# Comparing water-based and land-based exercise on 6-minute run test performance in overweight adults: A randomized controlled trial in Germany

## TL;DR

This study compared water-based and land-based exercises in overweight adults, finding both improved fitness and body composition, but only land-based exercise showed significant gains over a control group.

## Contribution

The study provides evidence on the relative effectiveness of water-based versus land-based exercise for improving fitness and cardiovascular risk factors in overweight adults.

## Key findings

- Both water-based and land-based exercise improved 6MRT, HBR, and BMI in overweight adults.
- Land-based exercise showed a significant improvement in 6MRT compared to the control group.
- Participants preferred water-based exercise despite smaller fitness gains.

## Abstract

This study compared the effects of water-based exercise (WBE) and land-based exercise (LBE) on 6-min run test (6MRT) performance in overweight adults (BMI ≥ 25 kg/m2) and examined changes in cardiovascular risk factors.

Participants were randomly assigned (1:1:1) to WBE (aqua-cycling), LBE (fitness) or a control group (CLG, no training). Sessions lasted 45 min, twice weekly, over 10 weeks (2018 professional facilities, Freiburg, Germany). The primary endpoint was change in 6MRT from baseline to post-intervention; secondary endpoints included hip-belly ratio (HBR), body mass index (BMI), and cardiovascular risk factors. Baseline assessments were double-blinded; 6MRT was analyzed single-blind.

Eightly-seven participants (56 female, age 52.2 ± 12.3 years, BMI 33.9 ± 4.95) were enrolled.Both exercise groups improved 6MRT, HBR, and BMI, but only LBE showed a significant advantage over CLG in 6MRT (p < 0.05). No significant differences were observed between WBE and LBE. Cardiovascular risk factors (blood pressure, lipids, HbA1c) did not differ significantly across groups.

WBE and LBE improved fitness and body composition, but only LBE achieved a significant gain versus control. No exercise modality differentially influenced cardiovascular risk factors. Choice between WBE and LBE could be guided by preference, access, and functional needs.

•Water- and land-based exercise were compared in overweight adults.•Randomized controlled trial with 87 participants in three groups.•Both exercise types improved fitness, body mass index, and waist-hip ratio.•Land-based exercise improved six-minute run compared with control.•Participants preferred water-based exercise despite smaller fitness gains.

Water- and land-based exercise were compared in overweight adults.

Randomized controlled trial with 87 participants in three groups.

Both exercise types improved fitness, body mass index, and waist-hip ratio.

Land-based exercise improved six-minute run compared with control.

Participants preferred water-based exercise despite smaller fitness gains.