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 randomly 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 land, 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) questionnaire, 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.

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