Osteoarthritis (OA) is a degenerative disease that affects articular cartilage and underlying subchondral bone. Cartilage surfaces are roughened, causing hypertrophic changes leading to joint space narrowing. Since there is no cure, normal treatment is to manage pain and to incorporate exercise to maintain or enhance functional status. While land-based exercise has demonstrated efficacy for pain management and functional status in OA patients less is known relative to aquatic exercise therapy. Examples of aquatic exercise include deep water and shallow water walking, aquatic therapy exercises and water treadmill exercise. A review examining aquatic therapy studies identified many studies lacking randomized or quasi-randomized clinical trials. Aquatic exercise appears to have some beneficial short-term effects for patients with hip and/or knee OA while no long-term effects have been documented. Based on this, one may consider using aquatic exercise as the first part of a longer exercise program for osteoarthritis patients. The controlled and randomized studies in this area are still too few to give further recommendations on how to apply the therapy, and studies of clearly defined patient groups with long-term outcomes are needed to decide on the further use of this therapy in the treatment of osteoarthritis. However, the ability to objectively control exercise intensity between water versus land may have limited researchers in determining if differences in therapy outcomes are due to the intervention or are just because of differences in exercise intensity. Perhaps the mixed results reported in the literature) may in part be related to the lack of control over exercise intensity. We recently examined the effect of an acute (one week) exercise regimen of walking on land vs on a water treadmill at preferred walking speed and faster in OA patients. The results of one week of land vs water walking at similar walking speeds suggests that OA patients are able to complete the same exercise task in water as on land with significantly less pain and energy expenditure, similar perception of exercise effort and significantly improved performance on a timed up & go test. It remains to be determined if these findings persist over the course of a typical exercise training program (8, 12, 16 weeks) and need to determine what is required as a threshold or maintenance exercise program to retain these benefits. Dennis Dolny received his BA and MS in Physical Education from Wake Forest University and PhD from Kent State University in Physical Education with an emphasis in Exercise Physiology. For the past 24 years he was on faculty at the University of Idaho where he also directed the Human Performance Laboratory. In 2008 he accepted the Department Head position in Health, Physical Education & Recreation in the College of Education & Human Services at Utah State University. He has chaired ten doctoral committees and published 30 peer-reviewed research articles. His recent research projects have included studying the acute effects of vibration exposure on subsequent muscle power output, developing techniques to monitor skeletal muscle activity during walking and running in water, and currently funded projects involve the use of aquatic exercise exposure on energy expenditure, joint discomfort and perceived effort in overweight subjects and those with osteoarthritis. At USU his laboratory collaborates with USU Sports Medicine examining the role of hydrotherapy in rehabilitation following lower extremity surgical procedures and joint replacement in the elderly.
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