Water- versus land-based exercise in elderly subjects: effects on physical performance and body composition
Open accessAbstract
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 land-based protocol and a control group. For this purpose, 59 subjects were recruited and randomly allocated to three groups: aquatic group (AG), land 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 land-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 land-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.
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Aquatic-based resistance exercises have shown promising results in improving strength and muscle mass in older individuals and metabolic health in patients with non-communicable diseases.
“In such clinical conditions, aquatic-based resistance exercises could also be a low-impact exercise alternative as they have shown promising results in improving strength and muscle mass in older individuals [141,142], as well as metabolic health in patients with non-communicable diseases [143,144].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [142]
A multicomponent exercise program incorporating cognitive dual-tasking effectively enhances the clinical hallmarks of frailty in those with cognitive impairment.
“For example, a multicomponent exercise program incorporating cognitive dual-tasking effectively enhances the clinical hallmarks of frailty in those with cognitive impairment (low body mass, strength, endurance, mobility, PA level, energy, and cognition) [58,142].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [142]
A multicomponent exercise program incorporating cognitive dual-tasking effectively enhances clinical hallmarks of frailty in those with cognitive impairment.
“For example, a multicomponent exercise program incorporating cognitive dual-tasking effectively enhances the clinical hallmarks of frailty in those with cognitive impairment (low body mass, strength, endurance, mobility, PA level, energy, and cognition) [58,142].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [142]
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- Authors
- Bergamin, M., Ermolao, Tolomio, S., Berton, Sergi, & Zaccaria
- Affiliations
- University of Padua (IT)
- Corresponding author
- Bergamin, Marco
- ORCID
- Bergamin, Marco
- Venue
- Clinical Interventions in Aging
- Publisher
- Informa UK Limited
- Published
- 2013-08
- Volume
- 8
- Pages
- 1109
- ISSN
- 1176-9092 (ISSN-L)
- 1178-1998
- PMC
- PMC3762608
- OpenAlex
- W2071991485
- Cited by
- 118
- References
- 46
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 6 · 2023: 10 · 2022: 9 · 2021: 17 · 2020: 16 · 2019: 2 · 2018: 9 · 2017: 10 · 2016: 10 · 2015: 8 · 2014: 6 · 2013: 2
- FWCI
- 6.02
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Clinical Interventions in Aging (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Padua Research Archive (University of Padova) (submittedVersion, cc-by-nc)
- Funders
- European Social Fund (2105/101/1/722/2009)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- aquatic exercise, hot spring bathing, land-based exercise, older adults, physical performance, body composition, muscle mass, fat mass, dynamic balance, flexibility, quadriceps strength, exercise intervention
- MeSH terms
- Aged, Body Composition, Exercise Test, Exercise Therapy, Female, Humans, Immersion, Italy, Male, Physical Fitness, Muscle Weakness, Exercise Movement Techniques
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