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Daniel Fulham O’Neill

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Sharon West

Column-editor : Robert D. Kersey

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Pamela J. Redding

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Helen Binkley and Traci Schroyer

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Yaser Alikhajeh, Elyas Barabadi, and Gholam Rasul Mohammad Rahimi

, Kavuncu V . Clinical effectiveness of aquatic exercise to treat chronic low back pain: a randomized controlled trial . Spine . 2009 ; 34 ( 14 ): 1436 – 1440 . doi:10.1097/BRS.0b013e3181a79618 19525833 10.1097/BRS.0b013e3181a79618 9. Prins J , Cutner D . Aquatic therapy in the rehabilitation of

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Anna C. Severin, Brendan J. Burkett, Mark R. McKean, Aaron N. Wiegand, and Mark G.L. Sayers

). This study showed that immersion in water gives older adults greater squat depths and encourages a squatting technique with less anterior trunk lean and more hip flexion than on land. The results from this study support the use of aquatic therapy for older adults because it provides an exercise

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Karlee Naumann, Jocelyn Kernot, Gaynor Parfitt, Bethany Gower, and Kade Davison

by the Australian Physiotherapy Association as therapeutic and exercise activities carried out in heated pools (Australian Physiotherapy Association website accessed May 14, 2020). Papers explored water-based programs, which identified as either hydrotherapy or aquatic therapy (i

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Samantha E. Scarneo, Hayley J. Root, Jessica C. Martinez, Craig Denegar, Douglas J. Casa, Stephanie M. Mazerolle, Catie L. Dann, Giselle A. Aerni, and Lindsay J. DiStefano


Neuromuscular training programs (NTPs) improve landing technique and decrease vertical ground-reaction forces (VGRFs), resulting in injury-risk reduction. NTPs in an aquatic environment may elicit the same improvements as land-based programs with reduced joint stress.


To examine the effects of an aquatic NTP on landing technique as measured by the Landing Error Scoring System (LESS) and VGRFs, immediately and 4 mo after the intervention.

Design and Setting:

Repeated measures, pool and laboratory.


Fifteen healthy, recreationally active women (age 21 ± 2 y, mass 62.02 ± 8.18 kg, height 164.74 ± 5.97 cm) who demonstrated poor landing technique (LESS-Real Time > 4).


All participants completed an aquatic NTP 3 times/wk for 6 wk.

Main Outcome Measures:

Participants’ landing technique was evaluated using a jump-landing task immediately before (PRE), immediately after (POST), and 4 mo after (RET) the intervention period. A single rater, blinded to time point, graded all videos using the LESS, which is a valid and reliable movement-screening tool. Peak VGRFs were measured during the stance phase of the jump-landing test. Repeated-measure analyses of variance with planned comparisons were performed to explore differences between time points.


LESS scores were lower at POST (4.46 ± 1.69 errors) and at RET (4.2 ± 1.72 errors) than at PRE (6.30 ± 1.78 errors) (P < .01). No significant differences were observed between POST and RET (P > .05). Participants also landed with significantly lower peak VGRFs (P < .01) from PRE (2.69 ± .72 N) to POST (2.23 ± .66 N).


The findings introduce evidence that an aquatic NTP improves landing technique and suggest that improvements are retained over time. These results show promise of using an aquatic NTP when there is a desire to reduce joint loading, such as early stages of rehabilitation, to improve biomechanics and reduce injury risk.

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Andresa R. Marinho-Buzelli, Ana Maria Forti Barela, Jose Angelo Barela, Melissa Leandro Celestino, Milos R. Popovic, and Mary Verrier

Aquatic therapies are used to restore step initiation in people with locomotor disabilities. However, there is lack of evidence of underlining mechanisms of gait initiation in water. We investigated center of pressure (CoP), vertical and anterior-posterior impulse forces, and kinematics of the first step performed in water in comparison with overground walking. The peaks of anticipatory postural adjustment (APA) and the sections of CoP trajectories were longer in water than on land. Impulse forces were increased in water compared with land. Range of motion (ROM) of ankle joint increased in water while knee joint ROM did not change. We suggest that the aquatic environment may facilitate gait initiation training by allowing a longer step execution with greater stimuli and imposed resistance for the phases of gait initiation.