by Bruce E. Becker, MD, MS
Aquatic exercise would seem to offer the safest and most protective environment for obese individuals because of the buoyancy effects of immersion, which minimizes the risk of joint injury.
With body weight reduced to essentially negligible levels, the immersed individual can exercise vigorously and is capable of producing increases in VO2max over relatively short periods.
Aquatic exercise programs may be highly beneficial in the restoration of fitness in obese patients because of the protective effects against heavy joint loading in the aquatic environment.
On dry land, the ability to achieve an aerobic exercise level for sufficient time to produce a conditioning effect may be difficult in this population, and a program that begins in water and moves to land as strength, endurance, and tolerance builds may be a more effective method of achieving both conditioning and weight loss.
A 2006 study compared the effects of a land-based aerobic exercise program with a swimming group and a water-walking group of obese subjects over a 13-week period and found no statistical differences between the groups, all losing weight (5.9 kg) and body fat percentages (3.7%) .
The advantages of aquatic exercise also include the heat conductive effects of water, which greatly reduces risk of heat stress when done in cooler pools [196,198].
Aquatic therapy programs for this population should include chest depth or deeper sustained aerobic exercise, alternated with balance and coordination drills.
aqua balance website