Effects of the Aquatic Combined Training in Different Weekly Frequencies on Anthropometric, Functional, Hemodynamics, Sleep, Mental Health and Quality of Life in Adults and Older People: A Pragmatic Trial

This study examined the effects of different weekly frequencies (2 vs three sessions) of combined aquatic training on anthropometric, functional fitness, hemodynamic, and psychosocial outcomes in adults and older adults. A pragmatic non-randomized trial (RBR-2txw8zy) included participants aged 30-80 years allocated to twice-weekly (2G) and three-times-weekly (3G) groups. Training lasted 12 weeks, organized into 3 4-week mesocycles (36-42 min/session). Aerobic training was prescribed by RPE (6-20), progressing from 11 to 15 for 21 minutes, while resistance training progressed from 2 × 30 to 4 × 15 seconds at maximal speed. Outcomes were assessed pre- and post-intervention using generalized estimating equations (α = 5%) with ITT and PP analyses. ITT showed similar functional improvements in the 30-second sit-to-stand, 30-second arm curl, and 6MWT. In PP, significant group*time interactions were observed for TUGmax and 6MWT, with 3G increasing TUGmax time 0.28 (0.00; 0.55) and 6MWT distance 55.54 (33.12; 77.96). DBP increased (ITT and PP), whereas HR and quality of life improved in both groups (ITT). SBP increased in 2G ITT: 2.15 (−3.01; 7.32); PP: 5.58 (0.03;11.82) but decreased in 3G ITT: −6.55 (−12.78;−0.32); PP: −6.61 (−13.11;−0.11). Combined aquatic training improves strength and endurance, and quality of life, while 3 weekly sessions yield greater benefits for aerobic capacity and SBP.