Summary: In a 5-week trial in type 2 diabetes, an aquatic exercise group improved blood pressure, respiratory measures, and walking capacity over time, but there were no statistically significant differences between the exercise and control groups, and no adverse effects.
PICO Summary
| Element | Detail |
|---|---|
| Population | 52 adults with type 2 diabetes; randomised controlled trial with blinded assessors, Brazil. |
| Intervention | Structured aquatic conditioning, 3×/week for 5 weeks (15 sessions); n=27. |
| Comparison | Control group (n=25); outcomes at baseline, 5 weeks, and 15-day follow-up. |
| Outcome | No statistically significant differences between groups for any variable. Within the exercise group over time, systolic (p=0.019) and diastolic pressure (p=0.011) fell and inspiratory pressure, peak expiratory flow, and 6-minute walk distance improved. No adverse effects. |
Expert Commentary
This is an honest small trial whose results must be read with the between-group comparison foremost, because that is the part that tests the intervention. The exercise group improved on blood pressure and functional measures over time, but those are within-group changes, and crucially the differences versus the control group did not reach statistical significance for any variable. That pattern usually signals either a modest true effect that the study was underpowered to detect or improvements that are not cleanly attributable to the intervention, and with only 52 participants over a brief five weeks, underpowering is the likely explanation. So the responsible interpretation is promising-but-unproven rather than effective. The clinical rationale for aquatic exercise nonetheless remains genuinely strong for the right patient, water’s buoyancy offloads joints and makes movement feasible for people limited by obesity, neuropathy, or arthritis, and the trial’s confirmation of safety supports that use. Can I use this with my patients? Yes, pragmatically. For a diabetic patient who cannot tolerate land-based exercise, I would recommend the pool as a safe and accessible way to be active, while being honest that this particular trial did not demonstrate superiority over no exercise, and that longer, larger studies are needed to quantify the benefit.
References
Calixto Júnior R, Terra AMSV, Gonçalves GCV, et al. Effects of an aquatic exercise protocol on blood pressure, respiratory function, and functional capacity in individuals with type 2 diabetes: a randomized controlled trial. J Bodyw Mov Ther. 2025;44:97–105. doi:10.1016/j.jbmt.2025.05.066