Different doses of aquatic exercise for improving muscle strength in older adults: a meta-analysis

• Aquatic exercise significantly improves muscle strength in healthy older adults (SMD=0.56, 95%CI 0.39-0.74). • Optimal dose: 2-3 sessions per week, 40 minutes per session, moderate-to-vigorous intensity (Borg RPE 10-12), for at least 24 weeks. • Training period, frequency, and weekly total duration show cumulative effects, while session duration and intensity follow an inverted U-shaped relationship. • Bayesian dose-response meta-analysis provides precise quantification of nonlinear dose-response relationships, guiding personalized exercise prescription.