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Cited by 45Balance, Gait, and Falls PreventionPhysical Activity and HealthStroke Rehabilitation and Recovery

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A systematic review and meta-analysis comparing the effect of aquatic and land exercise on dynamic balance in older adults

Open access
Kim, Youngwook, Vakula, Michael N., Waller, Benjamin, Bressel, Eadric·2020·BMC Geriatrics
DOI 10.1186/s12877-020-01702-9PMC PMC7446104
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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 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. 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.

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Crossref · 10.1186/s12877-020-01702-9

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Fig. 1 PRISMA flow diagram of article selection process
Fig. 1 PRISMA flow diagram of article selection processCC BY · PubMed Central
Fig. 2 Risk of bias of the included studies. a Risk of bias graph, b Risk of bias summary. Green, low risk; yellow, somewhat concerns; red, high risk. D1, Randomization process; D2, Deviation from intended interventions; D3, missing outcome data; D4, measurement of outcome; D5, selection of the reported result; Overall, overall bias
Fig. 2 Risk of bias of the included studies. a Risk of bias graph, b Risk of bias summary. Green, low risk; yellow, somewhat concerns; red, high risk. D1, Randomization process; D2, Deviation from intended interventions; D3, missing outcome data; D4, measurement of outcome; D5, selection of the reported result; Overall, overall biasCC BY · PubMed Central
Fig. 3 Funnel plot for all of the meta-analyses
Fig. 3 Funnel plot for all of the meta-analysesCC BY · PubMed Central
Fig. 4 Forest plot of comparison: AE versus LE. a Dynamic steady-state balance, b Proactive balance, c Balance test batteries
Fig. 4 Forest plot of comparison: AE versus LE. a Dynamic steady-state balance, b Proactive balance, c Balance test batteriesCC BY · PubMed Central
Fig. 5 Results of sensitivity analyses. a Dynamic steady-state balance, b Proactive balance, c Balance test batteries
Fig. 5 Results of sensitivity analyses. a Dynamic steady-state balance, b Proactive balance, c Balance test batteriesCC BY · PubMed Central

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Citations

Cites

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Metadata

Authors
Kim, Y., Vakula, M. N., Waller, B., & Bressel, E.
Affiliations
  • Utah State University (US)
  • Reykjavík University (IS)
Corresponding author
Kim, Youngwook
ORCID
Venue
BMC Geriatrics
Publisher
Springer Science and Business Media LLC
Published
2020-08-25
Volume
20
Issue
1
Pages
302-302
ISSN
1471-2318 (ISSN-L)
DOI
10.1186/s12877-020-01702-9
PMC
PMC7446104
OpenAlex
W3080792581
Cited by
45
References
4
Citations by year
2026: 8 · 2025: 9 · 2024: 9 · 2023: 7 · 2022: 10 · 2021: 2
FWCI
1.11
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Geriatrics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Opin vísindi (Opin vísindi) (submittedVersion, cc-by)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Keywords
aquatic exercise, land-based exercise, dynamic balance, older adults, fall prevention, balance disorders
MeSH terms
Accidental Falls, Aged, Postural Balance, Exercise Therapy, Humans, Exercise

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