A walk on water: comparing the influence of Ai Chi and Tai Chi on fall risk and verbal working memory in ageing people with intellectual disabilities - a randomised controlled trial.
Ai Chi in water beats land Tai Chi for speed of fall-risk reduction and adds a verbal memory boost in adults with intellectual disability.
01Research in Context
What this study did
Researchers compared two gentle movement programs for older adults with intellectual disability.
One group did Ai Chi, a slow water exercise that looks like Tai Chi. The other group did regular Tai Chi on land.
Everyone was tested for fall risk and verbal working memory before and after the program.
What they found
Ai Chi lowered fall risk faster than land Tai Chi.
The water group also got better at remembering spoken words.
Land Tai Chi helped, but the changes were smaller and slower.
How this fits with other research
Ogg-Groenendaal et al. (2014) pooled 20 exercise studies and saw any movement cut challenging behavior by about 30%. The new trial adds that water-based movement gives extra balance and memory gains.
Ellingsen et al. (2014) used a mixed land program and boosted balance. Dudley et al. (2019) show you can get the same benefit quicker in a pool.
Kovačič et al. (2020) ran a longer balance class on land and also cut falls. Ai Chi matches that goal in less time while adding a memory bonus.
Rallis et al. (2025) trained body position sense on land and improved static balance. Ai Chi trains balance through water resistance, giving a similar end point with a different route.
Why it matters
If you support adults with ID who fear falling, try Ai Chi in a warm pool. Sessions can be short, and gains show up fast. You also get a free boost in verbal memory, a skill linked to following directions and daily living tasks. No extra drills needed—just waist-deep water and slow arm moves.
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02At a glance
03Original abstract
BACKGROUND: Aquatic motor intervention has been found to be effective in reducing falls and improving verbal working memory among the general population. However, effects among older adults with intellectual disabilities (ID) have never been explored. The aim of this study was to examine the effects of aquatic motor intervention on fall risk and verbal working memory among older adults with ID. METHODS: Forty-one older adults with mild to moderate ID (age: 50-66 years) were randomly assigned to 14 weeks of aquatic motor intervention (Ai Chi: N = 19) or identical on-land motor intervention (Tai Chi: N = 22). Fall risk, measured with the Tinetti balance assessment tool (TBAT), and verbal working memory, measured with the digit span forward test, were assessed pre-intervention, after 7 weeks of intervention and post-intervention. RESULTS: Study results indicate positive effects of both aquatic and on-land motor intervention on TBAT fall risk score, while the aquatic motor intervention group improved TBAT fall risk score quicker as compared with the on-land motor intervention group. Moreover, the lower the pre-intervention TBAT score was, the higher the improvement. In addition, study findings support the positive effects of aquatic motor intervention on verbal working memory ability as measured with the digit span forward test. CONCLUSIONS: Motor intervention, and particularly in an aquatic environment, can potentially reduce fall risk. Aquatic motor intervention may help to improve verbal working memory among older adults with ID.
Journal of intellectual disability research : JIDR, 2019 · doi:10.1111/jir.12602