BACKGROUND AND PURPOSE: Exercise in water is a therapeutic intervention that can improve balance and prevent falls in elderly. This review examines published research that tests the effectiveness of aquatic exercise in healthy elderly for its effects on measures of functional balance. METHODS: A systematic search was made of 5 electronic databases for trials of aquatic exercise in populations of over 60 years with pre- and postintervention measurement of functional balance. Reference lists of articles meeting all criteria were hand-searched. Quality of studies was assessed using the Downs and Black assessment tool. RESULTS: Thirteen studies were identified for the review. There are methodological weaknesses in most studies, eg, failure to provide blinded assessors or show power calculations. Overall, the research found that aquatic exercise groups improved on balance measures significantly more than control groups, but in the few high-quality studies which compared aquatic- and land-exercise there was no significant difference between groups. DISCUSSION AND CONCLUSIONS: Aquatic exercise is an option for therapists in efforts to promote balance in the elderly. However, there is limited evidence comparing aquatic with land-based programs. Recommendations are made regarding further research.

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