Wearable technologies for monitoring aquatic exercises: A systematic review

Objective To review methods for aquatic exercise monitoring using wearables. Data sources Database search of PubMed, IEEEXplore, Scopus and Web of Science based on keywords, considering articles from the year 2000. The last search was performed on 26 October 2022. Review methods Following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) protocol, eligible articles on water exercises were selected and summarized. Further screening process concentrated on studies exploiting wearable devices, organized according to demographics, purpose, protocols, outcomes and methods. A custom critical appraisal questionnaire was applied. Results Out of the 1062 articles identified, 572 were considered eligible and subjected to preliminary synthesis. The final review focused on 27 articles featuring wearable devices applied to aquatic exercises. Four studies were disregarded as they applied wearable devices to determine daily physical activity or for sleep monitoring after training. Summary tables of 23 studies exploiting wearable devices for underwater motion analysis are provided, specifying the investigated parameters, major outcomes and study quality. This review identified four research gaps: (a) the absence of clinical protocols for underwater motion studies, (b) a deficit of whole-body studies, (c) the lack of longitudinal studies monitored via wearable devices and (d) the reliance of underwater studies on measurement and assessment methods developed for land-based investigations. Conclusions This review emphasizes the need for both technological and methodological improvements for underwater motion analysis studies using wearables. We advocate for longitudinal clinical investigations with wearables to substantiate water exercise as an addition or replacement for land-based physical activity.