People with chronic health issues that make it challenging to exercise may benefit from high intensity interval training (HIIT) workouts done in a swimming pool, a new study suggests.

While HIIT workouts can improve exercise capacity — measured by how efficiently the body uses oxygen during workouts and endurance during walking and fitness tests — many people with chronic medical problems have physical limitations that make it difficult to do this type of activity. For a new study, scientists wanted to see if HIIT workouts done in water, which can be less taxing on the joints, might be an effective way to boost exercise capacity for people who have a hard time with workouts on land.

Scientists examined data from 18 clinical trials with a total of 868 adult participants who had a range of medical conditions that might make HIIT workouts challenging, such as type 2 diabetes, chronic obstructive pulmonary disorder, osteoarthritis, and peripheral artery disease. All of the trials looked at the effectiveness of aquatic HIIT workouts as compared with either no exercise, land-based HIIT, or moderate-intensity exercise in the water.

They found that aquatic HIIT improved exercise capacity just as much as HIIT workouts done on land, according to results published in BMJ Open Sport and Exercise Medicine.

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