Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2011

Open Access 01-12-2011 | Research article

Systematic review and meta-analysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes

Authors: Stephanie I Batterham, Sophie Heywood, Jennifer L Keating

Published in: BMC Musculoskeletal Disorders | Issue 1/2011

Login to get access

Abstract

Background

Aquatic and land based exercise are frequently prescribed to maintain function for people with arthritis. The relative efficacy of these rehabilitation strategies for this population has not been established.
This review investigated the effects of aquatic compared to land based exercise on function, mobility or participants' perception of programs for people with arthritis.

Methods

Medline, CINAHL, AMED and the Cochrane Central Register of Controlled Clinical Trials were searched up to July 2010. Ten randomised, controlled clinical trials that compared land to aquatic exercise for adults with arthritis were included. Study quality was assessed with the PEDro scale. Data relevant to the review question were systematically extracted by two independent reviewers. Standardised mean differences between groups for key outcomes were calculated. Meta-analyses were performed for function, mobility and indices that pooled health outcomes across multiple domains.

Results

No differences in outcomes were observed for the two rehabilitation strategies in meta-analysis. There was considerable variability between trials in key program characteristics including prescribed exercises and design quality. Components of exercise programs were poorly reported by the majority of trials. No research was found that examined participant preferences for aquatic compared to land based exercise, identifying this as an area for further research.

Conclusion

Outcomes following aquatic exercise for adults with arthritis appear comparable to land based exercise. When people are unable to exercise on land, or find land based exercise difficult, aquatic programs provide an enabling alternative strategy.
Appendix
Available only for authorised users
Literature
1.
go back to reference Foley A, Halbert J, Hewitt T, Crotty M: Does hydrotherapy improve strength and physical function in patients with osteoarthritis--a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme. Annals of the rheumatic diseases. 2003, 62: 1162-1167. 10.1136/ard.2002.005272.CrossRefPubMedPubMedCentral Foley A, Halbert J, Hewitt T, Crotty M: Does hydrotherapy improve strength and physical function in patients with osteoarthritis--a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme. Annals of the rheumatic diseases. 2003, 62: 1162-1167. 10.1136/ard.2002.005272.CrossRefPubMedPubMedCentral
2.
go back to reference Silva LE, Valim V, Pessanha APC, Oliveira LM, Myamoto S, Jones A, Natour J: Hydrotherapy versus conventional land-based exercise for the management of patients with osteoarthritis of the knee: a randomized clinical trial. Physical Therapy. 2008, 88: 12-21. 10.2522/ptj.20060040.CrossRefPubMed Silva LE, Valim V, Pessanha APC, Oliveira LM, Myamoto S, Jones A, Natour J: Hydrotherapy versus conventional land-based exercise for the management of patients with osteoarthritis of the knee: a randomized clinical trial. Physical Therapy. 2008, 88: 12-21. 10.2522/ptj.20060040.CrossRefPubMed
3.
go back to reference Campion MR: Hydrotherapy: principles and practice. 1997, Oxford: Butterworth-Heinemann Campion MR: Hydrotherapy: principles and practice. 1997, Oxford: Butterworth-Heinemann
4.
go back to reference Harrison R, Bulstrode S: Percentage weight-bearing during partial immersion. Physiotherapy Practical. 1987, 3: 60-63. 10.3109/09593988709087741.CrossRef Harrison R, Bulstrode S: Percentage weight-bearing during partial immersion. Physiotherapy Practical. 1987, 3: 60-63. 10.3109/09593988709087741.CrossRef
6.
go back to reference Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M: OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis & Cartilage. 2008, 16: 137-162. 10.1016/j.joca.2007.12.013.CrossRef Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M: OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis & Cartilage. 2008, 16: 137-162. 10.1016/j.joca.2007.12.013.CrossRef
7.
go back to reference Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J: Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes. Arthritis & Rheumatism: Arthritis Care & Research. 2007, 57: 407-414.CrossRef Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J: Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes. Arthritis & Rheumatism: Arthritis Care & Research. 2007, 57: 407-414.CrossRef
8.
go back to reference Geytenbeek J: Evidence for effective hydrotherapy. Physiotherapy. 2002, 88: 514-529. 10.1016/S0031-9406(05)60134-4.CrossRef Geytenbeek J: Evidence for effective hydrotherapy. Physiotherapy. 2002, 88: 514-529. 10.1016/S0031-9406(05)60134-4.CrossRef
9.
go back to reference Bartels EM, Lund H, Hagen KB, Dagfinrud H, Christensen R, Danneskiold-Samsoe B: Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database of Systematic Reviews. 2009 Bartels EM, Lund H, Hagen KB, Dagfinrud H, Christensen R, Danneskiold-Samsoe B: Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database of Systematic Reviews. 2009
10.
go back to reference Thomas A, Eichenberger G, Kempton C, Pape D, York S, Decker AM, Kohia M: Recommendations for the treatment of knee osteoarthritis, using various therapy techniques, based on categorizations of a literature review. Journal of Geriatric Physical Therapy. 2009, 32: 33-38. 10.1519/00139143-200932010-00007.CrossRefPubMed Thomas A, Eichenberger G, Kempton C, Pape D, York S, Decker AM, Kohia M: Recommendations for the treatment of knee osteoarthritis, using various therapy techniques, based on categorizations of a literature review. Journal of Geriatric Physical Therapy. 2009, 32: 33-38. 10.1519/00139143-200932010-00007.CrossRefPubMed
11.
go back to reference Callahan LF: Physical activity programs for chronic arthritis. Current Opinion in Rheumatology. 2009, 21: 177-182. 10.1097/BOR.0b013e328324f8a8.CrossRefPubMed Callahan LF: Physical activity programs for chronic arthritis. Current Opinion in Rheumatology. 2009, 21: 177-182. 10.1097/BOR.0b013e328324f8a8.CrossRefPubMed
12.
go back to reference de Morton NA: The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Australian Journal of Physiotherapy. 2009, 55: 129-133. 10.1016/S0004-9514(09)70043-1.CrossRefPubMed de Morton NA: The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Australian Journal of Physiotherapy. 2009, 55: 129-133. 10.1016/S0004-9514(09)70043-1.CrossRefPubMed
13.
go back to reference Macedo LG, Elkins MR, Maher CG, Moseley AM, Herbert RD, Sherrington C: There was evidence of convergent and construct validity of Physiotherapy Evidence Database quality scale for physiotherapy trials. Journal of Clinical Epidemiology. 2010, 63: 920-925. 10.1016/j.jclinepi.2009.10.005.CrossRefPubMed Macedo LG, Elkins MR, Maher CG, Moseley AM, Herbert RD, Sherrington C: There was evidence of convergent and construct validity of Physiotherapy Evidence Database quality scale for physiotherapy trials. Journal of Clinical Epidemiology. 2010, 63: 920-925. 10.1016/j.jclinepi.2009.10.005.CrossRefPubMed
14.
go back to reference Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M: Reliability of the PEDro scale for rating quality of randomized controlled trials. Physical Therapy. 2003, 83: 713-721.PubMed Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M: Reliability of the PEDro scale for rating quality of randomized controlled trials. Physical Therapy. 2003, 83: 713-721.PubMed
16.
go back to reference Sadana R, Tandon A, Serdobova I, Cao Y, Xie WJ, Chatterji S, Ustün BL: Describing Population Health in six Domains: comparable results from 66 household surveys. 2002, Geneva, Switzerland: World Health Organization Sadana R, Tandon A, Serdobova I, Cao Y, Xie WJ, Chatterji S, Ustün BL: Describing Population Health in six Domains: comparable results from 66 household surveys. 2002, Geneva, Switzerland: World Health Organization
17.
go back to reference Hedges LV, Olkin I: Statistical Methods for Meta-Analysis. 1985, Orlando: Academic Press, Inc Hedges LV, Olkin I: Statistical Methods for Meta-Analysis. 1985, Orlando: Academic Press, Inc
18.
go back to reference Cohen J: Statistical power analysis for the behavioral health sciences. 1988, Hillsdale, New Jersey: Lawrence Erlbaum Associates, Inc, 2 Cohen J: Statistical power analysis for the behavioral health sciences. 1988, Hillsdale, New Jersey: Lawrence Erlbaum Associates, Inc, 2
19.
go back to reference The Cochrane Collaboration: Review Manager (RevMan). 2008, Copenhagen: The Nordic Cochrane Centre, 5.0 The Cochrane Collaboration: Review Manager (RevMan). 2008, Copenhagen: The Nordic Cochrane Centre, 5.0
21.
go back to reference Hall J, Skevington SM, Maddison PJ, Chapman K: A randomized and controlled trial of hydrotherapy in rheumatoid arthritis. Arthritis Care & Research. 1996, 9: 206-215. 10.1002/1529-0131(199606)9:3<206::AID-ANR1790090309>3.0.CO;2-J.CrossRef Hall J, Skevington SM, Maddison PJ, Chapman K: A randomized and controlled trial of hydrotherapy in rheumatoid arthritis. Arthritis Care & Research. 1996, 9: 206-215. 10.1002/1529-0131(199606)9:3<206::AID-ANR1790090309>3.0.CO;2-J.CrossRef
22.
go back to reference Suomi R, Collier D: Effects of arthritis exercise programs on functional fitness and perceived activities of daily living measures in older adults with arthritis. Archives of physical medicine and rehabilitation. 2003, 84: 1589-1594. 10.1053/S0003-9993(03)00278-8.CrossRefPubMed Suomi R, Collier D: Effects of arthritis exercise programs on functional fitness and perceived activities of daily living measures in older adults with arthritis. Archives of physical medicine and rehabilitation. 2003, 84: 1589-1594. 10.1053/S0003-9993(03)00278-8.CrossRefPubMed
23.
go back to reference Eversden L, Maggs F, Nightingale P, Jobanputra P: A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis. BMC Musculoskeletal Disorders. 2007, 8: Eversden L, Maggs F, Nightingale P, Jobanputra P: A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis. BMC Musculoskeletal Disorders. 2007, 8:
24.
go back to reference Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW: Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. Journal of Rheumatology. 1988, 15: 1833-1840.PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW: Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. Journal of Rheumatology. 1988, 15: 1833-1840.PubMed
25.
go back to reference Gill SD, McBurney H, Schulz DL: Land-based versus pool-based exercise for people awaiting joint replacement surgery of the hip or knee: results of a randomized controlled trial. Archives of Physical Medicine & Rehabilitation. 2009, 90: 388-394. 10.1016/j.apmr.2008.09.561.CrossRef Gill SD, McBurney H, Schulz DL: Land-based versus pool-based exercise for people awaiting joint replacement surgery of the hip or knee: results of a randomized controlled trial. Archives of Physical Medicine & Rehabilitation. 2009, 90: 388-394. 10.1016/j.apmr.2008.09.561.CrossRef
27.
go back to reference Lund H, Weile U, Christensen R, Rostock B, Downey A, Bartels E, Danneskiold-Samsoe B, Bliddal H: A Randomized Controlled Trial of Aquatic and Land-Based Exercise in Patients with Knee Osteoarthritis. Journal of Rehabilitation Medicine. 2008, 40: 137-144. 10.2340/16501977-0134.CrossRefPubMed Lund H, Weile U, Christensen R, Rostock B, Downey A, Bartels E, Danneskiold-Samsoe B, Bliddal H: A Randomized Controlled Trial of Aquatic and Land-Based Exercise in Patients with Knee Osteoarthritis. Journal of Rehabilitation Medicine. 2008, 40: 137-144. 10.2340/16501977-0134.CrossRefPubMed
30.
go back to reference Wyatt FB, Milam S, Manske RC, Deere R: The effects of aquatic and traditional exercise programs on persons with knee osteoarthritis. Journal of Strength and Conditioning Research. 2001, 15: 337-340.PubMed Wyatt FB, Milam S, Manske RC, Deere R: The effects of aquatic and traditional exercise programs on persons with knee osteoarthritis. Journal of Strength and Conditioning Research. 2001, 15: 337-340.PubMed
31.
go back to reference Smith SS, Mackay-Lyons M, Nunes-Clement S: Therapeutic benefit of aquaerobics for individuals with rheumatoid arthritis. Physiotherapy Canada. 1998, 50: 40-46. Smith SS, Mackay-Lyons M, Nunes-Clement S: Therapeutic benefit of aquaerobics for individuals with rheumatoid arthritis. Physiotherapy Canada. 1998, 50: 40-46.
Metadata
Title
Systematic review and meta-analysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes
Authors
Stephanie I Batterham
Sophie Heywood
Jennifer L Keating
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2011
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-12-123

Other articles of this Issue 1/2011

BMC Musculoskeletal Disorders 1/2011 Go to the issue