The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis

Schinzel E, Kast S, Kohl M, von Stengel S, Jakob F, Kerschan-Schindl K, Kladny B, Lange U, Peters S, Thomasius F, Clausen J, Uder M, Kemmler W (2023)


Publication Type: Journal article, Review article

Publication year: 2023

Journal

Book Volume: 14

DOI: 10.3389/fphys.2023.1135663

Abstract

Introduction: Aquatic or water-based exercise is a very popular type of exercise in particular for people with physical limitations, joint problems and fear of falling. The present systematic review and meta-analysis aimed to provide evidence for the effect of aquatic exercise on Bone Mineral Density (BMD) in adults.Methods: A systematic literature search of five electronic databases (PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science and CINAHL) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted until 2022/01/30, with an update to 2022/10/07. We included controlled trials with a duration of more than 6 months and at least two study groups, aquatic exercise (EG) versus non-training controls (CG) with no language restrictions. Outcome measures were standardized mean differences (SMD) with 95%-confidence intervals (95%-CI) for BMD changes at the lumbar spine (LS) and femoral neck (FN). We applied a random-effects meta-analysis and used the inverse heterogeneity (IVhet) model to analyze the data.Results: Excluding an outlier study with an exceptionally high effect size for LS-BMD, we observed a statistically significant (p = .002) effect (EG vs. CG) of aquatic exercise for the LS-BMD (n = 10; SMD: 0.30; 95%-CI: 0.11-0.49). In parallel, the effect of aquatic exercise on FN-BMD was statistically significant (p = .034) compared to the CG (n = 10; SMD: 0.76, 95%-CI: 0.06-1.46). Of importance, heterogeneity between the trial results was negligible for LS (I-2: 7%) but substantial for FN-BMD (I-2: 87%). Evidence for risks of small study/publication bias was low for LS-BMD and considerable for FN-BMD.Discussion: In summary, the present systematic review and meta-analysis provides further evidence for the favorable effect of exercise on bone health in adults. Due to its safety and attractiveness, we particularly recommend water-based exercise for people unable, afraid or unmotivated to conduct intense land-based exercise programs.

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How to cite

APA:

Schinzel, E., Kast, S., Kohl, M., von Stengel, S., Jakob, F., Kerschan-Schindl, K.,... Kemmler, W. (2023). The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis. Frontiers in Physiology, 14. https://dx.doi.org/10.3389/fphys.2023.1135663

MLA:

Schinzel, Eileen, et al. "The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis." Frontiers in Physiology 14 (2023).

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