Comparison of the effects of neuromuscular and aquatic exercise programs on falls and physical performance in geriatric individuals

Aim: The aim of this study is to compare the effects of neuromuscular exercise (NE) and aquatic exercise (AE) programs on fall-related outcomes and physical performance parameters in geriatric individuals. Materials and Methods: A total of 46 active and independent adults aged 65 years and above were included in the study. Based on their age and scores from the International Physical Activity Questionnaire (IPAQ) Short Form, participants were randomly assigned using block randomization into either the Neuromuscular Exercise (NE) group (n=22) or the Aquatic Exercise (AE) group (n=24). Both groups participated in their respective exercise programs three times per week for 12 weeks. Pre- and post-intervention assessments included pain (Geriatric Pain Measure), gait (Optical gait analysis system), aerobic capacity (6-Minute Walk Test), lower extremity muscle strength and functional capacity (30-Second Chair Stand Test), dynamic balance (Four Square Step Test), functional balance (Berg Balance Scale), and fall-prevention behaviors and awareness levels (Falls Behavioral Scale for the Elderly). Results: Both groups demonstrated significant improvements in gait, lower extremity muscle str In the within-group analyses, significant improvements were observed in lower extremity muscle strength, functional capacity, and dynamic balance in both the NE and SE groups (p<0.05), whereas a significant reduction in pain and a significant improvement in aerobic capacity were observed only in the NE group (p<0.05). Between group comparisons dynamic balance at the first measurement and fall prevention behaviors (total score, cognitive adaptation, safe movement, and attention) at the second measurement were significantly better in favor of the NE group, while pain levels were significantly lower in the SE group at the first measurement (p <0.05). However, no significant between-group differences were found in gait and aerobic capacity, lower extremity muscle strength and functional capacity, or functional balance outcomes (p> 0.05). Conclusion: Both neuromuscular exercise and aquatic exercise programs similarly improved dynamic balance, lower extremity muscle strength, and functional capacity in physically active older adults. These findings indicate that both exercise protocols can be safely and effectively used as preventive health interventions in active and independent older adults, and may serve as a reference for future studies aimed at developing structured programs tailored to the geriatric population. Keywords: Aquatic Exercise; Fall; Gait; Geriatric Rehabilitation; Neuromuscular Exercise; Physical Performance.