Effect of Therapeutic Aquatic Exercise on Symptoms and Function Associated With Lower Limb Osteoarthritis: Systematic Review With Meta-Analysis (original) (raw)

Waller B, Ogonowska-Slodownik A, Vitor M, et al. Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: a systematic review with meta-analysis. Phys Ther. 2014;94:xxx-xxx.] Abstract Background: Current management of osteoarthritis (OA) focuses on pain control and maintaining physical function through pharmacological, non-pharmacological and surgical treatments. Exercise, including therapeutic aquatic exercise (TAE), is considered one of the most important management options. Nevertheless, there is no up-to-date systematic review describing the effect of TAE on symptoms and function associated with lower limb OA. Purpose: To conduct a systematic review with meta-analysis determining the effect of TAE on symptoms and function associated with lower limb OA. Data Sources: Medline, Pubmed, Embase, Cinahl, PEDro, SPORTDiscus Study selection: All randomised controlled trials with an aquatic exercise group and a nontreatment control group. In total 11 studies fulfilled the inclusion criteria and were included in the synthesis and meta-analysis. Data Extraction: Data was extracted and checked for accuracy by 3 independent reviewers. Data synthesis: Data was adjusted for baseline values and standardised mean difference (SMD), with 95% confidence intervals, was calculated for all outcomes. The meta-analysis showed significant TAE effect on pain with a SMD of 0.26 [95% CI 0.11 to 0.41], selfreported function 0.30 [0.18 to 0.43] and physical functioning 0.22 [0.07 to 0.38]. Additionally, a significant effect was seen on stiffness 0.20 [0.03 to 0.36] and quality of life 0.24 [0.04 to 0.45]. Limitations: Heterogeneity of outcome measures and small sample sizes for many of the included trials implies that conclusions based on these results should be made with caution. Conclusions: The results indicate that TAE is effective in managing symptoms associated with lower limb OA. Rehabil. 2010;91(6):833-839. 46. Juhl C, Christensen R, Roos EM, Zhang W, Lund H. Impact of exercise type and dose on pain and disability in knee osteoarthritis: A systematic review and meta-regression analysis of randomized controlled trials. Arthritis Rheumatol. 2014;66(3):622-636. 47. Kelley GA, Kelley KS, Hootman JM, Jones DL. Exercise and health-related quality of life in older community-dwelling adults: A meta-analysis of randomized controlled trials.