comparative study on efficacy of moderate intensity land based endurance exercise & moderate...

7/29/2019 Comparative Study on Efficacy of Moderate Intensity Land Based Endurance Exercise & Moderate Intensity Water Based Endurance Exercise on Normal Young Individuals - Vish

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Those who think they have no time for bodilyexercise will sooner or later have to find time forillness. - Edward Stanley, Earl of Derby, in his address

to Liverpool College, 20th Dec. 1873 Health & Fitness is to the human body what fine

tuning is to an engine. More specifically, it is theability of the human body to function with vigor &

alertness, without undue fatigue, & with ample energyto engage in leisure activities.


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Cardio-respiratory fitness is an essential component ofphysical fitness & best describes the health of heart, lungs& circulatory system and is related to cardio-respiratory

endurance, which is the ability to sustain activities forprolonged time.

Cardio-respiratory endurance is the ability to deliveroxygen & nutrients to tissues & to remove wastes over

sustained periods of time. Various activities and exercises have been prescribed and

practiced, at different intensities, to attain fitness, walkingand swimming being two of the most common amongst

those. Efforts in the present study are directed towards finding

the effectiveness of walking and swimming, at moderateintensities, in improving the cardio-respiratory endurance

and also to compare the effects of both.


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To study the effects of moderate intensity walking onendurance in normal young individuals.

To study the effects of moderate intensity swimming

on endurance in normal young individuals. To assess the outcomes of endurance training on

exercise tolerance in normal young individuals.

To assess and compare the effectiveness of moderate

intensity land based endurance exercise & moderateintensity water based endurance exercise in normalyoung individuals.


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Study Design Randomized Control Trial. Sample Population Normal young individuals, males &

females, in the age group 20 to 30 years. Sample Size 50 subjects. Sampling Technique Subjects were randomly divided into

two groups, Group A & Group B, with 25 subjects in eachgroup. Inclusion Criteria Asymptomatic, normal, non-smoking,

non-exercising individuals, in the defined age group, withno history of Hypertension, Diabetes Mellitus,

Tuberculosis & Bronchial Asthma. Exclusion Criteria Presence of any disabling lung disease,

congenital or acquired chest deformities, cardiacimpairment, neurological disorder or any other musculo-skeletal condition, e.g. Knee Osteoarthritis, that couldinterfere with the subjects participation in the study.


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Outcome Measures Six Minute Step Test.

Borgs Scale for rate of perceived dyspnea.

Visual Analog Scale for dyspnea. Peak Expiratory Flow Rate.

Resting Pulse Rate.

Interventions

Group A: Subjects in group A received moderate intensityland based endurance exercise i.e. walking at a speed of 4miles/hr.

Group B: Subjects in group B received moderate intensitywater based endurance exercise i.e. swimming at a speed of 20

yards per minute with dog-paddle stroke of front crawlvariety.

[The Intensities of the exercises were selected on the basis ofMET levels of 4 to 5 METS i.e. 14 17.5 ml/kg/minutes, as perACSMs guidelines for exercise testing & prescription]


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Conversions used for the study:

Group A (Walking) Group B (Swimming)4 mph 0.68181 mph

= 6.43736 km/hr = 1.09728 km/hr= 6437.36 mt/min = 1097.28 mt/hr

= 107.28933 mt/min = 18.2888 mt/min

= 177.3316 yards/min = 20 yards/min The data on all the outcome measures for subjects in

both the groups was collected on day 0, day 7, day 14 &day 21. The data was analyzed on statistical softwareSTATA version 8.0. Continuous variables were

expressed as Mean + SD. Continuous variables werecompared between both the groups by performingunpaired t test and p 0.05 was taken as statisticalsignificance.


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Mean change in duration without rest on SMSUT

0

0.5

1

Day 7 Day 14 Day 21

0.11

0.63

0.94

0.15

0.79

0.86

MeanChange

Days

Mean Change in duration without rest on Day 7, Day 14 & Day 21 ascompared to Day 0 on Six Min. Step Up Test

Group A Group B


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0

1

2

Day 7 Day 14 Day 21

0.12

0.52

0.96

0.47

1.26

1.47

MeanChange

Days

Mean Change in No. of rest taken on Day 7, Day 14 & Day 21 ascompared to Day 0 on Six Min. Step Up Test

Group A Group B


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0

1

2

3

Day 7 Day 14 Day 21

0.6

1.2

2.04

1

1.84

2.58

MeanChange

Days

Mean Change in score on Borg's Scale on Day 7, Day 14 & Day 21 ascompared to Day 0

Group A Group B


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0

2

4

Day 7 Day 14 Day 21

0.84

1.32

1.88

0.95

1.84

2.68

MeanChange

Days

Mean Change in score on VAS on Day 7, Day 14 & Day 21 as comparedto Day o

Group A Group B


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0

10

20

30

40

50

60

70

80

90

Day 7 Day 14 Day 21

6.8

19.28

36.96

3.6

45.6

87.2

meanchange

Days

Mean change in PEFR on Day 7, Day 14 & Day 21 as compared to Day 0

Group A Group B


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0

5

10

Day 7 Day 14 Day 21

0.8

1.96

3.4

2.76

5.2

6.56

MeanChange

Days

Mean Change in resting pulse rate on Day 7, Day 14 & Day 21 ascompared to Day 0

Group A Group B


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Physical properties of water

Hydrostatic Pressure(Arrows represent pressure).Taken from Cameron MH.

Physical Agents inRehabilitation: From Research to

Practice. Missouri. Saunders,2003, pp. 265.

BuoyancyPercentage of body weight off-loadedwith increasing immersion depth.

Taken from Becker BE, Cole AJ.

Comprehensive Aquatic Therapy. Boston.Butterworth-Heinemann, 1997, pp. 41.


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Drag Passive Drag

Wave drag

Skin friction drag Viscous pressure drag

Active Drag

Physiological Effects of Water

Cardiovascular Effects of Immersion.Taken from: Cameron MH. Physical Agents

in Rehabilitation


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Respiratory Effects of Immersion,Taken from: Cameron MH. Physical Agents in Rehabilitation: From Research to

Practice. Missouri: Saunders; 2003, pp 269


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Cassady SL, Nielsen DH. Cardiorespiratory responses of healthy subjectsto calisthenics performed on land versus in water. Phys Ther. 1992; 72(7):532-538, concluded that water calisthenics appear to be of sufficientintensity to elicit training adaptations.

One project conducted by Hoeger et al. (1992) directly examined thetraining effects of an identical aerobics program performed on land(low-impact) and in the water.(48) Both the land-based (low-impact) andshallow water aerobics groups made similar gains in aerobic fitness, witha 14.8% relative improvement in estimated VO2max using a Bruceprotocol (pre = 31 6.8, post = 35.6 7.0 ml/kg/min) observed in the

shallow water aerobics group. Total treadmill time was also significantlyincreased (by one minute) following shallow water training. Inagreement 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) 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 ofshallow water aerobics.

Plowman S A, Smith D L (1997) stated that in the individuals whoparticipated in water based activities (swimming and diving),pulmonary adaptations occur, resulting in greater lung volumes andcapacities as compared with the matched land based trained anduntrained controls.


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Observations and findings showed that, there wassignificant improvements in readings for both the groupson the selected parameters in the form of: Increased Peak flow rate. Reduction in dyspnea.

Reduction in rate of perceived exertion. Improvement in 6 MST. Reduction in resting heart rate.

But when both the groups were compared there was asignificant improvement in the water based exercise

training group as compared to the land based exercisegroup in the form of increased endurance.

The results in the study were consistent with similar earlierlimited studies and need for further studies to explore the

depth of the topic cannot be understated.


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