Public Health Article

The effect of aquatic exercise on physical functioning in the older adult: A systematic review with meta-analysis

Review Quality Rating: 10 (strong)

Citation: Waller B, Ogonowska-Slodownik A, Vitor M, Rodionova K, Lambeck J, Heinonen A, et al. (2016). The effect of aquatic exercise on physical functioning in the older adult: A systematic review with meta-analysis. Age and Ageing, DOI: 10.1093/ageing/afw102.

Evidence Summary PubMed LinkOut Plain-language summary


BACKGROUND: Ageing and sedentary behaviour cause negative changes in the neuromuscular systems of healthy older adults resulting in a decrease in physical functioning. Exercising in water (aquatic exercise, AE) has been shown to be effective at improving physical functioning in this population; however, no systematic review with meta-analysis has been published.
PURPOSE: To investigate the effect of AE on physical functioning in healthy older adults compared to control or land-based exercise (LE) through a systematic review with meta-analysis of randomised controlled trials.
DATA SOURCES: Medline, Embase, Cinahl, PEDro, SPORTDiscus, Web of Science, Cochrane Library, published before 31st December 2015.
STUDY SELECTION: In total, 28 studies met the inclusion criteria and were included in the systematic review; 24 studies with 1,456 subjects (89% female) and with mean age 66.4 years were included in the meta-analysis.
DATA EXTRACTION DATA: Were extracted and checked for accuracy by three independent reviewers.
DATA SYNTHESIS: Size of treatment effect was measured using the standardised mean difference with 95% confidence intervals (CIs).
RESULTS: Compared to control interventions, AE had a moderate positive effect on physical functioning 0.70 [95% CI 0.48 to 0.92]. Compared to LE, AE had a small positive effect on physical functioning 0.39 [0.12 to 0.66].
LIMITATIONS: There is a high risk of bias and low methodological quality in the studies particularly when comparing AE to LE with possible over estimation of the benefit of AE.
CONCLUSIONS: AE may improve physical functioning in healthy older people and is at least as effective as LE.


Adults (20-59 years), Community, Education / Awareness & Skill Development / Training, Meta-analysis, Physical Activity, Senior Health, Seniors (60+ years)

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