Comparing the Effects of Aquatic and Land Based Exercise Programs on Balance in Female

Comparing the effects of aquatic and land based exercise programs on balance in female collegiate athletes: a pilot study

Meghan Cass SPT, Mariel Kunnapas SPT, Alexandra Lewis SPT, Caitlyn Maskell SPT,

Alyssa Milazzo SPT, Adam Tamburello SPT

Research Advisor: Dr. Christine McNamara PT, DPT

ABSTRACT

Introduction:In the female athletic population, balance, a key component in performance of sport specific skills, has been shown to be a risk factor for injury. Dynamic postural control, required for sport specific activities, causes the highest percentage of injuries in sports. Land based training is crucial in the athlete’s neuromuscular improvement. Based on the properties of buoyancy and viscosity, aquatic exercise may be utilized by the athletic population. Research in the aquatic environment is lacking regarding balance training in the athletic population. We conducted this study to determine the effects of an aquatic balance training program and create a positive impact on clinical decision-making. This study explores the efficacy of balance training programs for athletes performed in land and aquatic environments.

Methods:For this study, healthy female athletes were recruited from Ithaca College’s varsity athletic teams via flyers and emails. Subjects who met the inclusion criteria were randomized into the land or aquatic group. A four-week, evidence-based exercise program that was adapted to both environments was implemented. Balance was assessed using the Star Excursion Balance Test (SEBT) and the Neurocom’s Limits of Stability (LOS) and Sensory Organization (SO) tests. Assessments and interventions were supervised by two PT faculty members and carried out by eight graduate student physical therapists. Clinical significance was determined using measures of Minimal Detectable Change and Minimal Clinically Important Difference found in the literature.

Results:Subjects included two track and field varsity athletes ranging from ages 21±1 year. For the SEBT, both subjects showed clinically significant improvements in at least 50% of directions, with the aquatic subjects showing clinically significant improvement in 93.75% of directions. For the SO, both subjects showed clinically significant improvements in equilibrium score and strategy analysis of condition six.

Discussion:Improvements were found in balance in each environment demonstrating that either can be utilized effectively. Based on the unloading properties of buoyancy, the aquatic environment may be utilized to facilitate early balance training in the rehabilitation continuum for injured female athletes. This study provides the basis for further research on the effects of aquatic balance training on injured female athletes.

Conclusion:These results may inform clinical decision making of the interprofessional team rehabilitating female athletes. The current standard of care for training balance in the injured female athlete is land based, often limited by the deleterious effects of impact and loading on the lower extremity. Demonstrating that the aquatic environment is a viable option, balance training can be initiated earlier in the rehabilitation process. With earlier initiation of activity and the resistive properties of water, athletes are provided with the opportunity to maintain conditioning throughout the rehabilitation process. We hypothesize that this will facilitate a rapid and successful return to sport.