Those who think they have no time for bodily

exercise will sooner or later have to find time for illness. - Edward Stanley, Earl of Derby, in his address to Liverpool College, 20th Dec. 1873 Health & Fitness is to the human body what fine tuning is to an engine. More specifically, it is the ability of the human body to function with vigor & alertness, without undue fatigue, & with ample energy to engage in leisure activities.

 Cardio-respiratory fitness is an essential component of

physical fitness & best describes the health of heart, lungs & circulatory system and is related to cardio-respiratory endurance, which is the ability to sustain activities for prolonged time. Cardio-respiratory endurance is the ability to deliver oxygen & nutrients to tissues & to remove wastes over sustained periods of time. Various activities and exercises have been prescribed and practiced, at different intensities, to attain fitness, walking and swimming being two of the most common amongst those. Efforts in the present study are directed towards finding the effectiveness of walking and swimming, at moderate intensities, in improving the cardio-respiratory endurance and also to compare the effects of both.

 To study the effects of moderate intensity walking on

endurance in normal young individuals. To study the effects of moderate intensity swimming on endurance in normal young individuals. To assess the outcomes of endurance training on exercise tolerance in normal young individuals. To assess and compare the effectiveness of moderate intensity land based endurance exercise & moderate intensity water based endurance exercise in normal young individuals.

 Study Design Randomized Control Trial. Sample Population Normal young individuals, males &

females, in the age group 20 to 30 years. Sample Size 50 subjects. Sampling Technique Subjects were randomly divided into two groups, Group A & Group B, with 25 subjects in each group. Inclusion Criteria Asymptomatic, normal, non-smoking, non-exercising individuals, in the defined age group, with no history of Hypertension, Diabetes Mellitus, Tuberculosis & Bronchial Asthma. Exclusion Criteria Presence of any disabling lung disease, congenital or acquired chest deformities, cardiac impairment, neurological disorder or any other musculoskeletal condition, e.g. Knee Osteoarthritis, that could interfere with the subjects participation in the study.

 Outcome Measures
Six Minute Step Test.
Borgs Scale for rate of perceived dyspnea. Visual Analog Scale for dyspnea. Peak Expiratory Flow Rate.

Resting Pulse Rate.

Interventions
Group A: Subjects in group A received moderate intensity

land based endurance exercise i.e. walking at a speed of 4 miles/hr. Group B: Subjects in group B received moderate intensity water based endurance exercise i.e. swimming at a speed of 20 yards per minute with dog-paddle stroke of front crawl variety. [The Intensities of the exercises were selected on the basis of MET levels of 4 to 5 METS i.e. 14 17.5 ml/kg/minutes, as per ACSMs guidelines for exercise testing & prescription]

 Conversions used for the study:

Group A (Walking)
4 mph

Group B (Swimming)
0.68181 mph

= 6.43736 km/hr = 1.09728 km/hr = 6437.36 mt/min = 1097.28 mt/hr = 107.28933 mt/min = 18.2888 mt/min = 177.3316 yards/min = 20 yards/min The data on all the outcome measures for subjects in both the groups was collected on day 0, day 7, day 14 & day 21. The data was analyzed on statistical software STATA version 8.0. Continuous variables were expressed as Mean + SD. Continuous variables were compared between both the groups by performing unpaired t test and p 0.05 was taken as statistical significance.

 Mean changein duration without rest on Dayrest on&SMSUT Mean Change in duration without 7, Day 14 Day 21 as
compared to Day 0 on Six Min. Step Up Test
0.94 1 0.79

0.86

0.63

Mean Change

0.5

0.15 0.11

Day 7

Day 14

Day 21

Days
Group A Group B

Mean Change in No. of rest taken on Day 7, Day 14 & Day 21 as compared to Day 0 on Six Min. Step Up Test

2
1.47
1.26

Mean Change

0.96

1
0.47 0.52

0.12

Day 7

Day 14 Days
Group A Group B

Day 21

Mean Change in score on Borg's Scale on Day 7, Day 14 & Day 21 as compared to Day 0

2.58

2.04 1.84

Mean Change

2
1.2 1

0.6

Day 7

Day 14 Days
Group A Group B

Day 21

Mean Change in score on VAS on Day 7, Day 14 & Day 21 as compared to Day o

2.68

Mean Change

1.84 2 0.95 1.32 0.84

1.88

Day 7

Day 14 Days
Group A Group B

Day 21

Mean change in PEFR on Day 7, Day 14 & Day 21 as compared to Day 0

87.2
90

80
70

mean change

60 50 40

45.6 36.96

30
20 10 0

19.28 6.8

3.6

Day 7

Day 14 Days
Group A Group B

Day 21

Mean Change in resting pulse rate on Day 7, Day 14 & Day 21 as compared to Day 0

10

6.56

Mean Change

5.2

5
2.76 1.96 0.8

3.4

Day 7

Day 14 Days
Group A Group B

Day 21

 Physical properties of water

Hydrostatic Pressure (Arrows represent pressure). Taken from Cameron MH. Physical Agents in Rehabilitation: From Research to Practice. Missouri. Saunders, 2003, pp. 265.

Buoyancy Percentage of body weight off-loaded with increasing immersion depth. Taken from Becker BE, Cole AJ. Comprehensive Aquatic Therapy. Boston. Butterworth-Heinemann, 1997, pp. 41.

 Drag Passive Drag

Wave drag Skin friction drag Viscous pressure drag

Active Drag

Physiological Effects of Water

Cardiovascular Effects of Immersion. Taken from: Cameron MH. Physical Agents in Rehabilitation

Respiratory Effects of Immersion, Taken from: Cameron MH. Physical Agents in Rehabilitation: From Research to Practice. Missouri: Saunders; 2003, pp 269

 Cassady SL, Nielsen DH. Cardiorespiratory responses of healthy subjects

to calisthenics performed on land versus in water. Phys Ther. 1992; 72(7): 532-538, concluded that water calisthenics appear to be of sufficient intensity to elicit training adaptations. One project conducted by Hoeger et al. (1992) directly examined the training effects of an identical aerobics program performed on land (low-impact) and in the water.(48) Both the land-based (low-impact) and shallow water aerobics groups made similar gains in aerobic fitness, with a 14.8% relative improvement in estimated VO2max using a Bruce protocol (pre = 31 6.8, post = 35.6 7.0 ml/kg/min) observed in the shallow water aerobics group. Total treadmill time was also significantly increased (by one minute) following shallow water training. In agreement with Hoeger et al., a smaller yet significant 5.6% increase in VO2max (34.8 4.1 to 36.7 5.2 ml/kg/min) An improved run time to exhaustion (pre = 15.8 3.7 min, post = 19.4 5.0 min) was also observed by Abraham (1994) following eleven weeks of shallow water aerobics. Plowman S A, Smith D L (1997) stated that in the individuals who participated in water based activities (swimming and diving), pulmonary adaptations occur, resulting in greater lung volumes and capacities as compared with the matched land based trained and untrained controls.

 Observations and findings showed that, there was

significant improvements in readings for both the groups on the selected parameters in the form of:

Increased Peak flow rate. Reduction in dyspnea. Reduction in rate of perceived exertion. Improvement in 6 MST. Reduction in resting heart rate.

But when both the groups were compared there was a

significant improvement in the water based exercise training group as compared to the land based exercise group in the form of increased endurance. The results in the study were consistent with similar earlier limited studies and need for further studies to explore the depth of the topic cannot be understated.