Background: Shallow water walking is a popular aquatic exercise used to improve gait, balance, and quality of life. Unlike terrestrial locomotion, walking in water is affected by buoyancy and drag forces. These forces introduce biomechanical gait modifications that alter the metabolic energy cost of the exercise. Aim: This presentation aims to provide an integrated biomechanical and physiological analysis of human shallow water walking. Methods: First, we conducted a systematic review and meta-analysis evaluating the biomechanical and physiological responses of shallow water walking compared to dry land walking, specifically assessing the influence of immersion depth (Ivaniski-Mello et al., 2023). Next, we compared spatiotemporal and angular gait responses at distinct immersion depths in older adults with and without Parkinson`s disease (Bortoli et al., 2024). Finally, we assessed the metabolic cost of transport across different speeds and depths, developing a physiomechanical model integrating buoyancy, drag forces, and energy cost (Ivaniski-Mello et al., 2025). Results: The energy cost of shallow water walking is generally greater than dry land walking. Waist and xiphoid depths are adequate alternatives for programs aiming to increase energy expenditure while reducing lower limb impact forces. Furthermore, at greater immersion depths, older adults with Parkinson`s disease reduce their walking speed by decreasing stride frequency and show a reduced peak angular speed in distal lower limb joints. Ultimately, the interplay between buoyancy and drag forces explains the metabolic cost responses during this exercise. Conclusions: The interaction of buoyancy and drag forces dictates the metabolic energy cost of shallow water walking. This dynamic also has direct repercussions on spatiotemporal and angular gait responses.
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