BACKGROUND: Aging is associated with a progressive decline in physical capacities, making exercise essential for the maintenance of functional ability. Aquatic exercise is highly recommended for older adults; however, evidence in pragmatic, real-world settings remains limited.This study aimed to analyze the effects of water aerobics (HIDRO) and deep water running (DWR) on physical outcomes in older adults. METHODS: This quasi-experimental, pragmatic study included 92 older adults (*60 years), allocated to the HIDRO group (n = 42) and the DWR group (n = 50). Both groups participated in a 36-week periodized training program combining aerobic and resistance exercises. Physical fitness variables were assessed before and after the intervention, including muscular strength, flexibility, agility, dynamic balance, and aerobic endurance. Analyses were conducted according to the intention-to-treat principle, using Generalized Estimating Equations (GEE) with Bonferroni post hoc adjustment, adopting * = 0.05. RESULTS: A significant time effect was observed for most variables, with improvements in upper and lower limb strength (p = 0.001), lower limb flexibility (p = 0.001), agility (p = 0.006), and dynamic balance (p = 0.001). No significant changes were observed in upper limb flexibility, aerobic endurance, or handgrip strength (p > 0.05). No significant group-by-time interaction was found, indicating similar responses between the HIDRO and DWR groups. CONCLUSIONS: HIDRO and DWR are equally effective in improving physical fitness in older adults in real-world settings, with meaningful benefits for strength, flexibility, mobility and balance.
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