“…Many water-based exercise studies have demonstrated improvements between programs of similar intensities in cardiovascular fitness, body composition, muscle strength, and flexibility (Campbell, D'Acquisto, D'Acquisto, & Cline, 2003;Gappmaier, Lake, Nelson, & Fisher, 2006;Ruoti, Troup, & Berger, 1994;Sato, Kaneda, Wakabayashi, & Nomura, 2007;Shono, Fujishima, Hotta, Ogaki, & Ueda, 2001;Takeshima et al, 2002;Tsourlou, Benik, Dipla, Zafeiridis, & Kellis, 2006;Wang, Belza, Thompson, Whitney, & Bennett, 2007). And while some aquatic exercise studies have shown improvements in balance measures, including functional reach (Simmons & Hansen, 1996), postural sway (Lord, Mitchell, & Williams, 1993;Suomi & Koceja, 2000), and step test (Devereux, Robertson, & Briffa, 2005), these studies did not have the specific aim to overload or challenge the targeted balance systems (i.e., sensory, central integrative, and motor).…”