Document Type : Original Articles


Department of Psychology, Shahid Beheshti University, Velenjak, Tehran, Iran.


Background: The effects of aquatic exercises on strength and balance are still controversial, nevertheless an attempt has been made to investigate the effect of underwater trampoline exercise, in comparison with traditional aquatic exercise, on strength, balance, and quality of life in middle-aged women Methods: A total of 26 middle-aged women participated in this study. The participants were randomly allocated into two groups, i.e. underwater trampoline exercise (age: 44.8±10.3yr, height: 1.62±0.6 m, weight: 76.2±8.6 kg) and traditional aquatic exercise (age: 45.7±8.8yr, height: 1.58±0.5 m, weight: 71.8±8.8 kg), using a matching method. Static balance (by stork test), strength (by dynamometer), and quality of life (by SF 36 questionnaire) data were collected before and after applying an 8-week exercise regime (three sessions per week, each session of 30–45 minutes duration). Finally, the data was analyzed by repeated measures ANOVA using SPSS software (Version 21) (P<0.05). Results: The data analysis showed a significant interaction (P<0.05) in regard to higher mean value of criteria in the underwater trampoline group, however the values of hamstring strength and quality of life between the two groups were not significantly different. Conclusion: The current study showed that underwater trampoline exercises can well affect the balance and strength of the users. The underwater trampoline group showed better progress in terms of the mentioned criteria. Therefore, it can be concluded that the underwater trampoline device can create a unique aquatic environment for enhanced therapeutic treatment and musculoskeletal rehabilitation


  1. - Knopf A. Parent survey finds more than 5% of children have ADHD, with preschool prevalence increasing. The Brown University Child and Adolescent Behavior Letter. 2018; 34(3):3-4.
  2. -American Psychiatric Association. Diagnostic and statistical manual of mental 232 disorders (DSM-5®). 5th ed. American Psychiatric Pub. 2013. pp. 31-87.
  3. - Jansen D, Petry K, Ceulemans E, Noens I, Baeyens D. Functioning and participation problems of students with ASD in higher education: which reasonable accommodations are effective? European Journal of Special Needs Education. 2017; 32(1):71-88.
  4. -Muñoz-Silva A, Lago-Urbano R, Sanchez-Garcia M, Carmona-Marquez J. Child/adolescent’s ADHD and parenting stress: The mediating role of family impact and conduct problems. Frontiers in psychology. 2017; 22(8):22-52.
  5. - Halperin JM, Schulz KP. Revisiting the role of the prefrontal cortex in the pathophysiology of attention deficit hyperactivity disorder. Psychological bulletin. 2006; 132(4):560-581.
  6. - Schoemaker K, Bunte T, Wiebe SA, Espy KA, Deković M, Matthys W. Executive function deficits in preschool children with ADHD and DBD. Journal of Child Psychology and Psychiatry. 2012; 53(2):111-119.
  7. - Barkley RA. Taking charge of ADHD: The complete, authoritative guide for parents. 1st ed. Guilford Press; 2013. pp. 50-67.
  8. - Samuel R. Cognitive rehabilitation for reversible and progressive brain injury. Indian journal of psychiatry. 2008; 50(4):282-284.
  9. -Sohlberg MM, Mateer CA. Cognitive rehabilitation: An integrative neuropsychological approach. 2nd ed. Guilford Publications; 2001. pp. 194-220.
  10. - Evans SW, Owens JS, Bunford N. Evidence-based psychosocial treatments for children and adolescents with attention-deficit.hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology. 2014; 43(4):527-551.
  11. - Belsky J, Pasco Fearon RM, Bell B. Parenting, attention and externalizing problems: Testing mediation longitudinally, repeatedly and reciprocally. Journal of Child Psychology and Psychiatry. 2007; 48(12):1233-1242.
  12. - Shuai L, Daley D, Wang YF, Zhang JS, Kong YT, Tan X, Ji N. Executive function training for children with attention deficit hyperactivity disorder. Chinese medical journal. 2017; 130(5):549-559.
  13. - Traverso L, Viterbori P, Usai MC. Improving executive function in childhood: evaluation of a training intervention for 5-year-old children. Frontiers in psychology. 2015; 30(6):525-539.
  14. - Tamm L, Nakonezny PA. Metacognitive executive function training for young children with ADHD: A proof-of-concept study. ADHD Attention Deficit and Hyperactivity Disorders. 2015; 7(3):183-190.
  15. - Greenaway MC, Duncan NL, Smith GE. The memory support system for mild cognitive impairment: randomized trial of a cognitive rehabilitation intervention. International journal of geriatric psychiatry. 2013; 28(4):402-409.
  16. - Canela C, Buadze A, Dube A, Eich D, Liebrenz M. Skills and compensation strategies in adult ADHD–A qualitative study. PloS one. 2017; 12(9):e0184964.
  17. - Söderlund GB, Sikström S, Loftesnes JM, Sonuga-Barke EJ. The effects of background white noise on memory performance in inattentive school children. Behavioral and brain functions. 2010; 6(1):55-65.
  18. - Bikic A, Reichow B, McCauley SA, Ibrahim K, Sukhodolsky DG. Meta-analysis of organizational skills interventions for children and adolescents with Attention-Deficit.Hyperactivity Disorder. Clinical psychology review. 2017; 52:108-23.
  19. - Wennberg B, Janeslätt G, Kjellberg A, Gustafsson PA. Effectiveness of time-related interventions in children with ADHD aged 9–15 years: a randomized controlled study. European child & adolescent psychiatry. 2018; 27(3):329-342.
  20. - Gormley MJ, Pinho T, Pollack B, Puzino K, Franklin MK, Busch C, DuPaul GJ, Weyandt LL, Anastopoulos AD. Impact of study skills and parent education on first-year GPA among college students with and without ADHD: A moderated mediation model. Journal of attention disorders. 2018; 22(4): 334-348.
  21. - Reis SM, McGuire JM, Neu TW. Compensation strategies used by high-ability students with learning disabilities who succeed in college. Gifted Child Quarterly. 2000; 44(2):123-134.
  22. -Mundkur N. Neuroplasticity in children. The Indian Journal of Pediatrics. 2005; 72(10): 855-867.
  23. -Evans WN, Morrill MS, Parente ST. Measuring inappropriate medical diagnosis and treatment in survey data: The case of ADHD among school-age children. Journal of health economics. 2010; 29(5):657-73.
  24. - Gerstadt CL, Hong YJ, Diamond A. The relationship between cognition and action: performance of children 3–7 years old on a Stroop-like day-night test. Cognition. 1994; 53(2):129-153.
  25. - Archibald SJ, Kerns KA. Identification and description of new tests of executive functioning in children. Child Neuropsychology. 1999; 5(2):115-129.
  26. - Malmir M, Seifenaraghi M, Farhud DD, Afrooz GA, Khanahmadi M. Mother’s Happiness with Cognitive-Executive Functions and Facial Emotional Recognition in School Children with Down Syndrome. Iranian journal of public health. 2015; 44(5):646.
  27. - Buschke H. Relative retention in immediate memory determined by the missing scan method. Nature. 1963; 200(4911):1129.
  28. - Roman AS, Pisoni DB, Kronenberger WG. Assessment of working memory capacity in preschool children using the missing scan task. Infant and child development. 2014; 23(6):575-87..
  29. - Conners CK. Conners’ Kiddie Continuous Performance Test—Version 5. North Tonawanda, NY: Multi-Health Systems Inc. 2006.
  30. - Hadianfard H, Najarian B, Shokrkon H and Mehrabizadeh Honarmand M. Making the Persian form of the continuous performance test. Psychology J. 2000; 4(2):440-338.
  31. - Espy KA, Cwik MF. The development of a trial making test in young children: the TRAILS-P. The Clinical Neuropsychologist. 2004; 18(3):411-422.
  32. -Nejati V, Maghsudloo M. Management of attention deficit hyperactivity disorder by compensatory cognitive rehabilitation. 1st ed. Roshde Farhang Pub. 2017. pp. 52-88.
  33. - Re AM, Capodieci A, Cornoldi C. Effect of training focused on executive functions (attention, inhibition, and working memory) in preschoolers exhibiting ADHD symptoms. Frontiers in psychology. 2015; 6(6):1161-1170.
  34. - Halperin JM, Marks DJ, Bedard AC, Chacko A, Curchack JT, Yoon CA, Healey DM. Training executive, attention, and motor skills: a proof-of-concept study in preschool children with ADHD. Journal of attention disorders. 2013; 17(8):711-721.
  35. -Schaffer G. Practice Brief: Assessing Compensatory Strategies and Motivational Factors in High-Achieving Postsecondary Students with Attention Deficit/Hyperactivity Disorder. Journal of Postsecondary Education and Disability. 2013; 26(1):89-94.
  36. - Chacko A, Kofler M, Jarrett M. Improving outcomes for youth with ADHD: A conceptual framework for combined neurocognitive and skill-based treatment approaches. Clinical Child and Family Psychology Review. 2014; 17(4):368-84.
  37. -Volckaert AM, Noël MP. Training executive function in preschoolers reduce 307 externalizing behaviors. Trends in Neuroscience and Education. 2015; 4(1-2):37-47.
  38. - Merkt J, Reinelt T, Petermann F. A framework of psychological compensation in attention deficit hyperactivity disorder. Frontiers in psychology. 2015; 28(6):1580-1585.