Eversden (2007) A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis

Introduction to Hydrotherapy and Land Exercises

Hydrotherapy, or exercise in warm water, is often appreciated by individuals with rheumatoid arthritis (RA), yet its comparative benefits against land exercises remain underexplored, especially concerning quality of life. This study evaluates the effects of hydrotherapy versus land exercises on patients with RA, focusing on overall treatment response, physical function, and quality of life.

Study Design and Methodology

A pragmatic randomized controlled trial was conducted with 115 RA patients, who were allocated to either a 6-week hydrotherapy session or land exercises, each lasting 30 minutes weekly. The primary outcome was patients’ self-rated global impression of change post-treatment, while secondary outcomes included physical function, quality of life measures, and pain scores, assessed at baseline, post-treatment, and 3 months later.

Results: Hydrotherapy’s Superiority in Patient Perception

Significantly, more patients in the hydrotherapy group felt much better or very much better compared to the land exercise group immediately after completing the treatment program. However, no significant differences were observed between the two groups in terms of walk times, functional scores, quality of life measures, and pain scores.

Discussion on Hydrotherapy’s Benefits

The study underscores hydrotherapy as a more favorable option for RA patients in terms of perceived improvement. Despite the lack of significant differences in functional and quality of life measures between the two groups, the strong patient preference for hydrotherapy suggests its potential benefits in enhancing patient well-being, beyond what is captured by traditional outcome measures.

Conclusion: Advocating for Hydrotherapy in RA Management

Hydrotherapy appears to offer a notable advantage in terms of patient satisfaction and perceived improvement over land exercises for individuals with RA. This finding calls for a reevaluation of hydrotherapy’s place in RA treatment protocols, considering patient preference and perceived well-being alongside traditional clinical outcomes.

Keywords: Hydrotherapy, land exercises, rheumatoid arthritis, quality of life, patient well-being, physical function.