Effectiveness of aquatic versus land physiotherapy in the treatment of peripheral neuropathies: a randomized controlled trial.
Ilaria Zivi, Sara Maffia, Vanessa Ferrari and 4 others
PMID 29232980WHAT IT FOUND
Patients with peripheral neuropathy all received daily physiotherapy, equipment training and occupational therapy.
Replacing three weekly land balance and gait sessions with water sessions did not improve static balance more, improved walking quality more, and had smaller gains in walking independence and hip flexor strength.
Key findings
01The Berg Balance Scale showed no significant between-group difference (P = 0.86), but the water group was not worse than the land group by the trial's predefined limit (P = 0.024).
02The Dynamic Gait Index improved more in the water group than in the land group (P = 0.04).
03The land group improved more than the water group on Functional Ambulation Classification (P = 0.039) and the Medical Research Council Scale for hip flexors (P = 0.013).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The trial was small, with 21 patients assigned to water and 19 to land. The land group started with worse scores on several outcomes, so the groups were not perfectly balanced at baseline. All patients received a four-week inpatient program with daily physiotherapy, equipment training and occupational therapy, so the separate effect of the water sessions cannot be isolated. The trial did not analyse results by neuropathy cause, timing or sensory deficit. There was no follow-up after discharge to test whether the differences lasted.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research, authorship or publication.
The easy way to misread this
Do not read the better Dynamic Gait Index result as proof that aquatic therapy is the better treatment overall. The main Berg Balance Scale comparison was null, the land group improved more in Functional Ambulation Classification and hip flexor strength, and all patients received a full intensive rehabilitation program.