Comparison Between Water Aerobics and Deep-Water Running on Middle-Aged Adults’ Anthropometric, Hemodynamic and Functional Outcomes

Background: Head-out aquatic training, using modalities such as water-aerobics/hydrogymnastics (HYD) and deep-water running (DWR), has been effective in improving the physical, metabolic and cognitive health of middle-aged adults. However, direct comparisons between these modalities are lacking. Aim: The aim of this study was to compare the effects of water aerobics and deep-water running on anthropometric, functional and hemodynamic outcomes in adults and older adults. Methods: An uncontrolled pragmatic trial (RBR-2txw8zy) was conducted with participants aged 30 to 80, allocated to HYD and DWR groups. The intervention consisted of 12 weeks of progressive aerobic training with weekly undulating periodization (2× week), divided into three mesocycles (4, 5, and 3 weeks), each lasting 50 min. Intensity was prescribed using the Rate of Perceived Effort (RPE), ranging from RPE 11 to 17. Outcomes assessed included the 30 s chair stand, 30 s arm curl, Timed-Up-and-Go usual (TUG-u) and maximum (TUG-m), 6 min walking test (6MWT), body mass, waist circumference, blood pressure and resting heart rate-HRrest. The analysis was conducted using generalized estimating equations, with per-protocol (PP) and intention-to-treat (ITT) analyses. Results: The study included 104 participants (HYD: n = 63, mean age 59 years, 54 women; DWR: n = 41, mean age 53 years, 33 women). ITT analysis showed improvements in waist circumference, waist-to-height ratio, and TUG-m in the HYD group, and a reduction in HRrest in the DWR group. Both modalities showed significant improvements in the 30 s chair stand, 30 s arm curl, 6MWT, waist circumference, and waist-to-height ratio in the PP analysis. Conclusions: Both modalities promoted functional improvements and favorable changes in anthropometric evaluations, with DWR showing a greater reduction in HRrest.