Comparing durability of water- and land-based exercise benefits among older adults in South Korea: A randomized controlled trial with 1-year follow-up

Abstract

BACKGROUND: Aquatic exercise can improve strength, flexibility, and aerobic function while safely providing partial weight-bearing support through viscosity and buoyancy. OBJECTIVE: The aim of the present study was to compare the effects of water-based exercise with land-based exercise before and after a 10-week exercise intervention and again at one-year follow-up. METHODS: Eighty participants aged 65 years and older were randomly assigned to either a water- or a land-based 10-week exercise program. Assessment included the Senior Fitness Test (SFT), the Modified Falls-Efficacy Scale, and the 36-Item Short-Form Health Survey (SF-36). Hip and knee strength was also measured. All assessments were completed at three time points: pre- (T1), post- (T2), and at 1-year follow-up (T3). RESULTS: Significant differences were observed between the two groups on three parameters: the SFT timed up-and-go test; lower hip muscle strength in extension, adduction, and external rotation; and quality of life (QoL) measured by the SF-36 (p< 0.05). No significant differences were observed in the SFT chair stand test, dominant arm curl test, two-minute step test, chair sit-and-reach test, back scratch test, and Modified Falls-Efficacy Scale. CONCLUSION: Aquatic exercise provided greater improvement of physical health and QoL among older people than land-based exercise.

The Effectiveness of Water- versus Land-Based Exercise on Specific Measures of Physical Fitness in Healthy Older Adults: An Integrative Review

“…Moreover, both groups maintained their lower body strength values six months after the intervention period. In contrast, Oh and Lee [33] reported more profound increases in hip, knee, and hand-grip measures in the WBE group, during different testing points, whereas comparable improvements were shown during the chair-stand and the arm-curl test. The WBE group of Oh et al's study [27] reported significantly lower body muscle strength improvements (hip abduction and adduction), but no differences between the two groups were observed for the hip flexion and extension values.…”

“…Only in three cases [24,25,33] a comprehensive analysis of the physical fitness profile was performed. In the rest of the studies, the measure of cardiorespiratory fitness was absent, while two high-quality studies focused on a single parameter, namely aerobic endurance [32] and body composition [31].…”

“…Moreover, an unequal gender ratio among participants was observed. In three cases [27,31,33], the gender of the participants was not mentioned. Four studies included both men and women [26,28,29,32], two only involved women [24,25], while in the study of Askari [30], the participants were solely men.…”

“…In one study [28], the effects of five years of regular engagement in exercise programs executed on land or in water were examined. The intensity at which the exercise programs were performed was set according to the participant's heart rate [24,25,28,31,32] or the score based on self-reported measures (Borg scale) [26,27,29,33]. Four studies included a control group [25,29,31,32].…”

“…Among the 10 selected studies, 7 included muscle strength measurements of the upper and lower body by using different tests, such as the hand-grip test (n = 3), the arm-curl test (n = 2), and the chair-stand muscle endurance test (n = 3). The curl-up and the push-up tests were applied in one study [24], while in three cases, dynamometers were used to evaluate muscle strength of the hip and the knee joint [27,28,33]. The retrospective study of Tsujimoto et al [28] analyzed data from a large number of clinical examinations and compared the long-term effects (five-year follow-up) of participating in either a water-based program or a combination of land-based and in-water exercise, unsupervised, programs.…”