Many studies have recently shown that aquatic exercise is greatly beneficial to the cardiorespiratory system and that it prevents an abrupt increase in heart rate while at the same time requiring greater oxygen consumption than exercises performed on land. Water walking as an exercise is thought to offer many advantages over walking on land, especially for people suffering from arthritis or various orthopedic disorders of the lower limb joints, since the impact forces against the lower limb joints can be readily reduced by changing the combination of submersion level and walking speed. In this review we describe the recent advances made in our understanding of the conflicting effects of water resistance and buoyancy onto the kinematics and kinetics of water walking. We show the quantitative differences in ground reaction force, joint angle, joint moment, and electromyogram of the lower limb between land walking and water walking. Knowledge of how these biomechanical characteristics change between walking in water and on land, and of how they change in relation to the walking speed, will be useful for clinicians in prescribing safer and more effective aquatic exercise programs.
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