Electromyographic and kinematic analysis of therapeutic knee exercises under water

Objective. This study aimed to evaluate muscle function and kinematics during commonly used knee rehabilitation exercises performed in water. Design. Maximal effort single extension and flexion trials in still water and repeated extension–flexion trials in flowing water in barefoot condition were analysed from 18 healthy participants (8 men, 10 women). Background. Despite the fact that water exercises are widely used, there are only few studies involving biomechanical and hydrodynamical analysis of aquatic exercises in rehabilitation. Methods. Electromyography of the quadriceps (vastus medialis, vastus lateralis) and hamstring muscles (biceps femoris, semitendinosus) and angular velocities of the movements were recorded under water. Results. In the repeated extension–flexion exercises the early reduction of agonist activity occurred concurrently with a high level of activity of the antagonists. In the single trial exercises the level of antagonistic activity was low throughout the range of motion, whereas the level of agonist activity was higher during the final phase of the range of motion as compared with the repeated exercises. Angular velocity patterns and values were similar between the two types of exercises. Conclusions. The present data demonstrated that the flowing properties of water modified the neuromuscular function of the quadriceps and hamstring muscles acting as agonists and antagonists in the knee flexion–extension exercises.