Ma (2022) Overall treatment effects of aquatic physical therapy in knee osteoarthritis a systematic review and meta-analysis

Introduction:

This reseach is about the effectiveness of Aquatic Physical Therapy in Knee Osteoarthritis. Osteoarthritis (OA), particularly in the knee, is a prevalent form of arthritis causing disability and burdening healthcare resources. Exercise, including aquatic physical therapy, has been identified as an effective non-pharmacological intervention to alleviate pain and improve physical function in OA patients.

Aquatic Physical Therapy Advantages

Aquatic physical therapy, leveraging water’s buoyancy and warmth, reduces joint load, promotes blood circulation, and leads to better compliance compared to other treatments. Its application extends across various diseases, including OA, rheumatic disease, fibromyalgia, stroke, and Parkinson’s disease.

Study Objective

This systematic review and meta-analysis aimed to evaluate the overall treatment effects of aquatic physical therapy on knee OA. It involved a thorough analysis of randomized controlled trials (RCTs), assessing the quality of included studies based on Cochrane Collaboration Handbook recommendations.

Methodology

The review included 13 studies with 883 participants, focusing on pain, joint symptoms, physical function, quality of life (QOL), flexibility, muscle strength, walking ability, and body composition.

Results

Pain: Significant improvement in pain was observed, as indicated by changes in the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain and Visual Analog Scale (VAS) scores.
Joint Symptoms: No significant relief in joint symptoms (WOMAC stiffness and Knee Injury and Osteoarthritis Outcome Score (KOOS) symptoms) was observed.
Physical Function: Improvement in WOMAC physical function was noted, but not in KOOS activities of daily living (ADL) and sport/recreation or SF-36 physical function.
Quality of Life: There was no significant improvement in QOL.
Flexibility: No significant differences in joint range of motion (ROM) of knee extension and flexion were found.
Muscle Strength: Aquatic therapy improved knee extension muscle strength but showed no significant effect on knee flexion and hip abduction muscle strength.
Walking Ability: Improvement in Timed-Up-and-Go Test (TUGT) was observed, but not in the 6-minute walk test (6MWT), walking speed, or step test.
Body Composition: No significant differences in body mass index (BMI) and fat mass were found.

Conclusion Effectiveness of Aquatic Physical Therapy in Knee Osteoarthritis:

Aquatic physical therapy is effective in alleviating pain and improving physical function, knee extension muscle strength, and walking ability in knee OA patients. It is a viable treatment option, particularly for those with severe symptoms, and should be considered for rehabilitation programs. Future studies should focus on optimizing program content and maximizing water properties to enhance benefits for knee OA patients.