How to Prevent Fractures in the Elderly?

Study: High-intensity aquatic exercises (HydrOS) improve physical function and reduce falls among postmenopausal women.

Researchers: Denise Fernandes Moreira L, Fronza FC, Dos Santos RN, Teixeira LR, Kruel LF, Lazaretti-Castro M. from the Division of Endocrinology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil;  School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil;  Exercise Research Laboratory, School of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre, Brazil, 2013


This study aims to investigate the effects of an aquatic exercise program (HydrOS) on neuromuscular function and falls among postmenopausal women.


One hundred eight postmenopausal women (mean

[SD] age, 58.8 [6.4] y) were randomly divided into the control group (CG; n = 44) and the aquatic exercise group (AEG; n = 64).

Both groups received elementary calcium 500 mg/day and cholecalciferol 1,000 IU/day.

For 24 weeks, the AEG participated in the aquatic exercise program, whereas the CG remained sedentary.

The following variables were measured before and after the program:

  1. Number of falls and fallers (7 month before and after the intervention)
  2. Flexibility, using Wells’ Sit-and-Reach Test (FLEX)
  3. Static balance, using the Unipedal Stance Test (UST)
  4. Mobility, using the Timed-Up-and-Go test (TUG)
  5. Handgrip strength of the dominant hand (HGS)
  6. Maximal isometric strength of back extensor muscles (SBE), strength of hip flexor muscles (SHF), and strength of knee extensor muscles (SKE).

The muscle strength tests were considered the primary outcome, whereas the other neuromuscular tests, together with falls, were considered secondary outcomes.

Results were significant when P ≤ 0.05.


Serum 25-hydroxyvitamin D significantly increased by 21% in the CG and by 23% in the AEG (P < 0.001).

The number of falls and fallers after the program remained unchanged in the CG; in the AEG, the mean number of falls decreased from 2.00 to 0.29 (P < 0.0001), and the number of fallers decreased by 44% (P < 0.0001).

All neuromuscular variables significantly improved in the AEG:

  • FLEX (26.6%; P < 0.0001)
  • UST (14.1%; P < 0.001)
  • TUG (23.7%; P < 0.001)
  • HGS (13.4%; P < 0.001)
  • SBE (26.2%; P < 0.001)
  • SHF (18.5%; P = 0.039)
  • SKE (7.7%; P < 0.001)

In the CG, significant improvements in:

  • FLEX (12.2%; P = 0.009)
  • UST (4.5%; P < 0.001)
  • TUG (10%; P < 0.001)
  • SHF (5.7%; P = 0.039)

All were observed and could be explained by increasing serum 25-hydroxyvitamin D level attributable to supplementation.


The aquatic exercise program HydrOS is a safe and efficient way to improve physical function and to reduce falls among postmenopausal women.

References: PMID: 23531689 [PubMed – in process]