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The aquatic environment is ideal for early rehabilitation of injuries due to buoyancy, which decreases the effects of gravity on the body, and viscosity, which offers assistance or resistance. Performing joint movements in water provides limb support and allows range of motion, without excessive muscle activation, and this allows a transition to more advanced dynamic strengthening or conditioning exercises on dry land. Changing the water depth allows for progression of resistance, and warm water increases muscle efficiency.
Aquatic physical activity enhances coordination, while stimulating visual, vestibular, and perceptual systems. When using water for lower limb training including standing in the water and maintaining a stable upright stance over the base of support, although aquatic training provides a non-weight-bearing condition for the joints, water movement and turbulence play an important role by overloading the postural control systems especially during one-leg stance. In this review, 3 articles showed that the ability to maintain static and dynamic balance increased after aquatic and land-based training, but the results of comparing aquatic training with land-based were inconsistent.
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