Hydrotherapy improves pain and function in older women with knee osteoarthritis: a randomized controlled trial.
João Marcos Dias, Lígia Cisneros, Rosângela Dias and 5 others
PMID 28733093WHAT IT FOUND
Older women with knee osteoarthritis who added six weeks of hydrotherapy to education had less pain and better function than education alone.
The benefit was short-term and compared with education only, not land-based exercise.
Key findings
01Compared with education alone, hydrotherapy plus education gave less knee pain at six weeks, with an adjusted difference of 11 points on a 0-100 WOMAC pain scale.
02Function also improved more with hydrotherapy, with an adjusted difference of 12 points on a 0-100 WOMAC physical function scale.
03Secondary muscle outcomes showed significant between-group differences favouring hydrotherapy for knee flexor strength (4.9%), knee extensor strength (7.3%), knee flexor power (5.0 W), and knee extensor resistance (4.8%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Outcomes were assessed only at six weeks, so the trial does not show whether pain and function gains last. Participants were older women with knee OA who could enter and exit the pool, had no walking aid, had no recent lower-limb trauma, and did not have severe radiological knee OA, so results do not apply to men, younger adults, people with walking aids, or more severe knee OA. Four participants from each group dropped out and were not followed up, so the analysis included 33 hydrotherapy and 32 education-only participants rather than all 73 randomised women. The control group received education only, not land-based exercise, so the trial cannot show hydrotherapy is better than other exercise formats. The authors note that the improvements may be small relative to the cost of hydrotherapy setup.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that hydrotherapy is better than land-based exercise or that the benefit is long-term. This trial compared hydrotherapy plus education with education only, and outcomes were measured at six weeks.