Our program did not involve the use of any specific exercise equipment other than a step, which is a feature of most hydrotherapy pools. This study design was used to facilitate
participants’ understanding of exercise progression in the aquatic environment in order to improve confidence as well as to maximize adherence to the program independently at a local pool during follow up. The use of equipment (flippers, boots, and floats) can be beneficial for resistance training in the water, and greater strength gains might have been obtained in our study had equipment been incorporated into the program. The fact that quadriceps femoris muscle strength did not increase significantly with our program may argue for the need for equipment for this muscle group in particular. However, the additional benefits of equipment might be offset by increased financial costs of the intervention or by reduced ongoing adherence to the program by participants.