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Occupational therapy plays a significant role in wellness promotion for older adults. Critical to maintaining health and wellness in older adults is prevention of falls and fall-related injuries. One in three community-dwelling older adults reports a fall every year, and the incidence of falls increases exponentially from ages 60 to 65 and 80 to 85. Falls are associated with increased morbidity and mortality from fractures and secondary complications. Leading causes of falls in older adults include decreased balance and an abnormal gait pattern. Balance training programs can help improve balance, decrease the risk of falling, and promote functional independence. However, land-based exercises may pose safety risks or be intimidating to older adults with a fear of falling. The buoyant and viscous properties of water as well as proven clinical evidence of the benefits of aquatic therapy suggest that water-based balance training may be a safe and effective alternative to landbased training to improve balance performance for older adults.

In this study, 60 active and healthy community-dwelling older adults were randomly assigned to one of the two exercise groups: a land-based or water-based balance training group. In both groups, participants attended 5 1-hour sessions per week for 2 weeks of either land- or waterbased balance exercise training programs. The results from this study indicated that there was no statistical difference in balance performance following land-based or water-based exercise programs. Although there was no difference between posttest balance performances between the two exercise mediums, both groups showed significant improvement in balance performance following the 2-week intervention.


A product of the American Occupational Therapy Association's Evidence-based Literature Review Project.


Copyright © 2015 American Occupational Therapy Association. All Rights Reserved. Reproduced here with permission.

Publisher's Statement

Originally published as Pro, S., Bains, R., & Li, K. (In Press) For healthy older adults, does participation in a water-based balance training exercise program, when compared to a land-based balance training exercise program, improve balance performance? [Critically Appraised Paper]. Bethesda, MD: American Occupational Therapy Association, Evidence-Based Practice Project.