Specificity of functional exercise in water compared to on land: Understanding biomechanics to improve the clinical effectiveness of aquatic rehabilitation

Although aquatic rehabilitation is effective in improving function, pain and quality of life in musculoskeletal conditions, it is less clear if aquatic exercise improves muscle performance. Lower body closed kinetic chain (CKC) exercises are commonly used in aquatic rehabilitation because they are believed to reduce joint loading whilst replicating functional tasks. However, the forces and relationship to land-based functional movement is unknown. The aims of this thesis are to a) systematically review literature on the biomechanics of lower limb functional exercise in water compared to on land; b) evaluate the effectiveness and scope of aquatic exercise programs in improving muscle performance; c) compare the pattern and peak of vertical ground reaction (GRF) during squats, calf raises and jumping in water and on land and d) investigate how speed influences biomechanics and muscle activity parameters during functional CKC exercises in water compared to on land.Submitted in the fulfilment of the requirements of the degree of Doctor of Philosophy, University of the Sunshine Coast, 2019