Effectiveness of Deep Water Running in Improving Cardiorespiratory Fitness, Gait and Quality of Life: A Systematic Review.

Background and Purpose: Deep Water Running (DWR) is a form of aquatic aerobic exercise simulating the running patterns adopted on dry land. It has gained popularity among athletes for supplementary training and rehabilitation after injury or in various untrained populations. Previous studies have proved physical effects of DWR on muscle activity, while little is known for cardiorespiratory fitness, gait performance and quality of life. This review aims to (1) investigate effectiveness of DWR in improving cardiovascular fitness, gait and quality of life, and (2) examine appropriate target populations for the intervention. Methods: A systematic search was completed using six databases, including SPORTDiscus, MEDLINE, CINAHL, AMED, Embase, and The Cochrane Library up to May 2020. Eleven clinical trials evaluating effectiveness of DWR in cardiorespiratory fitness, gait performance or quality of life (QoL), compared with no interventions (or standard treatment) or land-based activities were identified. Data relevant to the review questions were extracted by two independent reviewers. When means and standard deviations were reported, standardised mean differences were calculated. Quality assessment was conducted using selected items from the Downs and Black checklist by two independent reviewers. Results: Compared to a control group, DWR resulted in no change in 6MWT and TUGT. In the domain of cardiorespiratory fitness, VO2 peak or VO2 max was no difference between DWR and a control group. In the domain of QoL, VAS was significantly reduced with a large to moderate effect size of (SMD = −2.16, 95% CI = −2.86 to −1.45) and (SMD: 0.52, 95% CI: −0.26 to 1.30) respectively. Conclusion: DWR can be an effective form of aquatic aerobic exercise for a variety of population in terms of rehabilitation or training, with effects in cardiorespiratory fitness, gait functions, and quality of life.