Ai Chi, Halliwick and Bad Ragaz in older adults: 12 months

In short: This randomized clinical trial followed 69 older adults for 12 months after eight weeks of Clinical Ai Chi, Water-Specific Therapy (Halliwick) or the Bad Ragaz Ring Method. The Ai Chi group kept clinically significant improvements in balance and gait and reported fewer falls; the Water-Specific Therapy group improved gradually, and the Bad Ragaz group showed only marginal, fading improvements.

About this study

Singh and Sarma included 69 older adults in Bangalore, India, who completed an eight-week aquatic therapy program with one of three methods: Clinical Ai Chi (CAC), Water-Specific Therapy (WST) or the Bad Ragaz Ring Method (BRRM). Over the following 12 months they used the Berg Balance Scale, Dynamic Gait Index, Functional Reach Test, Timed Up and Go test and a Balance Confidence Scale, together with self-reported falls and mobility diaries.

Main findings

After 12 months, the Ai Chi group maintained clinically significant improvements on the Berg Balance Scale (p < 0.01) and Dynamic Gait Index (p < 0.012).
The Water-Specific Therapy group showed a delayed but progressive improvement on the Functional Reach and Timed Up and Go tests.
The Bad Ragaz Ring Method group showed only marginal improvements that diminished over time.
The Ai Chi group reported significantly fewer falls than both other groups (p < 0.05) and more confidence in daily activities.

The authors conclude

The authors conclude that Clinical Ai Chi has long-term effects on balance and gait, fall risk and confidence in older adults, that Water-Specific Therapy has delayed but beneficial effects, and that the Bad Ragaz Ring Method has limited long-term impact.

Limitations

The study was carried out in one setting, and falls were self-reported. The authors call for tailored aquatic therapy protocols and research in more diverse populations.

Source

Singh P, Sarma PC. Long-term Efficacy of Aquatic Therapy on Balance and Gait in Older Adults: A Randomised Clinical Trial. Journal of Clinical and Diagnostic Research. 2025. doi: 10.7860/JCDR/2025/78107.20945. Published under a Creative Commons Attribution-NonCommercial-NoDerivatives (CC BY-NC-ND) licence.