Skip to main content

Research Repository

Advanced Search

Effects of aquatic therapy on balance in older adults: a systematic review and meta-analysis

Shariat, Ardalan; Ghayour Najafabadi, Mahboubeh; Ghannadi, Shima; Nakhostin-Ansari, Amin; Hakakzadeh, Azadeh; Shaw, Brandon S.; Ingle, Lee; Cleland, Joshua A.


Ardalan Shariat

Mahboubeh Ghayour Najafabadi

Shima Ghannadi

Amin Nakhostin-Ansari

Azadeh Hakakzadeh

Brandon S. Shaw

Joshua A. Cleland


Purpose: Balance is a key component of movement for daily activities, especially in older adults. Previous studies examining aquatic therapy as an effective way for improving balance have yielded inconsistent findings. The current systematic review and meta-analysis investigated the effectiveness of aquatic therapy on balance among older adults. Methods: Sources include Cochrane Central Register of Controlled Trials, Medline, ISI Web of Science, EBSCO, Embase, Cumulative Index to Nursing and Allied Health Literature, and Scopus. Randomized controlled or cross-over trials published by Feb 2020 were included following pre-determined search and selection criteria. Data extraction was performed by two researchers independently using a pre-determined data extraction form. Methodological quality was assessed by two reviewers using the PEDro scale which was used to rate trials according to criteria such as concealed allocation, blinding, and intention-to-treat analysis. Furthermore, meta-analysis was conducted where possible. This review was registered at PROSPERO CRD42018118382. Results: Fifteen trials with 385 healthy participants aged 50 or over were included. Results showed that aquatic therapy had a significant effect on dynamic balance (SMD, − 1.13; 95% CI, [− 1.45 to (− 0.82)]; I 2 = 77%). The analysis indicated that aquatic therapy improved balance ability compared to controls. Conclusions: Aquatic therapy has a positive impact on dynamic balance in older adults. However, further high-quality and appropriately powered studies are required to confirm this assertion.


Shariat, A., Ghayour Najafabadi, M., Ghannadi, S., Nakhostin-Ansari, A., Hakakzadeh, A., Shaw, B. S., …Cleland, J. A. (2021). Effects of aquatic therapy on balance in older adults: a systematic review and meta-analysis. European Geriatric Medicine,

Journal Article Type Review
Acceptance Date Oct 12, 2021
Online Publication Date Nov 24, 2021
Publication Date Nov 24, 2021
Deposit Date Nov 26, 2021
Journal European Geriatric Medicine
Print ISSN 1878-7649
Electronic ISSN 1878-7657
Publisher Springer
Peer Reviewed Peer Reviewed
Keywords Aging; Balance; Aquatic therapy
Public URL