title: Effects of underwater treadmill training on leg strength, balance, and walking performance in adults with incomplete spinal cord injury.
abstract: OBJECTIVE
  To document the effects of underwater treadmill training (UTT) on leg strength, balance, and walking performance in adults with incomplete spinal cord injury (iSCI).
  
  
  METHODS
  Pre-test and post-test design.
  
  
  METHODS
  Exercise physiology laboratory.
  
  
  METHODS
  Adult volunteers with iSCI (n = 11).
  
  
  METHODS
  Participants completed 8 weeks (3 × /week) of UTT. Each training session consisted of three walks performed at a personalized speed, with adequate rest between walks. Body weight support remained constant for each participant and ranged from 29 to 47% of land body weight. Increases in walking speed and duration were staggered and imposed in a gradual and systematic fashion.
  
  
  METHODS
  Lower-extremity strength (LS), balance (BL), preferred and rapid walking speeds (PWS and RWS), 6-minute walk distance (6MWD), and daily step activity (DSA).
  
  
  RESULTS
  Significant (P < 0.05) increases were observed in LS (13.1 ± 3.1 to 20.6 ± 5.1 N·kg(-1)), BL (23 ± 11 to 32 ± 13), PWS (0.41 ± 0.27 to 0.55 ± 0.28 m·s(-1)), RWS (0.44 ± 0.31 to 0.71 ± 0.40 m·s(-1)), 6MWD (97 ± 80 to 177 ± 122 m), and DSA (593 ± 782 to 1310 ± 1258 steps) following UTT.
  
  
  CONCLUSIONS
  Physical function and walking ability were improved in adults with iSCI following a structured program of UTT featuring individualized levels of body weight support and carefully staged increases in speed and duration. From a clinical perspective, these findings highlight the potential of UTT in persons with physical disabilities and diseases that would benefit from weight-supported exercise.
authors: Sandra L
authors: SL
authors: Stevens
authors: Jennifer L
authors: JL
authors: Caputo
authors: Dana K
authors: DK
authors: Fuller
authors: Don W
authors: DW
authors: Morgan
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007866:Leg / Q000502:physiology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D004856:Postural Balance; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D016138:Walking
keywords: Aquatic gait training; Gait training; Incomplete spinal cord injury; Partial body weight-supported treadmill training; Underwater treadmill; Water therapy