This systematic review examined papers published in Korean, English and newer publications that were not included in previous studies to assess the effect size of aquatic exercise-based interventions on pain, quality of life and joint dysfunction among patients with osteoarthritis. Six national and international databases were used to review literature (published up to 7 March 2019) on randomized controlled trials of aquatic exercise-based interventions in patients with osteoarthritis. For the 20 studies included, a meta-analysis showed that aquatic exercise produces 0.61-point reduction (n = 756; mean difference (MD) = − 0.61; 95% confidence interval (CI): − 0.90– − 0.32) in pain compared with a control group, and aquatic exercise was effective in reducing pain (n = 315; MD = − 0.28 ; 95% CI: − 0.50– − 0.05) compared with a land-based exercise group. Another meta analysis showed that aquatic exercise produces 0.77-point improvement in quality of life (n = 279; MD = − 0.77; 95% CI: − 1.38– − 0.15) compared with a control group. Finally, a meta-analysis showed that aquatic exercise produces 0.34-point reduction in joint dysfunction (n = 279; MD = − 0.77; 95% CI: − 1.38– − 0.15) compared with a control group. For patients with osteoarthritis, aquatic-exercise-based interventions are effective for reducing pain and joint dysfunction and improving quality of life.
This study systemically investigated, through assessment of RCTs, the effects of aquatic exercise on pain, quality of life and dysfunction in patients with osteoarthritis. As a result, aquatic exercise was found to alleviate pain, increase quality of life and reduce dysfunction in such patients. However, as the optimal program duration, session frequency and session duration for aquatic exercise have not yet been determined , future studies that analyze these effects are necessary. Furthermore, measures to overcome the space-, time- and cost-related limitations associated with aquatic exercise must be sought.
Keywords: osteoarthritis; hydrotherapy; exercise therapy; systematic review