The comparison of balance outcomes between an aquatic vs. land-based exercise program in older adults with knee osteoarthritis (OA)

Balance improvement has been well documented in healthy older adults after participating in aquatic or land-based exercise programs. Aquatic exercise is frequently recommended for people with arthritis. While various effects of aquatic exercise have been studied, limited research has investigated its effects on balance among people with osteoarthritis (OA). The purpose of the study was to compare balance outcomes between aquatic and land-based exercise programs in older adults with knee OA. A total of 14 participants (Mean age 75.65 ± 8.2, 13 females, and 1male) with knee OA were assigned to an aquatic exercise group or a land exercise group. The aquatic group participants completed a 45-minute Arthritis Foundation Aquatic Program (AFAP) 3 times a week for 12 weeks while the land exercise group performed the Arthritis Foundation Land Program (AFLP). Outcome measures were assessed by using a computerized posturographic balance test equipment (Neurocom Balance Master, NeuroCom International, Clackamas, OR, 2010), a psychometric balance measure, the activities-specific balance confidence (ABC) scale, a dynamic balance measure, the Timed Up and Go Test (TUG), a pain assessment measure, the visual analog pain scale (VAS), and the a functional balance measure, the functional reach test (FRT). All tests were performed pre and post-intervention. Within group analyses using paired t-tests showed that the AFLP had no statistically significant changes between pre and post in any of the outcome measures. The water group showed significant changes between pre and post in the TUG and Limits of Stability (LOS- NeuroCom Test). MANOVA showed no group-interaction in any of the balance measures. As a total group, there were significant differences found between pre and post in the FRT, TUG, and LOS. The findings indicate that aquatic or land exercise programs can help older adults with knee OA. Exercising in either program will show benefits in reaction time and in functional and dynamic balance.