical activity that would have made it possible to
increase the activity load.
Water-based exercise has the potential to serve as an important medium for physical
activity for the elderly population. Activity in water virtually precludes the danger of
falling and facilitates the maintenance of body balance. It may also reduce the joint
pains often suffered by this population after land-based physical activity. Activity in
water is comfortable and pleasant. Cumulative experience indicates that participants in
such activity often turn it into a steady way of life.
Establishing the validity of water-based physical activity for the elderly population as an
appropriate means for preventing bone density loss will provide doctors, physical
education teachers, therapists and instructors with another important treatment tool for
preventing osteoporosis in this population.
found that bone density of the radius and the back is significantly higher among
swimmers than among non-swimmers. Heinrich (1990) reported that the mineral levels
in the hip and radius bones of young female swimmers was identical to those of
sprinters and was significantly higher than those found among the normal population.
On the other hand, in a follow-up of his 1987 study, Orwell (1989) found no correlation
between bone density and swimming when examining the effect of swimming on bone
mineral content among women aged 40+ who swam three times a week for a period of
at least three years.
Studies conducted on animals also examined the effect of swimming on bone structure.
Swissa (1989) tested the effect of swimming on the bones of 40 young female mice. Of
them, 30 swam for one hour, five times a week, for a period of 20 weeks. The other 10
mice did not engage in any activity. Bone tests revealed significantly higher bonedensity values for the experimental group. In a follow-up study, Swissa (1992)
examined the effect of swimming on the bones of older female mice. This study did not
confirm the results of the first study although it did show a significant effect for
swimming on L4-L5 vertebrae. The hypothesis is that although the spine is not as
directly involved in swimming as the long bones, the intensive movement of the limbs
causes mechanical load on the muscles, which affects the vertebrae.
to moderate contact with the pool floor. In this way they succeeded in meeting the
activity requirements but the effectiveness of the physical activity in the water was
compromised if not completely canceled. Moreover, it is known that in order to increase
the effectiveness of the physical activity, it is necessary to vary as much as possible the
type of stimuli applied to the bone, however, in this study the women were required to
perform the same type of jump all the time. Thus, it appears that there is some lack of
clarity about the effect of non-swimming physical activity in water on bone density.
The aim of the present study is to examine the effect of specially adapted physical
activity in water on bone density among post-menopausal women. The experimental
group will engage in seven months of physical activity in water at a frequency of three
sessions per week of 60 minutes per session. The structure of the sessions will be
adapted to the population and will be composed of warm-up, aerobic activity, strength
training, flexibility and cool-down. The instructor for the activity will be the researcher,
a qualified water activity instructor with certification by the AEA (Aquatic Exercise
Association) from the U.S.A.
The study will make use, for the first time, of equipment especially suited for waterbased exercise (Thera-Band, www.Thera-Band.com), making it possible to increase
resistance and bone-load. The proposed study will emphasize four different patterns of
bone-loading: compression, tension, bending and torsion. The physiological load will
also be applied to different parts of the bone and at different angles. Unlike the previous
studies, the present study will test bone density by means of both DEXA and ultrasound.
The ultrasound does not employ radiation and will supplement the data obtained by
means of DEXA.
BIBLIOGRAPHY
Aquatic Exercise Association (AEA) (1995) Aquatic Fitness Professional Manual .
Nokomis, Fl. AEA Publishers
Bravo, G. (1997), A Weight-Bearing, water-Based Exercise Program for Osteopenic Women.Its
impact on bone, Functional Fitness ,and Well-being.Archives of Physical
Medicine
Rehabilitation
Nilsson,B,E. & Westlin , N. (1971). Bone density in athletes. Clinical and Related
Research, 77, 177-182.
Orwoll.E.S. (1989) The relationship of swimming exercise to bone mass in men and
women. Arch inter. Med., 149:2197-2200.
Swissa-Sivan, A., Simkin , A., Leichter, I. Niska, A., Nyska, M., Statter, M., Bivas, A.,
Menczel, J. & Samueloff, S.(1989). Effect of swimming on bone growth and
development in young rats. Bone and Mineral, 7 (2) 91-105
Swissa-Sivan , A., Azoury, R.,Statter, M., Leichter, I., Nyska, A, Nyska, M., Menczel, J. &
Samueloff, S.(1990) The effect of swimming on bone modeling and composition in
young adult rats. Calcified Tissue International,47 (3), 173-177.
Swissa-Sivan, A., Statter, M., Brooks, G.A, Azevedo, J., Viguie, C., Azoury, R.,
Greenfield, C., Oman, S., Leicher, I. & Zinker, B.A.(1992). Effect of swimming on
prednisolone-induced osteoporosis in elderly rats. Journal of Bone and Mineral
Research ,7(2),161-169.
Tesukahara, I. (1994): The Influence of water exercise on bone density in
postmenopausal women.Journal of Nutrtritional Science and Vitaminology, Vol. 40,
No.1.
Mushi Harush was born in Argentina and has lived in Israel for the past 30 years. Since
1992, Mushi has been an AEA International Aquatic Training Specialist representing
the association worldwide; she has offered educational courses and certifications in the
USA, Israel, Spain, Brazil, Holland, Finland and Italy. She is a PE teacher, a mentor of
education at the Wingate Institute in Israel and holds a Bachelors Degree in History of
Art and a Masters Degree in Athletic Administration. Mushi also serves as a swimming
coach, lifeguard, and a Watsu practitioner.
Mushi can be reached at
mushi@netvision.net.il
Propriedades da gua
At 4C pure water has a specific gravity of 1. ( Some reference the s.g. base
temperature as 60F.)
Water is essential for life. Most animals and plants contain more than 60 % water by
volume.
More than 70 % of the Earth's surface is covered with about 1.36 billion cubic kilometers
of water / ice
The density of pure water is a constant at a particular temperature, and does not depend on the size of the sample.
That is, it is an intensive property. The density of water varies with temperature and impurities.
Water is the only substance on Earth that exists in all three physical states of matter:
solid, liquid and gas.
When water freezes it expands rapidly adding about 9 % by volume. Fresh water has a
maximum density at around 4 Celsius. Water is the only substance where the
maximum density does not occur when solidified. As ice is lighter than water, it floats.
Water has a very simple atomic structure. This structure consists of two hydrogen
atoms bonded to one oxygen atom - H2O
Note; kg/m3 divided by 16.02 = lbs/cu.ft. kg/m 3 divided by 1,000 = g/ml
Convert g/cm3 = g/cc = g/ml = g/mL - they are all the same.
Density
pure
water
( g/cm3 )
Density
Density
tap
pure water
water
3)
( kg/m
( g/cm3 )
Density
pure
water
lb/cu.ft
Specific
Gravity
4C
reference
Specific
Gravity
60F
reference
0 (solid)
0.9150
915.0
0.915
0 (liquid)
0.9999
999.9
0.99987
62.42
0.999
1.002
1.0000
1000
0.99999
62.42
1.000
1.001
20
0.9982
998.2
0.99823
62.28
0.998
0.999
40
0.9922
992.2
0.99225
61.92
0.992
0.993
60
0.9832
983.2
0.98389
61.39
0.983
0.985
80
0.9718
971.8
0.97487
60.65
0.972
0.973
100 (gas)
0.0006
* This is for average, clean drinking water. It will vary from area to area
Pgina Principal
PARTES DA AULA:
Em geral , as aulas de Hidroginstica duram entre 45 minutos e 1 hora.
Basicamente, uma aula se divide em:
-soltura (cerca de 2min)
-aquecimento articular (3 min)
-aquecimento orgnico (5 a 10 min)
-parte principal (no mnimo 30 min)
-parte final (de 5 a 10 min.)
Luciane Sanchotene
Etchepare*
luciane.etchepare@terra.com.br
Susane Graup***
susigraup@bol.com.br
Resumo
O processo de envelhecimento ainda pouco conhecido, porm
o desgaste do organismo com o passar dos anos inevitvel
deixando-nos mais suscetveis a doenas. A prtica de exerccios
fsicos essencial em todas as fases de nossa vida e ser ainda
mais importante na terceira idade onde h uma perda de aptido
fsica e conseqentemente de sade. O objetivo deste estudo foi
verificar o efeito da prtica da hidroginstica sobre as variveis da
aptido fsica (equilbrio esttico, agilidade e flexibilidade) em
mulheres na terceira idade, aps 20 sesses de exerccios. A
amostra foi composta por 15 mulheres da terceira idade
praticantes de hidroginstica. Como instrumentos de coleta de
dados desta pesquisa foram utilizado os seguintes testes: "sentar e
alcanar" - para avaliar flexibilidade, "vai e vem" - para avaliar
agilidade e "stork stand" - para avaliar equilbrio esttico. Para
anlise dos dados foi utilizado um teste "t" de Student para
amostras dependentes para verificar se existem diferenas
significativas entre pr e ps-testes. Desta forma destacamos os
seguintes resultados: quanto as variveis flexibilidade e equilbrio
esttico houveram melhoras significativas aps as sesses de
hidroginstica. A varivel agilidade tambm apresentou melhoras,
porm no estatisticamente significativas.
Unitermos: Terceira idade. Qualidade de vida. Hidroginstica.
1/1
Introduo
Os avanos das cincias e das condies mdico-sanitrias tm
aumentado cada vez mais a expectativa de vida das pessoas, e a
tendncia no pas, que cada vez mais cresa o nmero de idosos.
Segundo Meireles (1999) o processo de envelhecimento comea
desde a concepo, ento a velhice, um processo dinmico e
progressivo em que h modificaes tantos morfolgicas como
funcionais, bioqumicas e psicolgicas que determinam a progressiva
perda da capacidade de adaptao ao meio ambiente, ocasionado
uma maior incidncia de processos patolgicos.
Para Zimerman (2000), o desgaste do organismo com o passar dos
anos inevitvel, apesar da velhice no ser uma doena uma fase
na qual o ser humano fica mais suscetvel a elas. Segundo Mazo
(1998) o Brasil passa por um processo de envelhecimento
populacional rpido. Estimativas apontam que, a partir do sculo XXI,
o pas ter a sexta maior populao de idosos do planeta e o maior
problema da velhice que os idosos so discriminados, tidos como
improdutivos e assim relegados ao esquecimento pela sociedade.
A prtica de exerccios fsicos essencial em todas as fases de
nossa vida e ser ainda mais importante na 3 idade onde h uma
perda de aptido fsica e conseqentemente de sade. A atividade
fsica agir positivamente a nvel cardiorrespiratrio e tambm nos
sistemas e rgos. Uma boa manuteno da massa muscular e ssea
na terceira idade ser imprescindvel para uma autonomia de vida e
para que o idoso continue produzindo e realizando suas tarefas
dirias. Para Otto (1987) se quisermos sade devemos desenvolver
uma filosofia de vida voltada para as atividades fsicas que devem
fazer parte do nosso dia a dia.
Segundo Leite (1996) o treinamento fsico pode imediatamente
produzir uma profunda melhora nas funes essenciais para aptido
fsica do idoso colaborando para que haja menor destruio de
clulas e fadiga, e o segredo de uma vida longa e sadia , na
verdade, uma frmula simples, que combina a relao apropriada dos
ancestrais, boa sorte e em grande parte adoo de um estilo de vida
sadio. Contudo pode-se observar um ciclo vicioso, pelo qual o
envelhecimento est associado a uma reduo na atividade fsica.
Com a inatividade ocorrem as seguintes modificaes funcionais:
Resultados e discusses
A partir do exposto sero apresentados os resultados do teste "t"
de student em que ser verificado se houveram diferenas
significativas nas variveis do estudo aps 20 sesses de
Concluses e sugestes
The
Physiological
Effects
of
Aquatic
Exercise
improved through DWR. The frequency and duration spent training at this critical
threshold is yet to be elucidated.
Morrow, Jensen & Peace (1996) divided 11 subjects into either DWR (female = 3,
males = 3) or land-based (female = 2, male = 3) exercise groups. Subjects trained three
days a week for 35 minutes a session at 80% of HRmax as determined by mode specific
VO2max tests. Additionally, subjects performed a timed 2.4-k run. Both training groups
significantly improved in VO2max (p < 0.01). DWR training also decreased run time (p
= 0.06). No mode specific differences between the two training methods (land vs. water)
were observed indicating that DWR can improve VO2max in a similar fashion as landbased exercise.
Michaud and colleagues (1995) had 10 inactive volunteers (female = 8; males = 2; mean
= 32 yr) complete maximal treadmill and DWR tests prior to and following an 8-week
aerobic interval DWR program. Improvements in VO2max of 10.7% and 20.1% for
treadmill and DWR, respectively were observed after DWR training. Recruits exercised
3 times per week with workouts ranging from 25-45 minutes a session. Interval length
varied from 30 seconds to 7 minutes in duration, with exercise heart rates averaging
63% to 83% of maximal treadmill heart rate. Michaud and associates propose the large
increases resulted from a combination of the high intensity workouts, unfit subjects, and
the specificity of training and testing involved in the study. By measuring pre-and posttraining VO2max while DWR a specificity of testing and training was clearly
established. Furthermore, this research also supports a significant crossover effect of
DWR to land-based training in untrained volunteers. The results of these training
studies support the use of DWR as an alternative form of exercise to land-based training
for maintenance of aerobic capacity in trained athletes as well as possible VO2max
improvements
for
unfit
participants.
Table
1.
Effects
of
Deep
Water
Running
on
VO2max
1st Author of Study # Subjects Length of DWR Training Status PrePost VO2max
(ml/kg/min)
%Change
in
VO2max
Bushman
1997
11
subjects
(10M, 1F) 4 wks Trained 63.41.362.21.3 Decrease 1.8% NS
Eyestone
1993 32M 6 wks Trained 56.31.553.51.6 Decrease 4.9% SIG
Michaud
1995
10
(2M, 8F) 8 wks Untrained 29.3.8.232.88.0 Increase 10.6% SIG
subjects
Quinn
1994 7F 4 wks Untrained 42.93.240.01.8* Decrease 6.75% SIG
Wilber
1996
16M
58.42.360.13.6
DWR
58.74.759.65.4
wks
Trained
Treadmill
Treadmill
Increase
DWR
Increase
3%
NS
1.5%
NS
NS=not
significant
SIG=significant
*Represents VO2max after land-based training but prior to DWR
Note: Table includes studies reporting pre- and post-training VO2max data
Maximal Oxygen ConsumptionShallow Water Aerobics
Research investigating the chronic effects of shallow water aerobic exercise on
VO2max improvements has been favorable. Various types of aquatic exercise have been
tested including aqua aerobics, aqua step, shallow water running, and deep water
aerobic training. However, regardless of training mode, relative improvements have
ranged from 5.6% to 18.9% with only a single study reporting a small, non-significant
decrease (0.82%) in aerobic capacity (see Table 2). These positive changes in maximal
oxygen consumption following aqua training match the improvements attained in
chronic land-based exercise. One project conducted by Hoeger et al. (1992) directly
examined the training effects of an identical aerobics program performed on land (lowimpact) and in the water. Forty-nine untrained female subjects (water n = 20; land n=
15; control n = 14) participated in the 8-week study with the experimental groups
exercising 3 times per week. The aerobic portion of the training session was 20 minutes
in duration with exercise intensity maintained between 70-85% of HRR. Both the landbased (low-impact) and shallow water aerobics groups made similar gains in aerobic
fitness, with a 14.8% relative improvement in estimated VO2max using a Bruce
protocol (pre = 31 6.8, post = 35.6 7.0 ml/kg/min) observed in the shallow water
aerobics group. Total treadmill time was also significantly increased (by one minute)
following shallow water training. In agreement with Hoeger et al., a smaller yet
significant 5.6% increase in VO2max (34.8 4.1 to 36.7 5.2 ml/kg/min) and an
improved run time to exhaustion (pre = 15.8 3.7 min, post = 19.4 5.0 min) was also
observed by Abraham (1994) following eleven weeks of shallow water aerobics.
As with other aerobic exercise modes, cardiovascular benefits of aqua training are not
restricted by age. Twenty female (40 13.99 yr) volunteers were divided into young (28
6.5 yr) and older (52 8.3 yr) adults to assess the effects of age on improvements in
cardiovascular fitness following an shallow water aerobics program (Sanders, 1993) .
Training included 8 weeks of shallow and deep water workouts using aquatic exercise
equipment. Heart rates were maintained between 74-84% of predicted heart rate
maximum during exercise. Post-training submaximal treadmill tests (Astrand-Rhyming)
revealed increases in aerobic capacity of 13.7% and 8.8% for both the young and old,
respectively. The authors suggest that an initial lack of muscular strength may have been
responsible for the differences observed in younger and older subjects. Nevertheless,
these findings support the use of shallow water exercise for cardiovascular
improvements in the aging population.
Simpson and Lemon (1995) examined the effects of a chronic deep water aerobic
training program. Eighteen adult females (22-39 years old) were buoyed in the water
either by using foam waist belts or ankle cuffs. All subjects trained a minimum of 3
days per week for 50 minutes per session using various aqua aerobics movements. The
exercise program in deep water significantly improved estimated VO2max (pre = 29.5
1.8, post = 35.1 1.9 ml/kg/min) in both groups as assessed from an Astrand-Rhyming
submaximal treadmill test.
One new area under investigation is aqua stepping which adapts bench stepping on land
to the water. The resistive properties of water makes aqua stepping very challenging in
both phases of the step movement compared to land-based stepping where the down
phase is aided by gravity. Currently, only two studies have been conducted determining
the effects of aqua step on gains in VO2max. Gaspard et al. (1995) found that a 7-week
aqua step program produced a 7% relative improvement in VO2max. In contrast,
Seefeldt and Abraham (1996) observed a small non-significant decrease (0.82%) after
11 weeks of aqua step training with 24 inactive college females. Both training programs
were similar with the most important difference being the intensity of exercise. Seefeldt
and Abraham reported average ratings of perceived exertion (RPE) during training of
11. 8 (fairly light). This was reflected by average training heart rates of 69.5% of
HRmax, which were very low in comparison with the heart rates reported by Gaspard et
al. (80% HRmax). Additionally, these higher heart rates may partially be attributed to
the music tempo employed in each study. Music tempos of 125-147 bpm and 80-120
bpm were used during workout sessions by Gaspard et al. and Seefeldt et al.,
respectively. The higher exercise intensity conceivably provided the training stimulus
necessary for VO2 improvements achieved by Gaspards subjects.
One unique project conducted by Hamer and Morton (1990) assessed the chronic
adaptations incurred from shallow water running in 1 meter deep water. Untrained
subjects used a high knee running technique immersing the forearms and hands in the
water. A 9% increase in VO2max (pre = 49.32 5.42, post = 53.98 4.83 ml/kg/min)
resulted after 8 weeks of water running.
Table 2. Effects of Shallow Water Aerobics Exercise on VO2max
1st Author of Study # Subjects Length of DWR Training Status & Type of Training Pre
Post
VO2max
(ml/kg/min)
%Change
in
VO2max
Abraham
1994
14F
11
wks
Untrained
Water Aerobics 34.84.136.75.2 Increase 5.6% SIG
Gaspard
1995
21F
7
Aqua Step 39.95.542.75.8 Increase 7% SIG
Hoeger
1992
Water
49F
Aerobics
Sanders
1993
20F
Shallow
&
32.32.736.72.5
Older
8
31.06.835.67.0
8
DW
Aerobics
wks
wks
Increase
wks
Young
Untrained
Untrained
14.8%
SIG
Untrained
participants
participants
25.02.827.22.5
Increase
Older
Increase 8.8% SIG
Seefelt
1996
22F
11
Aqua Step 35.46.635.29.2 Decrease .82% NS
Simpson
1995
Aqua
Aerobics
NS=not
SIG=significant
Young
SIG
13.7%
in
DW
18F
29.51.835.11.9
wks
Increase
Untrained
Untrained
18.9%
SIG
significant
Oxygen
Consumption
Summary
Of the five articles testing the effects of DWR training on land-based (treadmill)
VO2max improvements, three found decreases in VO2max after DWR training with
two of these studies recording significant improvements (Table 1). However, it should
be noted that these decreases possibly were the result of improper manipulation of
training variables (frequency, intensity, and duration). Both Eyestone et al. (1993) and
Quinn et al. (1994) trained subjects using the minimum ACSM guidelines which might
explain the small but significant decreases in VO2max. The changes in VO2max after
DWR training range from a 6.75% relative decrease (Quinn et al.) to a 10.6% relative
increase in a study by Michaud et al. (1995) . In spite of the current conflicting research,
DWR still remains an attractive option compared to the 14-16% decrements in aerobic
capacity seen when exercise training ceases due to injury or layoffs.
Table 2 describes the effects of shallow water exercise on maximal oxygen
consumption. Results of these studies indicate shallow water exercise not only leads to
significant improvements in VO2 but that the cardiovascular benefits are similar to
those achieved following chronic land-based exercise. The only reported training study
(Seefeldt & Abraham, 1996) which found non-significant decreases in maximal oxygen
consumption could be traced to an inadequate physiological training stimulus. The
subjects exercised at a training intensity that elicited heart rates averaging only 69.5% of
HRmax. This intensity, especially for the population of young college-aged females,
incorporated by Seefeldt and Abraham may not have been sufficient to achieve gains in
maximal
oxygen
consumption.
Currently, there is a need for more research testing the chronic physiological responses
to water exercise. Better control measures as well as standardized training protocols are
recommended.
Heart
Rate
The
Heart
Rate
Issue
in
Aquatic
Exercise
It is important to discuss the heart rate response to the aquatic medium. It has been
shown that the heart rate response in water depends considerably on water temperature
(Avellini, Shapiro, & Pandolf, 1983) . Head-out, underwater exercise at 25&Mac251;C
(77F) has been shown to produce a lower heart rate response than land, at a set oxygen
Chronic exercise training seems to have little effect on the hydrostatic pressures exerted
by water on the cardiovascular system. Therefore, it seems logical that chronic changes
in heart rate responses would follow a similar trend as acute heart rate responses with
submaximal DWR training producing heart rates which are approximately 10-15 beats
lower than those attained during treadmill running at matched intensities. As of yet
research has not compared post training submaximal DWR heart rates to submaximal
heart rates of treadmill exercise using sedentary subjects. For endurance trained
individuals, submaximal heart rate response during DWR is notably reduced compared
to treadmill responses. Wilber et al. (1996) reported average heart rates that were 14%
lower during DWR compared to treadmill exercise in endurance trained runners.
Similarly, after 4 weeks of training Hertler et al. (1992) documented significantly lower
submaximal heart rates for experienced runners during DWR (123.5 20.1 bpm)
compared to the treadmill running (169.5 10.9 bpm), while training at identical RPEs.
Additionally, there are conflicting reports as to the cross-over effects of water running to
treadmill exercise. Bushman et al. (1997) determined that four weeks of DWR had no
impact on post-training submaximal treadmill heart rate responses when compared to
pre-training submaximal values (pre = 158 5.0 bpm; post = 158 4.4 bpm). In
contrast, after training subjects in shallow water, Hamer and Morton (1990) observed
lower heart rates on 5 different submaximal treadmill workloads. In shallow water
running 1 meter deep (WR) Hamer and Morton found heart rates of sedentary subjects
to be 10-12 bpm lower during submaximal water running compared to treadmill
running. Interestingly, Hamer and Morton noted that as the intensity of exercise
increased towards VO2max, the disparity of heart rate response between the two modes
of exercise were diminished to within only a 5 bpm difference (50% VO2max: WR 122
8, TM 134 10 bpm; 90% VO2max: WR 168 11 bpm, TM 173 8 bpm).
Maximal Heart Rate
Chronic land-based exercise training has little if any effect on maximal heart rate
(MHR). In aquatic exercise the physiological changes due to hydrostatic pressure and
temperature of water warrants comparisons between maximal heart rate responses in
water versus land-based exercise. In aerobically trained athletes, no differences in
HRmax were observed during maximal DWR (193.9 8.8 bpm) and treadmill (192.1
10.2 bpm) tests before or after 6 weeks of DWR training (Wilber et al., 1996) . Quinn et
al. (1994) also found maximal heart rates to be similar for DWR (192 6 bpm) and
treadmill (190 6 bpm) exercise in sedentary females after a 4 week exercise regimen.
These results for inactive subjects were not supported by Michaud et al. (1995) who
found DWR elicited maximal heart rates that were approximately 15 beats lower
compared with treadmill prior to and following DWR training (DWR pre = 172 16.7;
post = 175 13.9 bpm; treadmill pre = 187 11.9; post = 189 11.2 bpm). These
differences in HRmax during DWR result from several factors including altered muscle
recruitment patterns, more upper body involvement, hydrostatic pressure, and water
temperature.
Hamer and Morton (1990) noticed differences in HRmax only in pre-training measures
while running in shallow water compared to the treadmill. Inactive females achieved
MHR values significantly lower while running in shallow water as opposed to the
treadmill (WR = 194 9, TM 198 6 bpm). This indicates familiarity of DWR may
also play a role in an individuals ability to perform a successful maximal test. Gaspard
et al. (1995) observed no change in MHR on pre or post training treadmill tests after 7
weeks of aquatic stepping.
Heart
Rate
Summary
The heart rate response to water exercise is based primarily on the depth of the water,
water temperature and intensity of the workout. The effects of water exercise on resting
heart rate have been reported by two investigators finding that heart rate at rest does
decrease as a result of chronic water aerobics exercise. Hoeger et al. (1992) and
Simpson and Lemon (1995) found reductions in resting heart rate of 7 bpm and 11 bpm,
respectively. These values are similar to those reported after land-based training.
A comparison of submaximal heart rate of DWR versus treadmill exercise finds that on
average heart rates are 3-15% lower in water compared to the treadmill. For trained
individuals, water immersion to the neck lowers heart rates to a greater extent at
submaixmal intensities than it does to untrained subjects. Hertler et al. (1992) found a
36% relative decrease in submaximal heart during DWR versus treadmill exercise while
at the same intensity.
In general there have been little changes in maximal heart rate on a treadmill after
aquatic exercise training. Investigators have found no difference in maximal heart rate
(Bushman et al., 1997; Gaspard et al., 1995; Hamer & Morton, 1990; Quinn et al.,
1994) , an increase (Wilber et al., 1996) , and a decrease in maximal heart rate (Michaud
et al., 1995) after a DWR training protocol.
Body
Composition
The positive effects of habitual land-based exercise training on body composition are
supported in the literature with the most important benefit being the reduction of percent
body fat. Research efforts to substantiate similar body fat changes following shallow
and deep water training has provided varying results. One major reason for the
discrepancy is that the majority of aquatic training studies are of short duration, ranging
in length from 4-11 weeks. Investigators agree that a minimum of 8 weeks are necessary
for training effects to occur in most physiological variables. This may be particularly
true for adaptations in body composition since dietary intake also plays a major role. No
dietary restrictions or considerations were given to subjects involved in any of the
training studies reviewed. Additionally, several studies conducted on DWR have utilized
endurance trained athletes. Significant changes in body fat are not expected for these
highly trained subjects who commonly have very lean physiques. One such study
performed by Wilber et al. (1996) measured body fat by hydrostatic weighing prior to
and following 6 weeks of DWR training with 16 endurance runners (VO2max = 58.6
3.6 ml/kg/min). DWR training closely replicated on-land training with exercise sessions
being conducted 5 days per week. A 3.6% increase in percent body fat was observed
after the training regimen in these fit runners.
Quinn and colleagues (1994) had untrained females perform 6 weeks of land-based
running prior to 4 weeks of DWR. An initial 6.7% decrease in body fat was noted
following the 6 weeks of land-based training. However, after 4 weeks of DWR training,
body fat increased by 2.1% (pre-training = 24.6 3.5 %, post-land-based running = 22.9
4.2%, post-DWR = 23.4 4.3%). In contrast to Quinn et al., Michaud and associates
(Michaud et al., 1995) found that 8 weeks of DWR training in 10 healthy untrained
subjects provided an adequate stimulus for body fat reduction. Subjects exercised 3 days
a week for 8 weeks at an intensity between 63-83% of HRmax. Post-testing via skinfold
measurements found a 2.6% decrease in body fat.
Simpson and Lemon (1995) used bioelectrical impedance to assess body fat percentage
finding a 2.7% relative decrease in percent fat after 8 weeks of deep water aerobic
exercise. Gaspard et al. (1995) used hydrostatic weighing before and after 7 weeks of
aqua step training to assess body composition in 21 untrained college aged females.
Results showed no significant differences within the experimental group or when
compared to controls.
Significant decreases in body fat have been observed in several studies conducted on
shallow water aerobics. Training 3 days per week for 50 min a session, an 11-week
training program completed by sedentary college-aged women (pre = 24.2 3.3 kg,
post = 22.8 3.0 kg) produced a 5.6% relative decrease in body fat (Abraham et al.,
1994) . In agreement with Abraham, Hoeger et al. (1992) reported decreases in body fat
with previously sedentary women exercising 3 days a week, 20 minutes a day at 7085% of heart rate reserve for 8 weeks. A 7.5% change in percent fat (pre = 26. 4 7.4%,
post = 24.4 6.7%) as measured by skinfold thickness were similar to the 5% decreases
seen in the land-based low-impact aerobics group (pre-test = 21.8 5.0%, post-test =
20.7
4.5%;).
No
changes
occurred
in
the
control
group.
Sanders and Rippee (1994) examined the effects of shallow and deep water exercise on
body fat of young (28 6.5 yr) and older (52 8.3 yr) women. All subjects achieved
significant reductions in body fat following the 8-week community based program with
decreases of 11.9% for the young and 5.8% for the older participants.
Table
3.
Effects
of
Aquatic
Exercise
on
Body
Composition
1st
Author
of
Study
#
Subjects
&
Fitness Status Length of DWR Type of Training PrePost Body Composition %BF
%Change
in
Body
Comp
Abraham
1994
14F
Untrained 11 wks Aqua Aerobics 24.23.322.83.0 -5.8%
Hoger
1992
Untrained
8
Aerobics 26.47.424.46.7 -7.5%
wks
49F
Aqua
Michaud
1995
8F,
Untrained 8 wks DWR 30.07.429.27.2 -2.6%
2M
Quinn
1994
Untrained 4 wks DWR 22.94.223.44.3 +2.1%
7F
Sanders
1994
Untrained
wks
Shallow
&
DWR
20F
25.11.222.11.1*
25.71.724.21.5
-5.8%
-11.9%
Seefeldt
1996
Untrained
11
Step 21.16.822.11.2 +4.7%
24F
Aqua
wks
Simpson
1995
18F
Untrained 8 wks DWR 35.92.036.41.9 +3.6%
Wilber
1996
Trained
6
16M
wks
*Young
subjects:
Older subjects: 52 8.3 yr
DWR
13.84.514.34.7
28
+3.6%
6.5
yr
Body
Composition
Summary
Similar to land-based research, the effects of chronic aqua training on changes in body
composition vary. Research findings range from a 4.7% increase to a 11.9% decrease in
body fat in studies lasting 4-11 weeks. A trend of body fat decreases were observed in
training programs lasting 8 weeks or greater. Four of the six studies recorded decreases
in body fat in training protocols of this duration (Abraham et al., 1994; Hoeger et al.,
1992; Michaud et al., 1995; Sanders, 1993) . This supports the opinion that training
effects are achieved in studies 8 weeks or greater in length. Furthermore, experiments
without dietary control will necessitate lengthier exercise training before notable
changes in body fat are attained.
Muscular
Strength
and
Endurance
Several researchers have examined the effects of water exercise on muscular fitness.
Shallow water aerobic exercise holds promise as a means of enhancing muscular
strength in untrained participants. After 8 weeks, untrained females (26 5.9 yr) who
performed shallow water aerobics exercise achieved significantly greater gains in
several strength measures such as left knee flexion at 300 degrees/s-1, left shoulder
extension at 60, 180, 300 degrees/s-1, left shoulder flexion at 60 degrees/s-1 and right
shoulder extension at 60, 180, 300 degrees/s-1 compared with the control group
(Hoeger et al., 1992) . In agreement, Sanders and Rippee (1994) found improvements in
both strength and endurance in young (28 6.3 yr) and older (52 8.3 yr) women.
Subjects participated in an 8-week community based program with exercise sessions
being a combination of shallow and deep water aerobic exercise using aquatic
equipment. Bench press and curl-ups were evaluated pre- and post-training to assess
muscular fitness. Although no specific muscular strength and endurance exercises were
incorporated into the aqua aerobics routine, increases in these muscular fitness
parameters occurred. In the bench press, an astonishing 136% improvement (pre = 14.2
1.95 kg, post = 33.6 4.91) was observed in the young while the older subjects
improved their lift by 180% (pre = 6.8 7.4 kg, post = 19.1 2.9 kg). Similarly,
muscular endurance was also enhanced in both groups as determined by the one minute
curl-up (Ys Way to Fitness) test. The younger participants improved curl-up pre-test
scores of 19.1 2.9 repetitions to 34.89 2.86 on the post-test, while the older subjects
significantly increased the number of successful curl-ups completed from an initial
score of 1.75 1.08 to 13.25 4.25 on the post evaluation. Based on these results, both
young and old improved muscular fitness through shallow water training. However, it is
noted that the dramatic increases in musculoskeletal fitness observed in these studies
can be partially credited to the initially low level of fitness of the subjects.
Simpson has also found strength benefits from aerobic exercise in deep water. After 8
weeks of training subjects (n = 18) improved isokinetic quadriceps (pre = 50.5 3.2
Nm, post = 55.2 3.3 Nm) and hamstring (pre = 35.4 2.4 Nm, post = 41.9 3.0 Nm)
strength
(p
<
0.01).
Hamer and Morton (1990) tested changes in musculoskeletal parameters before and
following 8 weeks of shallow water running (1 meter in depth). An interval training
program was conducted 3 days per week for 20-45 minutes per workout. Testing
employed isokinetic resistance (Cybex II dynamometer) equipment to measure peak
power, and initial and final peak torque during repeated maximal contractions of knee
extensors and flexors. Subjects completed a muscular fatigue test which consisted of 50
maximal contractions at 120 degrees/s-1 in a 2 minute period. Differences occurred
between the training group and controls in final mean peak torque (final three
contractions) for knee extensors (experimental group = 98 Nm; controls = 85 Nm).
Hertler et al. (1992) found that experienced runners were capable of maintaining leg
strength through DWR. Researchers had runners complete a 4-week land-based running
program prior to dividing the subjects in half with participants either continuing the
land-based training or engaging in a deep water running. Isokinetic testing measured
concentric and eccentric contraction of upper and lower leg and found no difference in
leg strength between DWR and land-based running after training.
Muscular
Strength
and
Endurance
Summary
All of the above projects testing either strength or endurance found improvements in
some aspect of muscular fitness. This indicates that the resistive properties of water
possibly facilitate the development of muscular strength and endurance in inactive
participants while maintaining leg strength of competitive athletes. The findings are
especially promising for older adults. More research in this area is necessary before
solid conclusions can be drawn concerning this aspect of health-related fitness.
Flexibility
Only four training studies have addressed this often overlooked aspect of health-related
fitness. The primary test used by all of the investigators to test flexibility was the sitand-reach test, which evaluates low back and hamstring flexibility. Hoeger et al. (1992)
observed a 10.5% improvement in the modified sit-and-reach measurements (pre = 37.9
7.6 cm; post = 41.9 8.9 cm) following 8 weeks of shallow water aerobics. This was
not surprising to the researchers since low back and hamstring exercises were integrated
into the stretching and warm-up phase of the program. Seedfeldt and Abraham (1996)
also incorporated flexibility exercises into the total conditioning program during 11
weeks of aqua step training. Twenty-two subjects were assessed on the sit-and-reach test
with 5.4% improvement being achieved, which approached significance (pre = 18.4
3.4 in, post = 19.4 5.4 in).
Findings do not seem to be limited to shallow water aerobics. Simpson and Lemon
(1995) also noted a 7.3% increase, although not significant (p > 0.07), in the sit-andreach flexibility test (pre = 34.1 2.1 cm, post = 36.6 1.8 cm) after 8 weeks of deep
water aerobic training. Sanders and Rippee (1994) combined both shallow and deep
water exercise during 8 weeks of water aerobics. As part of the experiment subjects
were separated into young (28 6.5 yr) and older (52 8.3 yr) adults. Results revealed
small, non-significant, improvements in the sit-and-reach for the younger (pre = 15.9 in,
post = 16.0 in) and older (pre = 12.8 in, post = 13.5 in) subjects.
Flexibility
Summary
Current studies, although small in number support the improvement of flexibility
through shallow and deep water exercise. Exercise participants are able to use the
buoyant properties of water to decrease joint stress while gaining flexibility. Additional
research needs to be conducted using various flexibility tests as well as training
regimens
of
increased
length.
Part
II:
Shallow
and
Deep
Water
Exercise
Responses
Treadmill running is considered the gold standard exercise modality to which all other
modalities are compared. Studies comparing treadmill to other modalities such as
cycling, simulated cross-country skiing, rowing, and stepping have shown treadmill
running to elicit the highest energy expenditure and oxygen consumption (Thomas,
Ziogas, Smith, Zhang, & Londeree, 1995; Zeni, Hoffman, & Clifford, 1996) . It
therefore can be assumed that water exercise comparisons to treadmill running will have
similar findings. However, the true relationship of water exercise to treadmill running
(and other forms of land exercise) can only be determined through experimental
research. Knowledge of the acute physiological responses of aquatic exercise programs
helps the applied professional make correct decisions on safe and effective
programming for participants. Part II of this aquatic review will summarize the
responses
to
shallow
and
deep
water
exercise.
Comparisons of Submaximal Land and Water Exercise in Waist-To-Chest Deep Water
A pioneer aquatic investigation examined the oxygen consumption and heart rate
responses of walking and jogging in waist deep water and on land with six males (21 42 yr) (Blanche, Evans, Cureton, & Purvis, 1978) . Water temperature was 30 degrees C
(86F) to 31 degrees C (88F). In waist deep water, walking and jogging produced
similar heart rate responses to land while oxygen consumption was higher in water. It
was concluded that the water resistance in waist deep water while walking and jogging
results in high levels of energy expenditure with relatively little strain on the lower
extremities.
Hered et al. (1997) compared aquatic exercise using the arms and legs, and legs only, on
land and in chest deep water at four different intensity levels with 12 females (mean =
20 yr). Results indicated that heart rates were lower in water than on land while oxygen
consumption at 2 of the 4 intensities were significantly higher in water. Subjects
incorporating both the arms and legs had the highest heart rates regardless of the
environment (land or water). This study substantiates that adding the arms to leg
exercise in chest deep water increases the energy expenditure cost of the aquatic
activity.
One investigation studied the effect of walking on land and in water (at a matched
cadence of 103 bpm), with and without an external elastic resistance belt, in ten male
and eight female college-aged participants (Robert, Jones, & Bobo, 1996) . The elastic
belt (tubing) allowed for more resistance to be applied to the arms and shoulders during
exercise. Water temperature ranged from 22.2 degrees C (72F) to 25.6 degrees C
(78F). Treadmill walking had significantly higher oxygen consumption and kilocalorie
expenditure than matched exercise in chest-deep water. The resistance belt was not of
sufficient magnitude to affect the oxygen cost or caloric cost of the exercise on land and
in
water.
Comparison of Aerobic Exercise on Land to Water
In a comparison of identical aerobic exercise routines on land and in water with ten
female subjects (mean = 43 yr), land exercise produced significantly higher oxygen
consumption results (Heberlein, Perez, Wygand, & Connor, 1987) . However, the
cardiovascular stimulus for the hydroaerobics program was within ACSM guidelines for
the improvement of cardiovascular endurance. Having the subjects perform the same
exact aerobic exercise routines on land and water may have impaired the participant
responses due to the varying effects of water density (800 times greater) compared to
land.
Cassady and Nielsen (1992) evaluated heart rate and oxygen consumption of 40 subjects
(20 males, 20 females, mean = 25 yr) performing upper extremity and lower extremity
exercise on land and in water, at three different cadences. The oxygen consumption
responses were greatest during water exercise, whereas heart rate, expressed as a
percent of age-predicted heart rate maximum was highest on land, attributable in part to
the
hydrostatic
pressure
of
water.
Maximal Intensity Land and Water Exercise Comparisons in Chest Deep Water
One investigation compared maximal oxygen consumption (VO2max), maximum heart
rate (HRmax) and ratings of perceived exertion (RPE) of treadmill running to aquatic
exercise (in chest deep water) with 19 males and 11 females (Hoeger, Hopkins, Barber,
& Gibson, 1992) . The aquatic exercise consisted of arm and leg work which was
gradually increased by speeding up the movement to attain maximal work output.
Maximal treadmill exercise elicited a significantly higher response in VO2max, HRmax
and RPE. This is not surprising since treadmill exercise has been shown to produce
higher VO2max values when compared to other modalities (Thomas et al., 1995) .
Comparison of Bench Stepping on Land and in Water
Evans and Cureton (1996) compared oxygen consumption, heart rate and perceptual
response of bench stepping on land and in chest-deep water. Ten women completed 5minute trials of aqua bench stepping (29 steps/minutes) at three different bench heights
(0, 7 in, 12.5 in) using a traditional stepping pattern and an arms and legs stepping
pattern (water only). Water temperature varied between 29 degrees C (84F) and 32
degrees C (90F). Heart rates and oxygen consumption were lower in the water,
although the perceived exertion response was very similar for stepping in water and on
land. The added use of arms to legs increased oxygen consumption demands of the
movement to 48%, 58%, and 78% of VO2peak, for the step heights 0, 7 in, and 12.5 in,
respectively. Thus, bench stepping with the use of the arms in water meets ACSM
guidelines for the improvement of aerobic capacity (50% to 85% VO2max).
water running as well as the altered leg muscle activation patterns of deep water
running.
An investigation by Glass, Wilson, Blessing and Miller (1995) compared the maximal
physiological costs of deep water running to treadmill running using ten male and ten
female subjects (26 yr). Treadmill running produced higher VO2 and heart rate values.
However, heart rate was measured by palpation, and water temperatures were reported
to be 24C (75F), which has been shown to be associated with a lowered exercise heart
rate response. Treadmill running elicited higher metabolic training intensities than deep
water running when equated for the same level of RPE. The authors suggested that due
to the density of water, subjects utilized more anaerobic energy because of the increased
challenge to the exercising muscles, and thus had lower VO2 and heart rate values. In
addition, the use of the arms and legs against the water resistance contributed to higher
lactate levels for deep water running as compared to treadmill running.
Frangolias, Rhodes, and Taunton (1996) compared the cardiovascular responses of
maximal deep water running to treadmill running utilizing 22 endurance runners (8
female, 14 males, ages 21 to 35 yr) who were divided into experienced and
inexperienced deep water running groups and given maximal exertion tests on the
treadmill and in the water. Experienced deep water runners were classified as those
doing at least 6 deep water running workouts per month for 6 months prior to the study.
Results indicated that the more familiar subjects were with deep water running, the
smaller the difference in maximal oxygen uptake values between water and land
running. Experienced deep water runners had VO2max values on land and in water that
were within 3.8 ml/kg/min whereas the difference in the inexperienced deep water
runners was 10.3 ml/kg/min. Underwater video analysis revealed that inexperienced
deep water runners were unable to maintain upright positions in the water and more
likely to cup the water with their hands, propelling themselves slightly forward. Leg
patterns of the inexperienced deep water runners adapted to a shorter stride cycle,
similar to a swimming kick motion, which increased the contribution of the upper body.
Maximal heart rate results indicated no significant differences in maximal heart rate in
land vs. water in the experienced deep water runners. The researchers concluded that the
more familiar individuals are with deep water running, the more closely matched the
physiological responses of the two exercise mediums.
In another study using experienced deep water runners, Frangolias and Rhodes (1995)
found higher maximal metabolic values on land compared to deep water running with
13 distance runners (21-35 yr). Experienced deep water runners were defined as those
who incorporated at least 6 DWR workouts per month into their training program for
six months prior to the study. Maximal VO2 and heart rate values were approximately
8% lower in water as compared to land. Also, lower ventilatory threshold (which is a
marker for the bodys production of lactic acid) values were noted for DWR as
compared to treadmill running at the same RPE and respiratory exchange ratio (the ratio
of carbon dioxide produced and oxygen consumed) levels. However, when ventilatory
threshold was expressed as a percentage of the respective DWR or treadmill VO2
values, there was no statistical difference. This suggests that factors dampening the
effect of maximal effort also appear to be factors limiting VO2 at the ventilatory
threshold. The authors suggest that the differences observed in maximal values in land
versus water are most likely related to hydrostatic responses, gravitational effects, and
running styles in the different mediums. It is noted that during exercise in water there is
a tendency for breathing frequency to be higher and tidal volume lower in submaximal
(80% of VO2max) and maximal exercise (Sheldahl et al., 1987) . This suggests that the
cost of breathing in DWR increases and a larger portion of oxygen is consumed by the
respiratory muscles during water exercise as compared to land. This may function to
limit the oxygen available to the leg muscles. Researchers also reported similar blood
lactate responses during submaximal, maximal and recovery periods in land and water.
This implies that variations in arm and leg actions (DWR technique) as well as the
recruitment patterns in the deep water running that may limit oxygen consumption also
contribute to the onset of blood lactate.
Michaud et al. (1995) compared the physiological, perceptual and metabolic responses
of peak and moderate intensity deep water running to treadmill running with six trained
male runners (mean = 25 yr). Peak oxygen consumption and heart rate were 12% and
8% greater for treadmill running than deep water running At similar relative and
absolute exercise intensities, blood lactate and respiratory exchange ratio were
significantly greater during deep water running. No significant difference was found in
submaximal heart rate responses between trials. Subjects in this study were
inexperienced DWR and received only three familiarization trials in deep water running.
Water temperature was maintained at approximately 29C (84F) to 30C (86F).
Submaximal trials were 75% of treadmill VO2peak on treadmill (TM 75%), 70% of
deep water running VO2peak in water (DW 70%), and 75% of treadmill VO2peak in
water (TM 75%-W). Oxygen consumption at 75% of deep water running VO2peak was
significantly lower than the other trials. No difference in heart rate occurred between
trials. For both blood lactate and respiratory exchange levels, the water responses were
significantly higher than land (TM 75%-W > DW 70% > TM 75%). At the same
absolute exercise intensity, RPE values were higher in deep water running. The authors
suggest that the mechanics of DWR are not as similar to land running as has been
suggested by others.
Butts, Tucker and Smith (1991) investigated the maximal responses to treadmill and
deep water running in 12 high school female cross country runners (mean = 15 yr).
Subjects were taught DWR technique prior to testing, but had no previous experience
with this form of training. Peak heart rate and oxygen consumption was higher on the
treadmill than in water by 9% and 13%, respectively. The authors suggest the lower
DWR metabolic responses may be attributable to a number of factors, including the
cooling effect of the water temperature (29C {84F}), the hydrostatic forces exerted by
water, the low body fat of the subjects (mean = 17.6%), and mechanical differences
observed in deep water running due to the buoyancy effect of water. It was concluded
that DWR provided numerous rehabilitation and training possibilities for athletes.
Maximal Gender Responses to Treadmill and Deep Water Running
Any investigation comparing maximal physiological responses between women and
men is complicated by differences in body composition, physical size, and level of
training. The larger percentage of body fat observed in women is a chief contributing
factor to the lower cardiorespiratory observations (Pate & Kriska, 1984) . These
differences in body composition may also facilitate buoyancy, possibly resulting in a
reduced metabolic response in women when compared to men (making the water
exercise more economical for women) (Brown, Chitwood, Beason, & McLemore, 1997)
.
Table
4.
Kilocalorie
Expenditure
The following are some kilocalorie expenditure comparisons of different exercise
modalities.
Exercise
Mode
Kilocalorie
Expenditure
Aquatic
exercise
5.7
6.5
kcal.min-1
Aerobic
dance
6.2
6.6
kcal.min-1
Circuit
training
5.1
6.1
kcal.min-1
Step
aerobics
6.7
7.7
kcal.min-1
Running
11
min
mile
8.0
kcal.min-1
Running
9
min
mile
11.4
kcal.min-1
Walking
normal
pace
4.7
kcal.min-1
Deep
water
walking
8.8
kcal.min-1
Deep water running 11.5 kcal.min-1
Table
5.
MET
Values
Table
Met levels are a unit of measurement frequently used to designate the energy costs of
exercise programs. One MET equals 3.5 ml/kg/min. This table will provide MET data
for various aquatic exercise programs. Due to variation in fitness levels of subjects and
gender, these values are best used as approximations for the aquatic activity.
1st Author of Study & Yr Type of Aquatic Exercise Gender MET Levels
Cassady
1992
Upper
extremity
only
Female
2.9-4.1
Cassady
1992
Upper
extremity
only
Male
3.3-5.7
Cassady
1992
Lower
extremity
only
Female
4.0-7.0
Cassady
1992
Lower
extremity
only
Male
4.6-9.2
Echerson 1992 Aqua exercise in 1-meter of water Female 5.25
Vickery 1983 Waist-to-chest deep aqua calisthenics Female 6.7-8.3
Hered 1996 Chest deep aqua exercise with arms and legs Female 4.8-6.8
Evans 1996 Bench stepping, 7 inch step (no arms/with arms) Female 4.2/7.4
Evans 1996 Bench stepping, 12 inch step (no arms/with arms) Female 6.5/9.9
Kirby
1984
Running
in
chest
deep
water
Female
&
Male
7.1
Heberlein
1987
Aqua
exercise
in
chest
deep
Female
5.4
Michaud 1995 Deep water running at 76% HRmax Male 11.0
Richie
1991
Deep
water
running
at
83%
HRmax
Male
13.1
Summary
Points
From this review of literature on the cardiovascular and energy expenditure responses to
aquatic
exercise,
the
following
is
a
summary
of
findings:
Adding arms to leg exercise in chest deep water significantly increases the energy cost
of the workout. This may equal or exceed matched exercise performed on land.
Water jogging and running in waist-deep water results in equal or even greater
cardiovascular
responses
compared
to
similar
exercise
on
land.
Aqua exercise routines can meet ACSM guidelines for the improvement of
cardiorespiratory endurance. However, the ACSM guidelines for improvement of
cardiovascular fitness may need to be adapted for aquatic training, since current
standards
prescribe
only
for
landbased
exercise.
Bench stepping exercise in water, using the arms, meets ACSM guidelines for the
improvement
of
cardiorespiratory
endurance.
Water exercise using elastic resistance with the upper body does not significantly
increase
energy
expenditure.
Investigations have found the cardiorespiratory responses of deep water running to be
less than, similar, and greater than treadmill running on land.
Blood lactate levels in deep water running have been shown to be higher and lower to
land exercise which may reflect variations in arm and leg actions and exercise protocols.
Ratings of perceived exertion for DWR appear to be elevated due to higher blood lactate
levels
and
upper
extremity
muscular
fatigue.
The hydrostatic pressure and altered running style (due to different muscle activity
patterns of DWR) contribute to a greater involvement of the anaerobic energy system
during
deep
water
running.
There is an increase in breathing frequency and cost of breathing during water exercise
which leads to the respiratory muscles consuming more oxygen. This may function to
limit
the
oxygen
available
for
the
legs.
The more familiar subjects are to DWR, the smaller the difference between VO2max
values
between
land
and
water.
Exercise heart rate and oxygen consumption comparisons of teenage females in land
and water exercise appear to result in similar responses to those seen in adults.
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