OBJECTIVE: The aim of this study was to assess whether the effects of a motorized aquatic treadmill exercise program improve the isometric strength of the knee muscles, cardiorespiratory fitness, arterial stiffness, motor function, balance, functional outcomes, and quality of life in subacute stroke patients. DESIGN: Thirty-two patients were randomly assigned to 4-wk training sessions of either aquatic therapy (n = 19) or land-based aerobic exercise (n = 18). Isometric strength was measured using an isokinetic dynamometer. Cardiopulmonary fitness was evaluated using a symptom-limited exercise tolerance test and by measuring brachial ankle pulse wave velocity. Moreover, motor function (Fugl-Meyer Assessment (FMA) and FMA-lower limb (FMA-LL)), balance (Berg Balance Scale (BBS)), activities of daily living (Korean version of the Modified Barthel Index (K-MBI)), and quality of life (EQ-5D index) were examined. RESULTS: There were no intergroup differences between demographic and clinical characteristics at baseline (p > 0.05). The results shows significant improvements in peak oxygen consumption (p = 0.02), maximal isometric strength of the bilateral knee extensors (p < 0.01) and paretic knee flexors (p = 0.01), FMA (p = 0.03), FMA-LL (p = 0.01), BBS (p = 0.01), K-MBI (p < 0.01), and EQ-5D index (p = 0.04) after treatment in the aquatic therapy group. However, only significant improvements in maximal isometric strength in the knee extensors (p = 0.03) and flexors (p = 0.04) were found within the aquatic therapy group and control group. CONCLUSIONS: Water-based aerobic exercise performed on a motorized aquatic treadmill had beneficial effect on isometric muscle strength in the lower limb.

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