Cureus · Jul 8, 2025

Effects of Aquatic-Based Resistance, Balance, and Proprioceptive Training on Ankle-Foot Malalignments in Postmenopausal Obese Women

By Hande D, Shinde S, Dhumale A et al.

BACKGROUND: Aquatic therapy has become a valuable rehabilitation method due to water's unique properties, including buoyancy, resistance, hydrostatic pressure, and temperature regulation. The study focuses on musculoskeletal changes associated with menopause, particularly the alterations in muscle strength and functional performance observed in postmenopausal women. It aimed to compare the outcomes of aquatic exercise programs with those of land-based exercises in terms of resistance training, balance, and proprioception. OBJECTIVES: This study aimed to determine the impact of aquatic resistance training on improving muscular strength, balance, and alignment in the lower extremities in postmenopausal obese women. METHODS: This study included a total of 146 participants, who were randomly assigned to two groups: Group A (Control) and Group B (Intervention), with 73 participants in each group initially. Following the exclusion of three participants, the final sample consisted of 71 participants in Group A and 72 in Group B. Over six weeks, participants underwent either land-based or aquatic-based exercise protocols, depending on group allocation. Outcome measures included the Numerical Rating Scale for pain, manual muscle testing (MMT) for strength, and the Star Excursion Balance Test (SEBT) for assessing balance and proprioception. RESULTS: The findings of this study demonstrated that aquatic-based resistance, balance, and proprioceptive training had a significantly greater impact on correcting ankle-foot malalignments in obese postmenopausal women compared to land-based exercises. Participants in the intervention group (Group B) showed notable improvements across multiple assessment parameters, including the Numerical Pain Rating scale, MMT, and SEBT. The statistical analysis revealed highly significant results (p < 0.0001), indicating that aquatic training was more effective in enhancing strength, balance, and foot alignment than traditional land-based exercises. CONCLUSION: The study found that a six-week aquatic training program helped alleviate pain and improved the overall ankle-foot complex performance (strength, balance, and proprioception) in postmenopausal obese women.

doi.org/10.7759/cureus.87571Open accessPubMed 40786333Interventions