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Land-walking versus water-walking interventions in older adults: effects on aerobic fitness [with consumer summary]
Haynes A, Naylor LH, Carter HH, Spence AL, Robey E, Cox KL, Maslen BA, Lautenschlager NT, Ridgers ND, Green DJ
Journal of Sport and Health Science 2020 May;9(3):274-282
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: Low cardiorespiratory fitness is an independent predictor of all-cause and cardiovascular mortality, and interventions that increase fitness reduce risk. Water-walking decreases musculoskeletal impact and risk of falls in older individuals, but it is unclear whether water-walking improves aerobic fitness in the same way as weight-dependent land-walking. This randomized controlled trial involved 3 intervention groups-a no-exercise control group (CG), a land-walking (LW) group, and a water-walking (WW) group-to investigate the comparative impacts of LW and WW to CG on fitness. METHOD(S): Both exercise groups attended individually tailored, center-based, intensity-matched 3 x weekly sessions for 24 weeks, which progressed to 150 min of exercise per week. This was followed by a 24-week no-intervention period. Maximal graded exercise tests were performed on a treadmill at weeks 0, 24, and 48. RESULT(S): Maximal oxygen uptake increased from week 0 to 24 in both exercise groups (0.57 +/- 0.62 mL/kg/min, 0.03 +/- 0.04 L/min for LW; 0.93 +/- 0.75 mL/kg/min, 0.06 +/- 0.06 L/min for WW, mean +/- SE) compared to the CG (-1.75 +/- 0.78 mL/kg/min, -0.16 +/- 0.05 L/min) (group x time, p < 0.05). Time to exhaustion increased significantly following LW only (123.4 +/- 25.5 s), which was significantly greater (p = 0.001) than the CG (24.3 +/- 18.5 s). By week 48, the training-induced adaptations in the exercise groups returned to near baseline levels. CONCLUSION(S): Our study supports current physical-activity recommendations that 150 min/week of moderate-intensity exercise produces improvements in fitness in previously sedentary older individuals. Also, LW and WW elicit similar improvements in fitness if conducted at the same relative intensities. Exercise-naive older individuals can benefit from the lower impact forces and decreased risk of falls associated with WW without compromising improvements in cardiorespiratory fitness.

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