Training on a treadmill in water – good idea?

February 12, 2018

Trends are funny things. Something can be hot one week, and out of style the next.  And while some are more exciting than others, those that have something substantial to offer stick around longer. But when it comes to post-stroke rehabilitation, should you be trying to follow the latest trends? According to a team of researchers in Korea, and provided that you’re talking about aquatic treadmill training (ATT; a kind of aerobic exercise that uses a submerged treadmill to administer walking training), the answer is yes.

Aquatic treadmill training: why it might pay to stay on-trend

While it started as a trend, ATT is beginning to gain traction in the world of post-stroke rehabilitation. The first studies of ATT focused on its use as a resistance-training program in healthy individuals. Then it expanded to patients with obesity and musculoskeletal disease, and eventually stroke patients. The logic behind ATT in stroke is quite simple. Water provides buoyancy, which supports and reduces the risk of falls, enabling patients to train safely at higher speeds.

While the studies are small, the results are encouraging. In a study based on a program of 15 sessions of 20 minutes each over a period of three weeks, 21 patients with subacute stroke reported improvements in walking speed, balance, and balance confidence. A second study of 21 patients showed that a program of five 30 minute sessions per week for six weeks increased peak aerobic capacity and walking endurance compared with regular treadmill training.

While we’re not suggesting you invest in your own submerged treadmill just yet, these studies do suggest that ATT might be more than just a passing trend. So if you happen to train at a center that offers this novel form of rehabilitation, it would be worth talking with your physiotherapist about adding ATT to your program.


The leading authors of the publications are Dr. Han from the Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju, Republic of Korea, and Dr. Lee from the Department of Physical Medicine and Rehabilitation, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

Editorial note:

Training on a treadmill underwater may be a good, safe alternative to standard treadmill training in the subacute phase after stroke.

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