Background: Women patients who have undergone high tibial osteotomy need management to control walking and balance and to enable functional daily life. In that way, land-based physical therapy and aquatic physical therapy were performed. Objectives: To investigated the effect of land-based and aquatic physical therapy on the balance and walking of women who had undergone high tibial osteotomy. Design: Randomized control trial. Methods: In all, this randomized controlled trial enrolled 21 patients with high tibial osteotomy who received land-based physical therapy (LP, n=7), aquatic physical therapy (AP, n=7), and land-based and aquatic physical therapy (LAP, n=7). Single-leg standing balance, 10-m walk test, and Knee injury and Osteoarthritis Outcome (KOOS-12) scores were. The intervention period was 3 days per week for 6 weeks. Results: One-leg standing balance and 10-m walk test increased statistically, and KOOS-12 score also increased statistically. All three groups have improved. As a result, the variable changes were compared in three groups, and although there was no significant difference between the land-based and aquatic physical therapy groups, the land-based and aquatic physical therapy combined programs improved further than the previous two groups. Conclusion: The balance and walking of female patients with high tibial osteotomy were found to have been very effective in land physical therapy and aquatic physical therapy. In addition, the land-based and aquatic physical therapy combination program can improve balance and walking more effectively.

Background: Obstacle training affects lower limb muscle activity, balance, reducing the risk of falls, and making gait more stable. Objects: This study aimed to investigate the effects of aquatic and ground obstacle training on balance and muscle activity in patients with chronic stroke. Methods: The study subjects included 30 patients with stroke, who were divided into aquatic (n1= 15) and ground (n2=15) groups. Groups underwent obstacle training three times per week, 30 min per session, for six weeks that went as follows: walking over sites with the paralyzed leg, stepping onto and down from a box step, and walking over obstacles with the non-paralyzed leg. Results: The experimental results were obtained by comparing muscle activity. Activity of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius were significantly increased in the aquatic group (p<.05). Activity of the biceps femoris and tibialis anterior were significantly increased in the ground group (p<.05); however, the rectus femoris and gastrocnemius were not significantly different. In the comparison of maximal distance regarding the limits of stability, it was significantly increased on the non-affected side, affected side, and anterior and posterior distance in the aquatic group (p<.05). It was significantly increased in the non-affected side and anterior and posterior distance the ground group (p<.05); however, maximal distance on the affected side distance was not significantly different. Conclusion: Gait training with aquatic and ground obstacles is effective for improving balance and gait ability of patients with stroke. However, it was more effective for the aquatic group than for the ground group.