Safety and Feasibility of Early Aquatic Physical Therapy for Military Survivors of Gunshot Wounds and Blast Injuries: A Case Series.

Only 3 patients were reported, and all were male military personnel injured in one mass casualty incident. There was no control group, so the results cannot show that early aquatic physical therapy caused the functional gains. Patients also received acute multidisciplinary care, land-based rehabilitation, and supervised aquatic therapy, so the contribution of the aquatic component cannot be separated. The authors noted small sample size and potential confirmation bias. No adverse events in 3 patients does not establish safety for other populations, because patients with systemic infection, dermatologic conditions, infected wounds, or pleural drains were excluded. The pools were inside a rehabilitation hospital with physiotherapists, hydrotherapists, and lifeguards nearby, so feasibility may not transfer to settings without that support.

The investigators reported no financial or nonfinancial disclosures.

Do not conclude that early aquatic physical therapy alone caused the improvements or is safe for all patients. The report has only 3 patients, all received acute multidisciplinary care and land-based rehabilitation, and the authors noted small sample size and potential confirmation bias.