You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Gait Kinematic Analysis in Water Using Wearable Inertial Magnetic Sensors
Abstract 1:
Walking is one of the fundamental motor tasks executed during aquatic therapy . Previous kinematics analyses conducted using waterproofed video cameras were limited to the sagittal plane and to only one or two consecutive steps . Furthermore , the set-up and post-processing are time-consuming and thus do not allow a prompt assessment of the correct execution of the movements during the aquatic session therapy . The aim of the present study was to estimate the 3D joint kinematics of the lower limbs and thorax-pelvis joints in sagittal and frontal planes during underwater walking using wearable inertial and magnetic sensors .  Eleven healthy adults were measured during walking both in shallow water and in dry-l and conditions .  Eight wearable inertial and magnetic sensors were inserted in waterproofed boxes and fixed to the body segments by means of elastic modular b and s. A vali date d protocol ( Outwalk ) was used . Gait cycles were automatically segmented and selected if relevant intraclass correlation coefficients values were higher than 0.75 . A total of 704 gait cycles for the lower limb joints were normalized in time and averaged to obtain the mean cycle of each joint , among participants . The mean speed in water was 40 % lower than that of the dry-l and condition . Longer stride duration and shorter stride distance were found in the underwater walking . In the sagittal plane , the knee was more flexed ( ≈ 23 ° ) and the ankle more dorsiflexed ( ≈ 9 ° ) at heel strike , and the hip was more flexed at toe-off ( ≈ 13 ° ) in water than on l and . On the frontal plane in the underwater walking , smoother joint angle patterns were observed for thorax-pelvis and hip , and ankle was more inversed at toe-off ( ≈ 7 ° ) and showed a more inversed mean value ( ≈ 7 ° ) . The results were mainly explained by the effect of the speed in the water as supported by the linear mixed models analysis performed . Thus , it seemed that the combination of speed and environment triggered modifications in the joint angles in underwater gait more than these two factors considered separately . The inertial and magnetic sensors , by means of fast set-up and data analysis , can supply an immediate gait analysis report to the therapist during the aquatic therapy session


Title 2:
Front-Crawl Instantaneous Velocity Estimation Using a Wearable Inertial Measurement Unit
Abstract 2:
Monitoring the performance is a crucial task for elite sports during both training and competition .  Velocity is the key parameter of performance in swimming , but swimming performance evaluation remains immature due to the complexities of measurements in water . The purpose of this study is to use a single inertial measurement unit ( IMU ) to estimate front crawl velocity .  Thirty swimmers , equipped with an IMU on the sacrum , each performed four different velocity trials of 25 m in ascending order . A tethered speedometer was used as the velocity measurement reference . Deployment of biomechanical constraints of front crawl locomotion and change detection framework on acceleration signal paved the way for a drift-free integration of forward acceleration using IMU to estimate the swimmers velocity . A difference of 0.6 ± 5.4 cm·s−1 on mean cycle velocity and an RMS difference of 11.3 cm·s−1 in instantaneous velocity estimation were observed between IMU and the reference . The most important contribution of the study is a new practical tool for objective evaluation of swimming performance . A single body-worn IMU provides timely feedback for coaches and sport scientists without any complicated setup or restraining the swimmer 's natural technique


Title 3:
Biomechanical characteristics of adults walking in shallow water and on land.
Abstract 3:
Although water environment has been employed for different physical activities , there is little available information regarding the biomechanical characteristics of walking in shallow water . In the present study , we investigated the kinematics , ground reaction forces ( GRF ) , and electromyographic ( EMG ) activation patterns of eight selected muscles of adults walking in shallow water and on l and . Ten healthy adults were videotaped while walking at self-selected comfortable speeds on l and and in water ( at the Xiphoid process level ) . In both conditions there was a force plate embedded in the middle of each walkway to register the GRF components . Reflective markers were placed over main anatomical l and marks and they were digitalized later to obtain stride characteristics and joint angle information . In general , walking in water was different to walking on l and in many aspects and these differences were attributed to the drag force , the apparent body weight reduction , and the lower comfortable speed during walking in shallow water . The joint range of motions ( ROM ) were not different , the segment ROM , magnitudes of GRF components , impact force , and impulse were different between the two conditions . The present results will contribute to a better underst and ing of this activity in the context of training and rehabilitation
The use of sensors in a rehabilitation/hydrotherapy perspective may provide major advantages for therapists