A systematic review and meta-analysis comparing the effect of aquatic and land exercise on dynamic balance in older adul
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RESEARCH ARTICLE
Open Access
A systematic review and meta-analysis comparing the effect of aquatic and land exercise on dynamic balance in older adults Youngwook Kim1* , Michael N. Vakula1, Benjamin Waller2 and Eadric Bressel1
Abstract Background: 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; 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. Methods: Electronic 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). Results: A total of 11 trials met the inclusion criteria, and 10 studies were eligible for the meta-analysis. The metaanalysis 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. Conclusions: AE 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. Keywords: Older adults, Seniors, Aquatic exercise, Aquatic therapy, Balance, Dynamic balance, Falls, Fall prevention
Background In adults aged 65 years or older, approximately 29% of the population experience at least one fall per year, and the rate of falls and fall-related injuries increase with age [1]. Falls are a common cause of morbidity and mortality * Correspondence: [email protected] 1 Department of Kinesiology and Health Science, Utah State University, 7000 Old Main Hill, Logan, UT 84322-7000, USA Full list of author information is available at the end of the article
including both fatal and non-fatal injuries and poor quality of life [2, 3]. Falls often cause substantial medical costs. In 2015, fatal fall-related and non-fatal fall-related injuries cost an estimated $637.5 million and $31.3 billion, respectively [4]. Considering the globally increasing proportion of older adults, the medical costs related to falls may constantly increase unless cost-effective interventions are established and implemented.
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International Licens
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