OBJECTIVE: This study compared the effects of water-based exercise (WBE) and land-based exercise (LBE) on 6-min run test (6MRT) performance in overweight adults (BMI >= 25 kg/m2) and examined changes in cardiovascular risk factors. METHODS: Participants were randomly assigned (1:1:1) to WBE (aqua-cycling), LBE (fitness) or a control group (CLG, no training). Sessions lasted 45 min, twice weekly, over 10 weeks (2018 professional facilities, Freiburg, Germany). The primary endpoint was change in 6MRT from baseline to post-intervention; secondary endpoints included hip-belly ratio (HBR), body mass index (BMI), and cardiovascular risk factors. Baseline assessments were double-blinded; 6MRT was analyzed single-blind. RESULTS: Eightly-seven participants (56 female, age 52.2 +/- 12.3 years, BMI 33.9 +/- 4.95) were enrolled. Both exercise groups improved 6MRT, HBR, and BMI, but only LBE showed a significant advantage over CLG in 6MRT (p < 0.05). No significant differences were observed between WBE and LBE. Cardiovascular risk factors (blood pressure, lipids, HbA1c) did not differ significantly across groups. CONCLUSIONS: WBE and LBE improved fitness and body composition, but only LBE achieved a significant gain versus control. No exercise modality differentially influenced cardiovascular risk factors. Choice between WBE and LBE could be guided by preference, access, and functional needs.

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