Abstract Background Previous studies have shown that the aquatic and land-based exercise programs are effective on thoracic kypho- sis angle and scapular position. However, little is known to compare these exercises on middle-aged women with kyphosis. Purpose This study aimed to compare the impact of aquatic versus land-based core strengthening exercise programs on the thoracic kyphosis angle and scapular position in young and middle-aged women with hyperkyphosis. Methods Thirty women aged 25 to 45 years, with thoracic kyphosis angles ranging between 42 and 50 degrees, participated in an 8-week exercise program comprising either aquatic or land-based core strengthening (15 participants per group). Each group attended three supervised sessions per week, lasting 60 min per session. Thoracic kyphosis angle and scapular posi- tion was measured using an inclinometer, and a tape measure respectively. Data were analyzed utilizing repeated measures analysis of variance (ANOVA), with significance level at P ≤ 0.05. Results No significant differences were observed between aquatic and land-based core strengthening exercises regarding the thoracic kyphosis angle and scapular position (P > 0.05). However, both exercise groups exhibited significant within-group improvements in these measurements. Conclusions The findings indicate that aquatic and land-based core strengthening exercise programs contributed to decreased thoracic kyphosis angle and improved scapular position in young and middle-aged women with hyperkyphosis. These find- ings highlight the efficacy of tailored both aquatic and land-based core strengthening exercise interventions in managing hyperkyphosis, emphasizing the importance of considering these exercise modalities when designing therapeutic strategies for this specific population

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