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Aquatic exercise improves physical function in sedentary older adults

Waller B, Ogonowska-Slodownik A, Vitor M et al. The effect of aquatic exercise on physical functioning in the older adult: A systematic review with meta-analysis Age and Ageing. 2016;45:594-602.

Review question

Does aquatic (water-based) exercise improve physical function in healthy older adults compared to land-based exercise or no exercise?


Physical function typically declines with age, but physical activity can slow this decline and sometimes even reverse the negative effect of aging on physical function. A variety of types of physical activity may have this benefit, but aquatic exercise is a particularly popular method for healthy older adults.

How the review was done

This is a review of 28 studies including 1,456 participants. Of these, 24 studies were combined in a meta-analysis. Eight studies were considered high quality.

  • All participants were >50 years old (average age was 66.4 years). Most participants were not engaging in regular exercise at the beginning of the study, but were otherwise healthy.
  • Aquatic exercise typically included a mixture of strength, endurance and flexibility exercises for the upper and lower body.
  • The amount of exercise in the included studies ranged from 80-250 minutes (1 hour and 20 minutes to 4 hours and 10 minutes) per week with exercise one to five times per week. The shortest exercise period was five weeks; the longest was 32 weeks.
  • Results were compared to control groups who did not take part in aquatic exercise

What the researchers found

Compared to doing no exercise, moderate to high intensity aquatic exercise helped improve physical function including maximum strength, muscular endurance, agility, flexibility, aerobic power and self-reported physical function. Aquatic exercise may have an advantage over land-based exercise, but more high quality research is needed to answer this question. Younger participants (<68 years old) may benefit more from aquatic exercise than older participants. There was no difference in physical function in those who did aquatic exercise two times compared to three times a week.


Aquatic exercise appears to be an effective way to improve physical function in older adults who were not previously participating in regular exercise. More research is needed to understand how aquatic exercise compares to land-based exercise and to identify the best type of aquatic exercise, and the amount and intensity of aquatic exercise needed for optimal results.



Control group
A group that receives either no treatment or a standard treatment.
Advanced statistical methods contrasting and combining results from different studies.

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