Aquatic treadmill walking at three depths of water in people with traumatic brain injury.

Objective: The purpose of this study was to analyse kinematic and spatiotemporal gait characteristics of aquatic treadmill walking among three different depths of water in individuals with traumatic brain injury.

Methods: A total of 13 individuals with traumatic brain injury participated in the study and completed walking trials at three different depths as follows: waist, chest, and neck level, which was adjusted by a movable floor pool. A self-selected comfortable walking speed at the waist level was used as a matched speed for all walking trials. Participants completed three aquatic treadmill walking trials under each of the three water depths. Each participant's gait was captured by a customized underwater motion analysis system and processed by a two-dimensional motion analysis software.

Results: The repeated measures analysis of variance showed significant differences in spatiotemporal and joint kinematic variables across three conditions: stance swing ratio (p = .023), peak hip flexion (p = .001), hip range of motion (p = .047), and peak ankle dorsiflexion (p = .000). Various water properties in conjunction with motor impairments might have contributed to alterations in gait kinematics.

Conclusion: Our findings suggest that walking in neck-depth water may not be ideal for gait training as it appears to limit hip flexion and ankle dorsiflexion. It is recommended that waist to chest-depth water be used to provide an accommodating environment for aquatic gait rehabilitation.