title: Water- versus land-based exercise in elderly subjects: effects on physical performance and body composition Use of the CONSORT statement and quality of reports of randomized trials: a comparative before-and-after evaluation. Functional autonomy, bone mineral density (BMD) and serum osteocalcin levels in older female participants of an aquatic exercise program (AAG). Effects of Aqua Aerobic Therapy Exercise for Older Adults on Muscular Strength, Agility and Balance to Prevent Falling during Gait A water-based training program that includes perturbation exercises improves speed of voluntary stepping in older adults: a randomized controlled cross-over trial. The effects of a water-based exercise program on strength and functionality of older adults. Effects of an aquatic versus non-aquatic respiratory exercise program on the respiratory muscle strength in healthy aged persons. Effectiveness of aquatic and non-aquatic lower limb muscle endurance training in the static and dynamic balance of elderly people. High-intensity aquatic exercises (HydrOS) improve physical function and reduce falls among postmenopausal women The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. Water- versus land-based exercise effects on physical fitness in older women. The water exercise improves health-related quality of life of frail elderly people at day service facility High intensity deep water training can improve aerobic power in elderly women Comparison of the effects of water- and land-based exercises on the physical function and quality of life in community-dwelling elderly people with history of falling: a single-blind, randomized controlled trial. Short and long-term adherence to swimming and walking programs in older women--the Sedentary Women Exercise Adherence Trial (SWEAT 2). Water-based exercise improves health-related aspects of fitness in older women. Effectiveness of water exercise on postural mobility in the well elderly: an experimental study on balance enhancement. THE EFFECTS OF A TWENTY‐FOUR‐‐WEEK AQUATIC TRAINING PROGRAM ON MUSCULAR STRENGTH PERFORMANCE IN HEALTHY ELDERLY WOMEN The effects of nonswimming water exercises on older adults. Effect of land-based and water-based fitness programs on the cardiovascular fitness, strength and flexibility of women aged 65-75 years. Effect of different types of exercise on postural balance in elderly women: a randomized controlled trial. The Effects of Resistance Training Performed in Water on Muscle Strength in the Elderly
abstract: The aim of this study was to assess the effectiveness of a 24-week exercise protocol carried out in geothermal spring water to improve overall physical function and muscle mass in a group of healthy elderly subjects . A further aim was to compare this water-based protocol with a l and -based protocol and a control group . For this purpose , 59 subjects were recruited and r and omly allocated to three groups : aquatic group ( AG ) , l and group ( LG ) , and control group ( CG ) . AG and LG followed a 6-month , twice-weekly , multimodality exercise intervention . AG underwent the protocol in hot-spring water ( 36 ° C ) while LG did it in a l and -based environment . After the intervention , knee-extension strength was maintained in AG and LG . The 8-foot up- and -go test showed a reduction in both exercise groups ( AG −19.3 % , P < 0.05 ; LG −12.6 % , P < 0.05 ) , with a significantly greater decrease in AG . The back-scratch test revealed an improvement only in AG ( 25.8 % ; P < 0.05 ) , while the sit- and -reach test improved in all groups . Finally , AG reduced fat mass by 4 % ( P < 0.05 ) , and dominant forearm fat decreased by 9.2 % ( P < 0.05 ) . In addition , calf muscle density increased by 1.8 % ( P < 0.05 ) . In summary , both water- and l and -based activities were beneficial in maintaining strength and in improving lower-body flexibility . Aquatic exercise appeared a better activity to improve dynamic balance . Thermal swimming pools and the use of rating of perceived exertion as a method of exercise monitoring should be considered potentially useful tools to enhance physical performance and body composition in healthy elderly CONTEXT The Consoli date d St and ards for Reporting of Trials ( CONSORT ) statement was developed to help improve the quality of reports of r and omized controlled trials ( RCTs ) . To date , a paucity of data exists regarding whether it has achieved this goal . OBJECTIVE To determine whether use of the CONSORT statement is associated with improvement in the quality of reports of RCTs . DESIGN AND SETTING Comparative before- and -after evaluation in which reports of RCTs published in 1994 ( pre-CONSORT ) were compared with RCT reports from the same journals published in 1998 ( post-CONSORT ) . We included 211 reports from BMJ , JAMA , and The Lancet ( journals that adopted CONSORT ) as well as The New Engl and Journal of Medicine ( a journal that did not adopt CONSORT and was used as a comparator ) . MAIN OUTCOME MEASURES Number of CONSORT items included in a report , frequency of unclear reporting of allocation concealment , and overall trial quality score based on the Jadad scale , a 5-point quality assessment instrument . RESULTS Compared with 1994 , the number of CONSORT checklist items in reports of RCTs increased in all 4 journals in 1998 , and this increase was statistically significant for the 3 adopter journals ( pre-CONSORT , 23.4 ; mean change , 3.7 ; 95 % confidence interval [ CI ] , 2.1 - 5.3 ) . The frequency of unclear reporting of allocation concealment decreased for each of the 4 journals , and this change was statistically significant for adopters ( pre-CONSORT , 61 % ; mean change , -22 % ; 95 % CI , -38 % to -6 % ) . Similarly , 3 of the 4 journals showed an improvement in the quality score for reports of RCTs , and this increase was statistically significant for adopter journals overall ( pre-CONSORT , 2.7 ; mean change , 0.4 ; 95 % CI , 0.1 - 0.8 ) . CONCLUSION Use of the CONSORT statement is associated with improvements in the quality of reports of RCTs The aim of the present study was to evaluate the effects of an AAG on BMD , osteocalcin and functional autonomy in older women . The sample consisted of eighty-two post-menopausal women with low BMD , r and omly divided into two groups : the Aquatic Aerobics Group [ AAG ; n=42 ; age : 66.8±4.2years ] , su bmi tted to two weekly sessions over eight months , and the  Control Group ( GC ; n=42 ; age : 66.9±3.2years ) , which did not participate in regular exercise . BMD was measured by  Dual Energy X-ray Absorptiometry [ DXA ] of the lumbar and femur , and serum osteocalcin was measured using electrochemiluminescence . A functional autonomy assessment protocol ( GDLAM , 2004 ) was also applied . Statistical analyses used were repeated measures ANOVA and Tukey 's post hoc tests . The results showed a significant improvement in tests following the GDLAM protocol : 10 meters walk ( 10mw ) -p=0.003 ; rising from a ventral decubitus position ( RVDP ) - Δ%=0.78 , p<0.001 ; rising from a chair and moving around the house ( RCMH ) -p<0.001 and autonomy index ( AI ) -p=0.007 , with more favorable results observed in the AAG when compared to the CG . The AAG achieved the best results for BMD ; however , no inter or intragroup statistical differences were recorded for total femur -p=0.975 and lumbar L(2)-L(4)p=0.597 . For serum osteocalcin , intra and intergroup statistical differences of p=0.042 and p=0.027 were observed in the AAG , respectively . This demonstrates that an eight-month aquatic aerobic exercise program can improve functional autonomy and osteocalcin levels , although training did not improve lumbar and total femur BMD in the older women [ Purpose ] The purpose of the present study was to examine the effects of an aqua aerobic therapy exercise for older adults on biomechanical and physiological factors affecting gait . [ Subjects ] A total of 15 subjects participated in this study and they were r and omly divided into the experimental and the control group . [ Methods ] Physiological variables , leg strength , power and flexibility , and biomechanical variables , both kinematic and kinetic , were measured before and after the aqua aerobic therapy exercise . Each subject was instructed to walk along an elevated walkway and during the trials a trapdoor opened at r and om to create a 10 cm falling perturbation . Full body motion and kinetics was gathered during the gait . [ Results ] There were significant reductions in body weight , and body fat mass , and stride time after the perturbation . Significant increases in leg strength corresponded to the maximum joint moment of the l and ing leg showing that the subjects ' ability for recovery of balance after the perturbation improved . [ Conclusion ] As the results showed significant improvements in gait pattern and recovery time after perturbed gait , we conclude that aqua aerobic therapy is an effective exercise method for training older adults to reduce their risk of falling This study evaluated the effects of a water exercise training program that includes perturbation exercises ( WEP ) to improve the speed of voluntary stepping reaction in older adults .  Speed of voluntary stepping considered as an important skill to prevent a fall when balance is lost . In a single-blinded r and omized controlled trial with a crossover design thirty-six independent old adults ( 64 - 88 years old ) were divided into two groups . Group A received WEP for the first 12 weeks , followed by no intervention for the second 12 weeks . Group B did not receive intervention for the first 12 weeks and received WEP for the second 12 weeks . Voluntary Step Execution Test and postural stability in upright st and ing ( eyes open and closed conditions ) were measured at baseline , 12 weeks , and 24 weeks . A significant interaction effect between group and time was found for the step execution , due to improvement in initiation phase and swing phase duration s in the WEP group . Also significant improvement in postural stability parameters in eyes open and closed conditions is noted . The present results indicate that the primary benefit of WEP that include perturbations to induce stepping , was a reduction in voluntary stepping times . The WEP generalized to a better control of balance in up-right st and ing OBJECTIVE To analyze the effects of a water-based exercise program on peak torque ( PT ) and rate of torque development ( RTD ) during maximal voluntary ballistic isometric contractions of the lower limb muscles and the performance of a number of functional tests in the elderly . METHOD Thirty-seven elderly were r and omly assigned to water-based training ( 3 d/wk for 12 wk ) or a control group .  Extensor and flexor PT and RTD of the ankle , knee , and hip joints and functional tests were evaluated before and after training . RESULTS PT increased after training for the hip flexors ( 18 % ) and extensors ( 40 % ) and the plantar-flexor ( 42 % ) muscles in the water-based group . RTD increased after training for the hip-extensor ( 10 % ) , knee-extensor ( 11 % ) , and ankle plantar-flexor ( 27 % ) muscles in the water-based group . Functional tests also improved after training in the water-based group ( p < .05 ) . CONCLUSION The water-based program improved PT and RTD and functional performance in the elderly UNLABELLED Aging of the worldwide population is a concern of most governmental entities , spanning practically all areas of prevention and rehabilitation . Aging leads to physiological alterations that result in adverse social and financial effects . There is a trend to emphasize prevention , which is less expensive and socially more desirable than therapeutic intervention . PURPOSE To assess the effect of a program of aquatic versus non-aquatic respiratory exercises on respiratory muscle strength in healthy aged persons . METHODS The respiratory muscle strength was measured in 81 subjects between 60 and 65 years , 59 of which completed the program . Subjects were r and omized into 3 groups . G(aquatic ) undertook a program of respiratory exercise in an aquatic environment . G(non-aquatic ) undertook the same program in a non-aquatic environment . G(control ) acted as the negative control . Programs were applied three times a week for 10 consecutive weeks . Subsequently , subjects were reevaluated , and results compared to each individual 's pre-treatment own result and between the groups . The data were statistically analyzed using the paired t test and the Sign test . Comparisons between the groups were performed through parametric and nonparametric variance . A comparison of G(aquatic ) and G(non-aquatic ) versus G(control ) was performed using the Dunnett test . RESULTS A significant improvement in the inspiratory muscle strength in the G(aquatic ) group compared to the G(control ) , group was found , suggesting beneficial effects mediated by the aquatic exercise . The expiratory muscles did not show significant alterations . CONCLUSION Aquatic respiratory exercise improves the inspiratory muscle strength of healthy aged persons . However , neither aquatic nor non-aquatic respiratory exercise influences the expiratory muscle strength BACKGROUND Aging compromises the ability of the central nervous system to maintain body balance and reduces the capacity for adaptive reactions . To prevent falls , the reception conditions for sensory information need to be improved . OBJECTIVES To evaluate the impact of a structured aquatic and a non-aquatic exercise program for lower-limb muscle endurance on the static and dynamic balance of elderly people . METHODS This was a prospect i ve r and omized clinical study in which the variables were assessed before and after the training program . Thirty-six elderly people were evaluated using four tests : the Berg Balance Scale , Dynamic Gait Index , gait speed and t and em gait . The participants were r and omized into three groups : aquatic exercise group , non-aquatic exercise group and control group . The exercise groups underwent a program for lower-limb muscle endurance that consisted of 40-minute sessions twice a week for six weeks . The participants were reevaluated after six weeks . The data were analyzed statistically using the univariate ANOVA test for comparisons between the groups before and after the intervention . RESULTS The program for lower-limb muscle endurance significantly increased balance ( p<0.05 ) in the evaluation tests after the training program . CONCLUSION The muscle endurance program provided a significant improvement in static and dynamic balance among community-dwelling elderly people . It was also possible to infer that this improvement occurred regardless of the environment , i.e. aquatic or non-aquatic . Article registered in the Australian New Zeal and Clinical Trials Registry ( ANZCTR ) under the number ACTRN 12609000780257 Objective This study aims to investigate the effects of an aquatic exercise program ( HydrOS ) on neuromuscular function and falls among postmenopausal women . Methods One hundred eight postmenopausal women ( mean [ SD ] age , 58.8 [ 6.4 ] y ) were r and omly divided into the  control group ( CG ; n = 44 ) and the  aquatic exercise group  ( AEG ; n = 64 ) . Both groups received elementary calcium 500 mg/day and cholecalciferol 1,000 IU/day . For 24 weeks , the AEG participated in the aquatic exercise program , whereas the CG remained sedentary . The following variables were measured before and after the program : number of falls and fallers ( 7 mo before and after the intervention ) ; flexibility , using Wells ’ Sit- and -Reach Test ( FLEX ) ; static balance , using the Unipedal Stance Test ( UST ) ; mobility , using the Timed-Up- and -Go test ( TUG ) ; h and grip strength of the dominant h and ( HGS ) ; and maximal isometric strength of back extensor muscles ( SBE ) , strength of hip flexor muscles ( SHF ) , and strength of knee extensor muscles ( SKE ) . The muscle strength tests were considered the primary outcome , whereas the other neuromuscular tests , together with falls , were considered secondary outcomes . Results were significant when P ⩽ 0.05 . Results Serum 25-hydroxyvitamin D significantly increased by 21 % in the CG and by 23 % in the AEG ( P < 0.001 ) . The number of falls and fallers after the program remained unchanged in the CG ; in the AEG , the mean number of falls decreased from 2.00 to 0.29 ( P < 0.0001 ) , and the number of fallers decreased by 44 % ( P < 0.0001 ) . All neuromuscular variables significantly improved in the AEG : FLEX ( 26.6 % ; P < 0.0001 ) , UST ( 14.1 % ; P < 0.001 ) , TUG ( 23.7 % ; P < 0.001 ) , HGS ( 13.4 % ; P < 0.001 ) , SBE ( 26.2 % ; P < 0.001 ) , SHF ( 18.5 % ; P = 0.039 ) , and SKE ( 7.7 % ; P < 0.001 ) . In the CG , significant improvements in FLEX ( 12.2 % ; P = 0.009 ) , UST ( 4.5 % ; P < 0.001 ) , TUG ( 10 % ; P < 0.001 ) , and SHF ( 5.7 % ; P = 0.039 ) were observed and could be explained by increasing serum 25-hydroxyvitamin D level attributable to supplementation . Conclusions The aquatic exercise program HydrOS is a safe and efficient way to improve physical function and to reduce falls among postmenopausal women Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to 9 items in three Delphi rounds . The final criteria list ( the Delphi list ) was satisfactory to all participants . It is a starting point on the way to a minimum reference st and ard for RCTs on many different research topics . This list is not intended to replace , but rather to be used alongside , existing criteria lists AIM The effectiveness of a water-based exercise ( WE ) program and a walking on l and ( WL ) program was evaluated in older women ( aged 62 - 65 years ) . METHODS Fifty healthy sedentary women were r and omly assigned to sedentary ( S ) , WE and WL groups . The two groups were exercised for 12 weeks at 70 % of the age-predicted maximum heart rate ( HR ) . The subjects were evaluated before and after the training period , and measurements of bodyweight , HR at rest , maximum aerobic power ( VO(2max ) mL/kg per min ) and neuromuscular performance ( upper and lower body strength ; agility ; upper and lower body flexibility ) were included . RESULTS After training , bodyweight was unchanged in both programs . The WE decreased the HR at rest by 10 % . Both WE and WL enhanced VO(2max ) by 42 % and 32 % , respectively . However , for the WE group the VO(2max ) values were significantly higher compared with the WL group ( P < 0.05 ) . All neuromuscular parameters improved after exercise , but only the WE group showed a significant improvement on the upper body strength and lower body flexibility . Besides , the upper and lower body strength and upper and lower body flexibility were significantly higher in the WE group compared with the WL group ( P < 0.05 ) , respectively . CONCLUSIONS Current results indicate that the WE and WL programs improved the cardiorespiratory and neuromuscular fitness of older women . Furthermore , when the effectiveness of the training programs were compared , it was verified that the WE program was more powerful in inducing changes in physical fitness versus the WL program Objective The purpose of this study was to investigate the effects of water exercise  at a day service facility and the effects of water exercise frequency on health-related quality of life ( HRQL ) . Methods Participants ( n = 30 ) were r and omly separated into three groups : two indicating exercise frequency , at once-weekly or twice-weekly , and a control group . One-hour exercise intervention sessions were carried out once or twice a week , accordingly , for 24 weeks . The water exercise session comprised a warm-up on l and , activities of daily living ( ADL ) exercises , stretching , strength training , and relaxation in water .  HRQL was evaluated using the Medical Outcomes Survey Short-Form 36 ( SF-36 ) question naire , and ADL disability was assessed using the Functional Independence Measure . Results Significant differences were found between pre- and 6 months in both the once- and twice-weekly groups in HRQL ( p < 0.05 ) . No significant difference was found among pre- , 3 months , and 6 months . The effect size between the once and twice groups was moderate in both the physical component summary ( 0.72 ) and mental component summary ( 0.75 ) at 3 months . ADL disability shows significant correlation with HRQL . Conclusion Water exercise intervention at a day service facility improved participants ’ HRQL for 6 months by improving exercise habits and ADL disability . Furthermore , the HRQL change differed according to exercise frequency : twice-weekly exercise showed more rapid improvement than once-weekly Deep water running with wet vest is a safe form of exercise for elderly with mobility limitations . However , it is not known to what extent their aerobic power may be improved . Therefore , the aim was to assess the effects of high intensity deep water interval training with vest in elderly women . Twenty-nine healthy women 69 ± 4 years old participated . They performed a grade d maximal exercise test on the cycle ergometer . They were r and omly assigned to a control or to a training group . A submaximal exercise test on the cycle ergometer was executed only by the training group . They trained in deep water running/walking wearing a vest two times a week for 8 weeks . The target heart rate was 75 % of maximal heart rate and the training consisted of several short working periods and resting intervals . After the intervention the heart rate at rest was 8 % lower for the training group ( P<0.01 ) . Their heart rate at submaximal exercise was 3 % less ( P<0.01 ) , their maximal oxygen uptake was raised by 10 % ( P<0.01 ) , and their maximal ventilation was increased 14 % ( P<0.01 ) . The values for the control group were unaltered after the period of intervention . In conclusion , high intensity deep water running with vest  improves submaximal work capacity , maximal aerobic power , and maximal ventilation with the effects transferable to l and -based activities in elderly women PURPOSE The purpose of this study was to identify the effects of water-based exercises on the physical functions and quality of life ( QOL ) in community-dwelling elderly people with history of falling . MATERIAL S AND METHODS Participants were r and omly assigned to the water-based exercise group ( n=34 ) or l and -based exercise groups ( n=32 ) . To identify the effects on physical functions , muscle strength , flexibility , and mobility were measured . QOL and fear of falling were evaluated using the Short Form 36-item question naire and the modified falls efficacy scale ( M-FES ) . The measurements were performed before and after the 10-week training period . RESULTS Within-group analysis indicated that hip abduction and adduction strength improved significantly in both groups ( p=0.005 ; p=0.007 ) . However , no statistically significant within-group differences were found in the back scratch test ( p=0.766 ) and chair sit- and -reach test ( p=0.870 ) . QOL was significantly different in both groups ( health transition : p=0.014 , physical functioning : p<0.001 , role physical : p<0.001 , role emotional : p=0.002 , bodily pain : p<0.001 , vitality : p<0.001 , and mental health : p<0.001 ) . There was a significant difference in the M-FES in both groups ( p=0.040 ) . CONCLUSIONS These results indicate that water-based exercises are beneficial to improve the QOL , as well as physical activities , of community-dwelling elderly compared with l and -based exercise . Water-based exercises would be useful to improve physical and psychological health in the elderly people with history of falling OBJECTIVE To examine in previously sedentary older women the effects of exercise mode and a behavioural intervention on short and long-term retention and adherence . METHODS Healthy , sedentary women aged 50 - 70 years ( N=116 ) were r and omly assigned to a supervised 6-month swimming or walking program 3 sessions a week . They were further r and omised to usual care or a behavioural intervention . The same program was further continued unsupervised for 6 months . We assessed retention , adherence , stage of exercise behaviour and changes in fitness . RESULTS One hundred women ( 86 % ) completed 6 months and 86 ( 74 % ) continued for 12 months . Retention rates were similar for both exercise modes at 6 and 12 months . Adherence to swimming or walking was similar after 6 months ( 76.3 ( 95 % CI : 69.5 , 83.1)% vs. 74.3 ( 67.7 , 80.9)% ) and 12 months ( 65.8 ( 57.9 , 73.8)% vs. 62.2 ( 54.6 , 70.0)% ) . The behavioural intervention did not enhance retention or adherence . Fitness improved for both exercise modes after 6 months and was maintained at 12 months . CONCLUSIONS Either swimming or walking programs initiated with careful supervision over 6 months result ed in similar high retention and adherence rates by highly motivated older women over 12 months . Behavioural intervention in this setting did not improve these rates further PURPOSE The purpose of this study was to determine the physiological responses of elderly women to a well-rounded exercise program performed in water ( WEX ) . METHODS The participants ( 60 - 75 yr of age ) were r and omly divided into a training ( TR ) group ( N = 15 ) and a control group ( N = 15 ) . The TR group participated in a 12-wk supervised WEX program , 70 min x day(-1 ) , 3 d x wk(-1 ) . The WEX consisted of 20 min of warm-up and stretching exercise , 10 min of resistance exercise , 30 min of endurance-type exercise ( walking and dancing ) , and 10 min of cool-down exercise . RESULTS The WEX led to an increase ( P < 0.05 ) in peak VO2 ( 12 % ) and VO2 at lactate threshold ( 20 % ) . Muscular strength evaluated by a hydraulic resistance machine increased significantly at resistance dial setting 8 ( slow ) for knee extension ( 8 % ) , knee flexion ( 13 % ) , chest press ( 7 % ) and pull ( 11 % ) , shoulder press ( 4 % ) and pull ( 6 % ) , and back extension ( 6 % ) . Vertical jump ( 9 % ) , side-stepping agility ( 22 % ) , trunk extension ( 11 % ) , and FEV1.0 ( 7 % ) also increased significantly . There was a significant decrease in skin-fold thickness ( -8 % ) , low-density lipoprotein ( LDL ) cholesterol ( -17 % ) , and total cholesterol ( -11 % ) . There were no significant changes in these variables in the control group . CONCLUSION These results indicate that WEX elicits significant improvements in cardiorespiratory fitness , muscular strength , body fat , and total cholesterol in older adult women .  Water-based exercise appears to be a very safe and beneficial mode of exercise that can be performed as part of a well-rounded exercise program BACKGROUND The fear of falling may cause elderly people to limit their movement . As movement errors are known to facilitate the acquisition of motor skills , the elderly may inadvertently cause the loss of postural skills by constraining their movements , and hence avoid potential movement errors . It was hypothesized that by having elderly individuals exercise in a risk-free environment-water was utilized in this experiment-their postural capabilities would improve . METHODS Four groups of elderly subjects ( 80 + /- 5.8 years old ) were placed into four groups : Water Exercisers ; L and Exercisers ; Water Sitters ; and L and Sitters . Each group met twice per week for 45 minutes for 5 weeks of simple exercises or socializing in the design ated medium . The distance each individual could reach ( Functional Reach , FR ) was measured at the end of each week . RESULTS Initially , each group was at risk ( FR < 10 inches ) for falling Statistical testing showed that the Water Exercisers ( WE ) increased their FR almost every week ; the L and Exercisers ( LE ) increased only during the first week ; and the Water Sitters ( WS ) and L and Sitters ( LS ) did not increase at all . The FRs after 5 weeks were 13.4 + /- 1.6 ( WE ) , 11.3 + /- 1.5 ( LE ) , 9.6 + /- 1.3 ( WS ) , and 9.3 + /- 0.71 ( LS ) inches for each group , respectively . CONCLUSIONS The data showed that the postural capabilities in these elderly people , as measured by the FR , were enhanced by the production of movement errors that was facilitated in a water environment ( in the case of the Water groups ) or the initiation of a novel exercise program ( L and Exercisers ) . Alternative explanations , and implication of these results , are discussed The purpose of the present study was to determine the effectiveness of a 24-week aquatic training ( AT ) program , which included both aerobic and resistance components , on muscle strength ( isometric and dynamic ) , flexibility , and functional mobility in healthy women over 60 years of age . Twenty-two subjects were assigned r and omly to either an  AT ( n = 12 ) or a  control ( C , n = 10 ) group . Volunteers participated in a supervised shallow-water exercise program for 60 minutes a day , 3 days a week ; the exercise program consisted of a 10-minute warm-up and stretching , 25 minutes of endurance-type exercise ( dancing ) at 80 % of heart rate (HR)max , 20 minutes of upper- and lower-body resistance exercises with specialized water-resistance equipment , and a 5-minute cool down .  Maximal isometric torque of knee extensors ( KEXT ) and knee flexors ( KFLEX ) were evaluated by a Cybex Norm dynamometer , grip strength ( HGR ) was evaluated using a Jamar hydraulic dynamometer , and dynamic strength was evaluated via the 3 repetition maximum ( 3RM ) test for chest press , knee extension , lat pull down , and leg press . Jumping performance was evaluated using the squat jump ( SJ ) , functional mobility with the timed up- and -go ( TUG ) test , and trunk flexion with the sit- and -reach test . Body composition was measured using the bioelectrical impedance method . The AT induced significant improvements in KEXT ( 10.5 % ) and KFLEX ( 13.4 % ) peak torque , HGR strength ( 13 % ) , 3RM ( 25.7–29.4 % ) , SJ ( 24.6 % ) , sit- and -reach ( 11.6 % ) , and TUG ( 19.8 % ) performance . The AT group demonstrated a significant increase in lean body mass ( 3.4 % ) . No significant changes in these variables were observed in the C group . The results indicate that AT , with both aerobic and resistance components , is an alternative training method for improving neuromuscular and functional fitness performance in healthy elderly women Exercise in a water medium reduces weight-bearing stresses on the skeletal joints , which may be advantageous for older individuals needing rehabilitation . The purpose of this study was to determine the effects of nonswimming exercises on muscle endurance , % body fat , and aerobic work capacity of an older adult population . Twelve subjects were in an exercise group ( 10 females and two males ) , and eight were in a control group ( five females and three males ) . The mean ages of the groups were 65 ( + /- 5.29 ) years and 56 ( + /- 6.78 ) years , respectively . Before and after 12 weeks of training , subjects were measured three times weekly for resting heart rate , maximum heart rate , VO2 max , body composition , and work capacity in water . A general linear model ANCOVA was used with age as the covariate . The exercise group improved significantly ( p < .05 ) on all dependent variables examined except body composition after 12 weeks . However , the control group experienced no significant changes on any variable over this period . In the comparisons between groups , the exercise group significantly surpassed the control group on all variables except body composition , where neither group experienced change . Nonswimming exercises appear to be a viable and effective means to improve cardiorespiratory function and physical work capacity of the elderly The purpose of this study was to determine the effectiveness of a generalized water-based exercise program ( WBE ) compared to a l and -based exercise program ( LBE ) on improving cardiorespiratory fitness , body composition , forward trunk flexion and strength measurements of elderly women aged 70 + /- 3.2 years ( mean + /- SD ) . Forty-one healthy , sedentary women were selected to participate in the study and were r and omly assigned to the LBE or WBE . The 2 groups exercised for 12 weeks , 3 times/week for 45 min . Fitness testing was done before , during and after training , and included measurements of peak aerobic power ( VO2 peak ) , forward trunk flexion , sum of skinfolds , grip strength , curl-ups and push-ups . Between the tests performed before and after training , there were significant improvements in VO2 peak in both groups ( p < 0.05 ) with no significant differences between the groups ( p > 0.05 ) . The LBE group also showed a significant improvement in the total number of curl-ups performed ( p < 0.05 ) . There were no significant differences in trunk forward flexion , total ( right plus left ) grip strength , push-ups , waist to hip ratio , sum of skinfolds or body mass index between the tests performed before and after training over time within groups or between groups ( p > 0.05 ) . The results show that general exercise interventions result ed in improvements in cardiovascular fitness ( for both groups ) and abdominal endurance ( in the LBE only ) , but the two exercise programs used were not specific enough or long enough to cause improvements in muscular strength , flexibility or body composition . Furthermore , except for changes in abdominal endurance , the type of exercise venue ( l and vs. water ) did not have a significant effect on the results obtained Different types of exercise are indicated for the elderly to prevent functional capacity limitations due to aging and reduce the risk of falls . This study aim ed to evaluate the effect of three different exercises ( mini-trampoline , MT ; aquatic gymnastics , AG and general floor gymnastics , GG ) on postural balance in elderly women . Seventy-four physically independent elderly women , mean age 69±4 years , were r and omly assigned to three intervention groups : ( 1 ) MT ( n=23 ) , ( 2 ) AG ( n=28 ) , and ( 3 ) GG ( n=23 ) . Each group performed physical training , including cardiorespiratory , muscular strength and endurance , flexibility and sensory-motor exercises for 12 weeks . To determine the effects on each intervention group , five postural balance tasks were performed on a force platform ( BIOMEC 400 ) : the two-legged st and with eyes open ( TLEO ) and two-legged st and with eyes closed ( TLEC ) ; the semi-t and em st and with eyes open ( STEO ) and semi-t and em st and with eyes closed ( STEC ) and the one-legged st and . Three trials were performed for each task ( with 30s of rest between them ) and the mean was used to compute balance parameters such as center of pressure ( COP ) sway movements . All modalities investigated such as the MT , AG and GG were significantly ( P<0.05 ) efficient in improving the postural balance of elderly women after 12 weeks of training . These results provide further evidence concerning exercise and balance for promoting health in elderly women Graef , FI , Pinto , RS , Alberton , CL , de Lima , WC , and Kruel , LFM . The effects of resistance training performed in water on muscle strength in the elderly . J Strength Cond Res 24(11 ) : 3150 - 3156 , 2010-The purpose of the present study was to compare the effects of a program of resistance training in water-based exercises ( RWE ) with those of a program without resistance control in water-based exercises ( WEs ) .  Twenty-seven women ( aged 60 - 74 years ) were r and omly assigned to the  RWE group ( n = 10 ) , WE group ( n = 10 ) , or nontraining control ( CON ) group  ( n = 7 ) . The RWE and WE groups trained classes with aerobic exercises and localized muscular resistance exercises for 50 minutes , twice a week for 12 weeks . For the RWE group , the program included 4 mesocycles of 3 weeks-respectively , 4 sets of 15 repetitions , 4 sets of 12 repetitions , 5 sets of 10 repetitions , and 5 sets of 8 repetitions-of shoulder horizontal flexion exercise at maximum speed , with the use of resistive equipment . For the WE group , the training was not periodized , and the resistance in the localized muscular exercises was not controlled . One repetition maximum ( 1RM ) was measured on a pectoral fly machine at baseline and after the training period . The level of significance adopted was p ≤ 0.05 . The results showed that the only significant increase in 1RM ( 10.89 % , p < 0.001 ) occurred in the RWE group after training . In conclusion , these findings suggest that WEs with emphasis on resistance training in a periodized program can efficiently increase maximum strength in elderly women . Thus , it is suggested that the strategies used in WE programs be modified to offer suitable stimuli for the development of strength
target: AE may improve physical functioning in healthy older people and is at least as effective as LE
background: BACKGROUND ageing and sedentary behaviour cause negative changes in the neuromuscular systems of healthy older adults result ing 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 .