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Table 1 The aquatic exercise protocol design for the first 4 weeks of the PICO program

From: The PICO project: aquatic exercise for knee osteoarthritis in overweight and obese individuals

Music BPM Week1-5 (128 bpm) Week 1 Week 2 Week 3 Week 4
Warm up (5-8′) Duration 8′ 8′ 8′ 8′
Patterns Walking combined with static and gentle movements of main joints. Use hands to keep thermal comfort Walking combined with static and gentle movements of main joints Walking combined with static and gentle movements of main joints Walking combined with static and gentle movements of main joints
Aquatic adaptation Vertical balance Vertical balance Submersion Submersion
Travellings Travellings Underwater breathing Underwater breathing
Aerobic (15-30′) Duration 3x5min 4x5′ 4x5′ (1x10′) + 5′ + 5′
Exercise pattern Walking patterns with variation of upper limb patterns Walking patterns with variation of upper limb patterns Walking patterns with variation of upper limb patterns 10′ walking patterns + (2x5′) de basic aquatic patterns (Jumping jack, Ski, Leg Curl and Kicks)
Intensity (%HRmax and RPE scale) 57%-67% RPE 4-6 57%-67% RPE 4-6 57%-67% RPE 4-6 64-74% RPE 5-6
Impact level 1 1 1 1
Strength Repetitions 2x8 1 x16 2x16 2x16t1 + 1x8tt
Cadence t1 = water tempo t1 = water tempo t1 = water tempo t1 = water tempo tt = land tempo
Sets interval Active 1-2′ Active 1-2′ Active 1-2′ Active 1-2′
Equipment added No No No No
Intensity (Omni-RES) 6-7 6-7 6-7 6-7
Cool down (5-6′)   Static stretching on the wall Static stretching (center) Dynamic/static stretching (center) Dance + Dynamic/static
  1. RPE- Rate of perceived exertion scale.
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