14 Week Deep Water Exercise Program Improves Components of Fitness Rosie Barretta, PhD

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1 1 Background 14 Week Deep Water Exercise Program Improves Components of Fitness Rosie Barretta, PhD This study was conducted as a doctoral dissertation at the University of New Mexico in 1993; and, later published in the Journal of Aquatic Therapy in At that time, the interest was not high and the distribution of the information was very limited. Now, there seems to be much more interest in the topic. The author/researcher has summarized the results of the study in the hopes that the fitness benefits can be more widely known. For detailed information bibliography or questions please rosiebarretta257@hotmail.com Purpose of Study. The purpose of the study was to evaluate the efficacy of deep water exercise to develop fitness. A by-product of the study also showed the approximate number of calories burned per kg/minute while participating in this deep water program. Participants. Male and female volunteers were recruited via flyers and advertisements in a University newspaper to register for a class of deep water exercise as part of an elective physical activity program at a major university. Initially, nineteen volunteers started the study, with seventeen completing the semester and 15 participating in the entire battery of pre and post tests. Two subject dropped out dropped the course. Two students were not able to complete the entire battery of post-tests due to schedule conflicts. Five men and twelve women completed the study. The ages of participants ranged from 19 to 43 years. Prior to the investigation, participants completed a health history questionnaire to assess any contraindications to participation in this study. Since diet can influence body composition, two three-day food records were collected during the study. These food records were assessed by the investigator of this study using the West Nutrition computer protocol. No attempt was made to modify the participants' dietary intake. Testing protocol. Participants in this study were pre-tested and post-tested for the following fitness components with standard physiological assessments: Height. Weight. Body composition was assessed through hydrostatic weighing and RV assessed using the helium dilution method. Body mass Index (BMI) was computed from height and weight. Girth measurements of the upper arm, thigh and waist. Flexibility was assessed using the modified sit and reach test. Maximum muscular strength of shoulders, chest, and thigh as assessed using the Omnitron. Cardiovascular fitness and endurance using a calibrated maximal bicycle test to volitional exhaustion. Expired air samples were collected on the pool deck at the beginning and at the end of the study. After a steady state had been achieved, 30 seconds of expired gases were collected and analyzed with the Jaeger Gas Analyzer. For the purpose of analyzing caloric expenditure

2 2 Circumferences The upper arm, waist, hip and thigh circumference were measured and reported in cm. All measures were performed three times on the right side of the body. Residual Volume and Hydrostatic Weighing. The residual volume (RV) was determined Subjects were hydrostatically weighed (underwater weighing) at residual volume. Body density was estimated by dividing body weight by body volume. Percent body fat (BF) was calculated using age-gender specific equations Body Mass Index was determined by the standard formula BMI= wt (kg)/ht 2 (m). Strength Assessment. Muscular strength was evaluated by a hydraulic resistance machine. Subjects were allowed three sub-maximal practice trials using a lower resistance setting of 2. After two minutes of rest, five maximal contractions at maximum speed were performed in both directions (flexion and extension). Shoulder strength was assessed with an overhead shoulder press-up/lateral pull down movement. Chest strength was assessed with a chest press/lateral row movement and thigh strength was assessed with a knee extension/flexion movement. The Omnitron system is computerized and a printed summary and analysis was provided on the variables tested. The summary was provided in foot-pounds and converted to Newton meters (Nm). Flexibility Assessment. The Modified Sit and Reach test used to measure flexibility. Three trials were performed, and the best of the three trials was recorded. Cardiovascular Endurance Assessment. An electronically braked ergometer (bike) was used to determine VO 2max. The initial work rate consisted of three minutes of cycling at 50 Watts (W) for women and 75 W for men. The work load was then increased by 25 W every minute until a cadence of 40 rpm could not be maintained. Oxygen consumption was measured continuously. A light weight headpiece consisting of velocity non-re-breathing valve and mouth piece velocity non-re-breathing valve and mouth piece was fitted worn by the subject to collect and analyze expired gases. Indirect calorimetry measurements of minute ventilation, (VE, V O2, carbon dioxide production (V CO2 ), respiratory exchange ratio (RER) and heart rate (HR) electrocardiography was integrated and calculated at 30 second intervals. All subjects received verbal encouragement throughout the tests. Aerobic capacity (V O2 max ) was determined by averaging the last two of the highest recorded values of oxygen uptake (30/sec. intervals) observed during the exercise test. A plateau in V O2 and/or a respiratory exchange ratio greater than 1.1 was used as the criterion for the attainment of V O2 max. Exercise Training Program. Subjects participated in a 14-week deep water exercise program. The training was progressive in nature. Each exercise session was forty-five minutes in length. The exercise session included a warm-up period of five to seven minutes; a cool-down session of five to seven minutes and the aerobic portion was progressively increased from minutes. Ten to twelve minutes of each session included exercises during which subjects were required to use the hand bars for either resistance and/or support. Exercise sessions were offered four times a week, Participants attended class three times per week. Each subject wore one flotation belt in deep water (6-14 feet deep). The exercise routines were developed by a certified Aquatic Exercise Instructor (AEA) and primary researcher. The exercise sessions consisted of deep water walking, running and striding, interspersed with other activities in deep water, and exercises using the hand bars.

3 3 Individuals were trained to measure their own exercise heart rate. Heart rates were monitored at the beginning of each class with both an out-of-water and in-water resting heart rate. Exercise heart rate was self-monitored two or three times during the aerobic portion of the workout. After cool down, a final heart rate was also taken by the participants. Since water temperature can influence heart rate, the temperature of the water was recorded after each class session. Subjects recorded their maximum heart rate attained during the session and ranked the intensity of the exercise, using the Borg (RPE) scale at the end of each exercise session. Water Exercise Equipment. Equipment for this study consisted of a flotation belt for each participant supplied by Boat USA, manufactured by Wellington, Madison, GA. Each participant also used a pair of Hand Bars. The Hand Bars were obtained from J & B Foam, Ludington MI. The Hand Bars were composed of a 12" long and 1" in diameter, PVC tube 6" in diameter, by 2" wide Styrofoam disk. These bars added resistance and additional support to the participant. As the study progressed, most students in the study elected to use larger hand bars with a diameter of four inches. Data Analysis and Statistical Analysis. Subjects participated in a correlated (dependent) sample T-tests, utilizing repeated measures. This is also known crossover design. Pre and post tests were used to assess the various physiological indicators of fitness of each individual. These physiological indicators were: (a) VO2 max, (b) body weight, (c) per cent body fat, (d) muscular strength, (e) flexibility, and (f) girth measures and (g) body mass index (BMI) In addition caloric uptake during exercise was also computed and analyzed. Data was analyzed using cross-over design comparative dependent t-tests. Data was analyzed using SPSS Version 6 (1991) Results and Discussion VO2 max and Training In this study most subjects in this study increased their land based VO 2 max (p=.0287). In-water measures of the percent of VO 2 max also indicate sufficient intensity to elicit a training effect (74-81% VO2 max), although heart rates did not reflect the intensity of the workload. Subjects daily Borg (RPE) ratings of the water workout indicated at least a moderate workout as well. The phenomenon of reduced heart rate associate with water immersion and water immersion exercise has been observed for many years and is noted in several studies. Recommendations from various researchers indicate land target heart rate is not appropriate to monitor deep water exercise. Most research does recommend dropping the target heart rate by 10% (10-17 bpm) from land based computed target heart rate. The research suggests that this reduced heart rate is due increased stroke volume due to the following: 1. increased preload in the heart atria due to increased blood volume caused by a. Compression of the water on the limbs forcing blood into the heart and lungs b. Vaso-constriction due to temperature of water, 2. Increased perfusion and absorption of O2 in the lungs/blood (Boyles Law ) 3. Decrease in systemic vascular resistance (due to decreased gravity influence) 4. Decrease in vital capacity 5. Increase in cardiac blood volume, 6. Increase in central venous pressure.

4 4 Exercising heart rates were self-monitored and recorded throughout the exercise and testing portions of this study. The results of this monitoring were not used in the results of this study due to the possible inaccuracy of self monitored measures. Percent Fat, Weight, Lean Body Mass, Girth and Kcal In this study there was a significant drop in percent body fat, however, there was no mean weight loss, or significant change in body mass index (BMI). These results are consistent with some water exercise research, and some resistance weight training research. This study showed an overall average of just under two per cent loss (1.97%) of body fat (26.06% reduced to 24.08%.) These results are similar to other deep water studies. When the results of this study are examined by gender, the difference is remarkable. The five males in this study decreased percent body fat by 2.722% (from 19.95% to %). The females dropped 0.94% (from % %). Girth measures showed little change is this study. Strength and Flexibility The most significant results of this study were the strength gains in the shoulder and chest area and a significant improvement in lower back and hamstring flexibility. In this study, these gains are attributable to the specific and intentional involvement of the upper body in the deep water exercise format, and the use of Styrofoam hand bars. These hand bars were used as an additional factor in upper body resistance exercise. Upper body exercises emphasized the use of the arms in assisting body propulsion through the water in various forward backward and sideways movements, both at the surface and below the surface of the water. The hand bars were also used as an additional resistance factor by being held underwater, or moved though the water. Additional gains in abdominal strength were noted by the participants, but were not part of the assessments in this study. These strength gains demonstrated by this study through water exercise may give an alternative to those who may not or cannot participate in weight training activities. The American College of Sports Medicine (1991) recommended that strength training activities be included with a regular fitness regimen, particularly for the older adult. It has been found that older adults show a decline in strength and muscle mass during their middle age years. Inadequate strength can lead to low back problems and mobility problems later in life. Deep water exercise could help to retard the loss of strength in older adults and in individuals with various debilitating conditions. Although no specific exercises were done to increase flexibility, a significant increase occurred in low back and hamstring flexibility. The flexibility gains are attributed to the medium of water. Movement that is difficult or not possible on dry land is easy in the water. The weight of the water also helps by both supporting and resisting movements. One female subject increased her sit and reach score by cm (7 inches). Additional gains in shoulder flexibility were noted by the participants, but were not assessed.

5 5 Summary of Results Training effects of 14 week water based exercise on selected physiological parameters Physiological Adaptations to a 14 week Deep Water Exercise Program Test Baseline Post Treatment P value S NS Weight (kg) P =.0813 NS BMI (kg/m 2 ) P =.0840 NS % Fat * P =.008 S Flex (cm) * P =.0025 S VO 2 /Bike (land) ml. kg.-1 min * P =.0297 S Ride time (minutes) * P =.0016 S Max HR (land) (bpm) P =.133 NS Strength sh-pull (Nm) * P =.0002 S Strength sh press (Nm) * P =.032 S Strength th-flx (Nm) * P =.0299 S Strength th ex (Nm) * P =.0082 S Strength ch-pul (Nm) * P =.0001 S Strength ch-press (Nm) * P =.0001 S Girth-thigh cm P =.4095 NS Girth-waist cm P =.7538 NS Girth-arm cm P =.1897 NS H 2 O Kcal/min P =.1107 NS Note: Values are mean + SD; P value based on Paired t test *S = Statistical significance NS = No Statistical significance

6 6 Summary of Results For individuals wishing to start or maintain a fitness regimen, deep water exercise may be ideal by itself or in combination with other aerobic activities. This study has found that participants in this deep water exercise improved most fitness components: Increase cardio-vascular strength and endurance Increase upper body strength in shoulders and chest Increase in leg strength. Increase flexibility in the lower back and hamstrings. Decrease percent body fat. A caloric expenditure similar to running a 11.5 minute mile is possible with deep water exercise As determined from collected expired gasses, this study indicated an average caloric output of 9.8 kcal.min -1.kg -1. Individual caloric expenditure varied from 5-18 kcal/min -1 with an average of kcal.min -1.kg -1 (range of kcal.min -1.kg -1 ) during the pre- testing; and.155 kcal.min -1.kg -1 (range of kcal.min -1. kg -1 ) during the post-testing. This compares with various other activities as follows: Comparison of deep water exercise to aerobic activities by energy expenditure Activity kcal.min -1.kg -1 Running, 11.5 min/mile Running, 9 min/mile, Running, 6 min/mile Walking 2.0 mph Walking 3.0 mph Walking 4.0 mph Cycling, 9.4 mph (leisure) Cycling, racing Swimming front crawl (fast) Treading water, normal Treading water fast From McArdle, Katch and Katch * Deep water Exercise This study can be obtained from Journal of Aquatic Physical Therapy using the following citation. Journal of Aquatic Physical Therapy, (1995). Training Effects of a 14 week Deep Water Exercise Program, (3) 3, pp By Rosie G. Barretta and Robert Robergs Aquatic Physical Therapy Section 7400 E. Arapahoe Rd., #211 Centennial, CO (303)

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