Comparison of Neuromuscular and Aquatic Exercise Programs on Fall Risk and Physical Function in Geriatrics

Human aging is a complex and individual process that occurs in biological, psychological, and social areas. The metabolic and physicochemical characteristics of cells gradually change with age, a process known as biological aging. This results in cellular self-regulation, regeneration, and structural alterations as well as the degeneration of healthy tissues and organs.

Physical performance impairments are linked to a wide range of negative health consequences, including osteoporosis, falls, and fractures, and are one of the most important health problems in geriatrics. Proprioceptive perception is significantly related to postural stability. Musculoskeletal system disorders (in physiological, neurological, kinesthetic, auditory, vestibular proprioception, and cognitive systems) cause balance problems, which may lead to an increase in the frequency of falls in the elderly. Exercise is critical for healthy aging and may improve walking and balance and reduce the risk of falls in the geriatric population.

Neuromuscular exercise is a relatively broad class of exercise programs that include programs aimed at improving balance, muscle activation, functional alignment, and functional joint stability, known by terms such as functional exercise, proprioceptive, agility, or perturbation training. Unlike traditional strength training, neuromuscular exercise addresses the quality of movement and emphasizes joint control in all three planes. The primary goal of neuromuscular exercise is to achieve compensatory functional stability and improve sensorimotor control. Neuromuscular exercises have been researched in knee osteoarthritis and patellofemoral pain, anterior cruciate ligament injury, fibromyalgia, obesity, autism spectrum disorder in children, cancer, chronic pain, and in various sports fields to improve balance and physical performance after injury.

Aquatic exercises are mostly rehabilitation-oriented practices that can be applied at different temperatures and depths, structured according to a specific goal. In aquatic exercises, the buoyancy of the water reduces the load on the joints, and thanks to the hydrostatic pressure providing support and resistance, older adults can exercise with a lower risk of injury and pain. Studies have shown the positive effects of aquatic exercises on improving dynamic balance, reducing the risk of falling, lower extremity strength, and mental-physical health in geriatrics.

In the literature review on the subject, no study was found comparing neuromuscular exercise and aquatic exercises in the field of geriatrics.