title: Aquatic versus land-based exercises as early functional rehabilitation for elite athletes with acute lower extremity ligament injury: a pilot study.
abstract: OBJECTIVE
  To compare outcomes between aquatic and land-based exercises during early-phase recovery from acute lower extremity ligament injuries in elite athletes.
  
  
  METHODS
  A single-blinded, covariate adaptive randomized, controlled study.
  
  
  METHODS
  National training center for elite athletes.
  
  
  METHODS
  Twenty-two athletes with isolated grade I or II ligament injury in ankles or knees were randomized into either an aquatic or land-based exercise group.
  
  
  METHODS
  Early functional rehabilitation program (ranging, strengthening, proprioceptive training, and functional exercises) was performed in both groups. All exercises were identical except for the training environment.
  
  
  METHODS
  Data were collected at baseline and at 2 and 4 weeks using a visual analog scale (VAS) for pain; static stability (overall stability index [OSI] level 5 and 3); dynamic stability (TCT), and percentage single-limb support time (%SLST).
  
  
  RESULTS
  Both groups showed decreases in VAS, OSI 5 and 3, and TCT, with a concomitant increase in %SLST at 2 and 4 weeks (P < .05). No significant differences were detected between the 2 groups in any of the outcome measures. However, the line graphs for VAS, OSI 3, TCT, and %SLST in the aquatic exercise group were steeper than those in the land-based exercise group indicating significant group by time interactions (P < .05). These data indicate that the aquatic exercise group improved more rapidly than the land-based exercise group.
  
  
  CONCLUSIONS
  For elite athletes with acute ligament sprains in the lower limb, aquatic exercises may provide advantages over standard land-based therapy for rapid return to athletic activities. Consequently, aquatic exercise could be recommended for the initial phase of a rehabilitation program.
authors.affiliation: Department of Sports Medicine and Science, National Training Center of Korea Olympic Committee, Seoul, Korea. eunkuk.kim@gmail.com
authors.forename: Eunkuk
authors.initials: E
authors.lastname: Kim
authors.forename: Taegyu
authors.initials: T
authors.lastname: Kim
authors.forename: Hyunyong
authors.initials: H
authors.lastname: Kang
authors.forename: Jongha
authors.initials: J
authors.lastname: Lee
authors.forename: Martin K
authors.initials: MK
authors.lastname: Childers
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000473:pathology / Q000503:physiopathology / Q000534:rehabilitation*; D001265:Athletic Injuries / Q000473:pathology / Q000503:physiopathology / Q000534:rehabilitation*; D015331:Cohort Studies; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000473:pathology / Q000503:physiopathology / Q000534:rehabilitation*; D008022:Ligaments / Q000293:injuries*; D008297:Male; D010865:Pilot Projects; D020127:Recovery of Function; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult