Water Specific Therapy was used as intervention in this newly published research, see underneath
The original protocol consisted of:
18 treatments > 3 phases of 6 treatments. Each session 40 minutes
1. warm up 5 min: getting loose at the wall with various big movements of LE joints and spine
2. Balance exercises standing (RPE 8-9) and/or Balance exercises walking (RPE 10-11) 20 min with 5 (random) blocks of 4 minutes
A - Walking slow agility: forward/backward/sideways in random order with directional changes/stop-go, turns
B - Ai Chi, kata's depending on ability: rmedio-lateral stability, hip-strategies, limits of reaching
C - Walking with (EWAC) obstacles and/or double tasks and/or silly walks
D - Ai Chi as in B but anterior-posterior stability, only 1 kata to 2 sides
E - Walking with focus on muscle power > fast agility, perhaps even in a Tabata like system
3. Aerobic part 10 min 60-79% VO2 max / RPE 13-15
4. Cool down 5 min: Ninja walking and other forms for fascial resilience
#2 is based on the concept of sustained distributed concept: patients will be active around 95% of the time
#3 is based on recent literature, stating that every intervention should have end with an endurance component
Dosage measuring > RPE if possible, amount of rep's, velocity, distance (cadence)
#1 Walking comfortable speed
Walking variables in agility: forward/backward/sideways in random order with directional changes/stop-go, turns > COG displacement
> 4 speeds: 20% slower than comfortable / comfortable / 20% and 40% more
Standing: stab with external perturbations by patients themselves: open fingers and 10 movements sagittal plane bilateral / frontal plane bilateral / sagittal alternating; Acceleration at start of movement and 2 sec stop at end
standing wide arms abducted horizontally frontal plane: weight transfer left-right going to limits of reaching and stay 2 seconds 15 reps left and 15 right. Variations:
hand out of water / vary speed .
/ angle from the frontal plane
walking for muscle power: 20 sec fastest walking (with plantar push-of) 10 sec rest in regular standing or squatting: 8 reps
