Water-based exercise for cardiovascular fitness in people with chronic stroke: a randomized controlled trial. [A study on the quality of life in ischaemic vascular accidents and its relation to physical activity]. The effect of aquatic therapy on postural balance and muscle strength in stroke survivors--a randomized controlled pilot trial.
To evaluate the effect of an 8-week, water-based exercise program (experimental group) with that of an upper-extremity function program (control group) to increase cardiovascular fitness within a community setting for people with stroke.
                Single-blind randomized controlled trial.
                Public community center.
                A volunteer sample of 12 community-dwelling people with stroke with mild to moderate residual motor deficits.
                Study subjects participated in group exercise programs for 1 hour, 3 times a week for 8 weeks. The experimental group exercised in chest-deep water at targeted heart rates. The control group performed arm and hand exercises while sitting. Main outcome measures The primary outcome measure was cardiovascular fitness (V(O2)max). Secondary measures were maximal workload, muscle strength, gait speed, and the Berg Balance Scale score.
                The experimental group attained significant improvements over the control group in cardiovascular fitness, maximal workload, gait speed, and paretic lower-extremity muscle strength. The relatively short program (8 wk) of water-based exercise resulted in a 22% improvement in cardiovascular fitness in a small group of people with stroke who had relatively high function.
                A water-based exercise program undertaken as a group program may be an effective way to promote fitness in people with stroke. Cerebrovascular accidents (CVA) are the third most common cause of death and are the main cause of permanent disability in the western world, where they also rank first as regards the loss of years of disability-adapted independent life. Ischaemic CVAs tend to present irreversible sequelae, which reduces the patient's quality of life.
                To analyse the effect of a series of exercises carried out in water on the quality of life of patients who have had an ischaemic CVA.
                Two groups were studied: an experimental group made up of 15 subjects aged 50.3 +/- 9.1 years, and a control group consisting of 13 subjects aged 52.5 +/- 7.7 years. The experimental group followed a 12-week programme of aquatic physical exercises. The two groups were evaluated in a pre- and post-treatment and then results from both groups were compared. Data were collected by administering a generic health-related quality of life survey (SF-36).
                Significant differences were found between the pre- and post-treatment in the experimental group. In the between-groups evaluation, significant differences were recorded with regard to functional capacity, physical aspects, pain, general state of health, vitality, social aspects and mental health.
                Doing physical exercises in water tends to improve motor behaviour, with a greater degree of independence, significant improvements in functional capacity and other aspects linked to physical aptitude. As a result, the level of quality of life of individuals affected by ischaemic CVA is enhanced. To evaluate the effect of an aquatic therapy programme designed to increase balance in stroke survivors.
                A randomized, controlled pilot trial.
                Rehabilitation department of a university hospital.
                Ambulatory chronic stroke patients (n = 25):13 in an aquatic therapy group and 12 in a conventional therapy group.
                The aquatic therapy group participated in a programme consisting of Ai Chi and Halliwick methods, which focused on balance and weight-bearing exercises. The conventional therapy group performed gym exercises. In both groups, the interventions occurred for 1 hour, three times per week, for eight weeks.
                The primary outcome measures were Berg Balance Scale score and weight-bearing ability, as measured by vertical ground reaction force during four standing tasks (rising from a chair and weight-shifting forward, backward and laterally). Secondary measures were muscle strength and gait.
                Compared with the conventional therapy group, the aquatic therapy group attained significant improvements in Berg Balance Scale scores, forward and backward weight-bearing abilities of the affected limbs, and knee flexor strength (P < 0.05), with effect sizes of 1.03, 1.14, 0.72 and 1.13 standard deviation units and powers of 75, 81, 70 and 26%, respectively. There were no significant changes in the other measures between the two groups.
                Postural balance and knee flexor strength were improved after aquatic therapy based on the Halliwick and Ai Chi methods in stroke survivors. Because of limited power and a small population base, further studies with larger sample sizes are required.