Date of Award:


Document Type:


Degree Name:

Doctor of Philosophy (PhD)


Special Education and Rehabilitation Counseling

Committee Chair(s)

Eadric Bressel


Eadric Bressel


David Bolton


Chris Dakin


Brennan Thompson


Timothy A. Slocum


Loss of balance and consequential falling, caused by natural degenerations in the sensory and motor systems with aging, are critical issues that require constant research exploration to ultimately improve the quality of life in older populations. Balance can be simply classified into static and dynamic balance, and the latter is more associated with common causes of falling in older adults. There are numerous ways to improve dynamic balance, and exercise training has been considered the most beneficial intervention for that purpose. Specifically, aquatic exercises have been suggested as a promising modality because several properties of water, including buoyance and hydrostatic pressure, impart direct benefits to older adults during the exercise. However, it is still inconclusive whether aquatic exercises are more effective than land exercises at improving dynamic balance.

Further, slips and trips are the most predominant causes of falls in older adults, and they often require a rapid, accurate action to avoid a potential fall. This process is called reactive balance (i.e., compensatory balance reaction). It also can be enhanced by exercise interventions; however, it is unclear what type of exercise is most effective at improving reactive balance. In this dissertation, we compared the impacts of exercise environments on dynamic balance, and then explored what type of exercise intervention improves reactive balance the most in older adults.

These studies revealed that both aquatic and land exercises have equivalent effects on improving dynamic balance, and reactive balance improved most successfully after one or more reactive balance exercises were provided. In addition, power training was the second most effective intervention for improving reactive balance. The findings from this dissertation suggest that when exercise-based interventions are used to improve dynamic balance, the exercise environments can be selected based on the purpose of the intervention or each participant’s subjective decision. Moreover, practitioners may wish to implement task-specific reactive balance training on the preferential basis for the intervention aiming at reactive balance. Also, power training, which reflects the mechanism of the targeted reactive balance task, can be jointly or adjunctly utilized to improve reactive balance, which is critical for decreasing falls in older adults.