The short-term effects of hydrotherapy on pain and self-perceived functional status in individuals living with osteoarthritis of the knee joint.

The study had no control group, so change over time, attention, or other factors cannot be separated from the hydrotherapy programme. Outcomes were measured only before and immediately after the 4-week programme, so the duration of any effect was not assessed. The sample was small and selected by convenience: 36 people were screened, 21 took part, and 18 were analysed. Three participants attended less than 50% of sessions and were excluded, and 16 of the 18 analysed participants were female. Participants who were unable to walk were excluded, so the findings do not apply to people who cannot walk. Participants could receive home exercise programmes if needed, so the effect of hydrotherapy alone cannot be isolated. Lifestyle behaviour patterns were not measured, so differences in activity outside the programme are unknown. Heated hospital hydrotherapy pools may not be available in many primary care settings. The study did not use ICF principles to evaluate participation, so societal participation outcomes were not described.

Do not conclude that hydrotherapy caused the improvement. The study had no control group, outcomes were measured only before and immediately after, and participants could also receive home exercise programmes, so the contribution of hydrotherapy alone cannot be separated.