Effectiveness of aquatic Tai Chi on balance indicators: a systematic review

Background Balance disorders expose older adults to an increased risk of falls. The combination of Tai Chi and an aquatic environment may improve balance. The aim of this review was to assess the effectiveness of Ai Chi in improving balance in older adults. Methods The systematic review was conducted in accordance with the PRISMA guidelines. Criteria: population individuals aged ≥60 years with balance disorders or at risk of falling; intervention Ai Chi (Tai Chi in water); control no intervention or other exercises; outcomes balance measures. The PubMed, Scopus, Web of Science and EBSCO databases were searched without time restrictions for RCTs and quasi experimental studies. Study selection and risk-of-bias assessment were performed independently by two authors. Results Seven studies (6 RCTs, 1 non-randomized) with a total of 213 participants were included. Ai Chi programs lasted from 2 to 12 weeks (2–3 sessions/week). All studies showed an improvement in balance in the Ai Chi groups compared with controls. A significant improvement in static and dynamic balance (shortening of TUG time) was observed in the Ai Chi groups. In one study, only Ai Chi participants achieved a TUG score below the fall-risk threshold. Ai Chi proved to be as effective as land-based exercise and aquatic kinesiotherapy. No serious adverse events were reported. Conclusion Ai Chi effectively improves balance in older adults, which may reduce the risk of falls and improve mobility. It is a safe, low joint-load form of exercise recommended as an adjunct to geriatric physiotherapy. A limitation is the small number of studies of moderate quality. Further large-scale RCTs with longer follow-up are needed to confirm the long-term effects of Ai Chi. Systematic review registration PROSPERO, Identifier (CRD420251162371).