Abstract
BackgroundBalance impairments are the leading causes of falls in older adults. Aquatic-based exercises have been broadly practiced as an alternative to land-based exercises; however, the effects on dynamic balance have not been comprehensively reviewed and compared to land exercises. Thus, the purpose of this systematic review and meta-analysis was to compare the effectiveness of aquatic exercises (AE) to land exercises (LE) on dynamic balance in older adults.MethodsElectronic databases (PubMed, MEDLINE, CINAHL, SPORTDiscus, psycINFO), from inception to November 2019, were searched. Studies met the following eligibility criteria: Randomized controlled trials, English language, older adults aged 65 years or older, a minimum of one AE and LE group, at least one assessment for dynamic balance. For the meta-analysis, the effect sizes of dynamic balance outcomes were calculated using a standardized mean difference (SMD) and a 95% confidence interval (CI).ResultsA total of 11 trials met the inclusion criteria, and 10 studies were eligible for the meta-analysis. The meta-analysis presented that older adults in AE groups demonstrated comparable enhancements in dynamic steady-state balance (SMD = − 0.24; 95% CI, −.81 to .34), proactive balance (SMD = − 0.21; 95% CI, −.59 to .17), and balance test batteries (SMD = − 0.24; 95% CI, −.50 to .03) compared with those in LE groups.ConclusionsAE and LE have comparable impacts on dynamic balance in older adults aged 65 years or older. Thus, this review provides evidence that AE can be utilized as a reasonable alternative to LE to improve dynamic balance and possibly reduce the risk of falls.
Highlights
Balance impairments are the leading causes of falls in older adults
11 studies were retained for our systematic review, and 10 studies were included in the meta-analysis after excluding one study due to insufficient data [32]
Characteristics of included studies Participants Eleven studies included in this systematic review were randomized controlled trials, which compared the impacts of aquatic exercises (AE) and land exercises (LE) on dynamic balance in older adults aged 65 years or older
Summary
Balance impairments are the leading causes of falls in older adults. Aquatic-based exercises have been broadly practiced as an alternative to land-based exercises; the effects on dynamic balance have not been comprehensively reviewed and compared to land exercises. A Cochrane systematic review by Howe et al indicated that exercise on land is the most common form of treatment in older adults to improve balance and reduce fall risk [9]. Land-based exercises contain a higher rate of extrinsic fall risk factors (e.g., uneven walking surface) when compared to aquatic exercises, which may, in turn, interrupt the progression of a fall prevention exercise program. This is important to note because extrinsic risk factors account for the majority of all falls [10]. These aforementioned limitations associated with the safety issues during land-based exercises are less common in aquatic-based exercise programs [11]
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