# Effects of an aquatic protocol on electromyography activation and strength of lower limb muscles in blind women: A randomized controlled trial

**Authors:** Asma Salari, Mansour Sahebozamani, Abdolhamid Daneshjoo, Mohammad Alimoradi, Mojtaba Iranmanesh, Nicola Relph, Guillermo Mendez-Rebolledo, Luciana Labanca, Luciana Labanca, Luciana Labanca

PMC · DOI: 10.1371/journal.pone.0322395 · PLOS One · 2025-05-27

## TL;DR

This study shows that aquatic exercise improves muscle activation and strength in blind women, helping counteract the effects of a sedentary lifestyle.

## Contribution

The study introduces a tailored aquatic exercise protocol specifically for visually impaired women and demonstrates its neuromuscular benefits.

## Key findings

- Aquatic exercise increased EMG activation in key lower limb muscles in blind women.
- Muscle strength in ankle dorsiflexors and knee extensors improved significantly in the experimental group.
- Onset time of muscle activation decreased, indicating faster neuromuscular responses after the aquatic program.

## Abstract

Visual impairment poses considerable challenges to mobility and everyday tasks, frequently leading to a more sedentary lifestyle and reduced physical fitness levels. Therefore, this study investigated the effects of a tailored aquatic exercise protocol on muscle activation and strength in visually impaired individuals.

Thirty women who were blind (mean age = 29.03 ± 2.20 years) were randomly assigned to an experimental (EX) group and a control (CO) group. The EX group participated in three weekly 60-minute aquatic sessions, while the CO group maintained regular activities. Electromyography (EMG) activation and onset time were measured in the tibialis anterior, gastrocnemius medialis, rectus femoris, and biceps femoris. Muscle strength was also assessed in the ankle dorsiflexors and plantarflexors, as well as the knee flexors and extensors.

The EX group showed increased EMG activation for the tibialis anterior, gastrocnemius medialis, rectus femoris, and biceps femoris in both anterior-posterior (2.23 MVIC%, 95% CI: 1.13 to 3.34, p < 0.001) and posterior-anterior directions (2.35 MVIC%, 95% CI: 1.80 to 2.91, p < 0.001) compared to CO group. Onset time decreased significantly in the EX group relative to CO group (anterior-posterior: -108.07 ms, 95% CI: -117.23 to -98.89, p < 0.001; posterior-anterior: -98.72 ms, 95% CI: -106.54 to -90.90, p < 0.001). Muscle strength significantly increased in the EX group compared to the CO group, with greater strength in ankle dorsiflexors (4.42 N/kg, 95% CI: 3.42 to 5.42, p < 0.001) and knee extensors (2.72 N/kg, 95% CI: 1.04 to 4.40, p < 0.001).

The aquatic exercise program improved neuromuscular function and strength in women with visual impairments, supporting its use in rehabilitation.

IRCT2017022132705N1

## Full-text entities

- **Diseases:** Visual impairment (MESH:D014786)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

49 references — full list in the complete paper: https://tomesphere.com/paper/PMC12111718/full.md

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Source: https://tomesphere.com/paper/PMC12111718