Aquatic exercise for the treatment of knee and hip osteoarthritis

Bartels EM, et al. · Cochrane Database of Systematic Reviews

13 trials, 1,190 participants, 75% female, mean age 68, mean programme 12 weeks. Moderate-quality evidence of small short-term benefits immediately after treatment: pain SMD -0.31 (95% CI -0.47 to -0.15; 12 trials, 1,076 participants) and disability SMD -0.32 (95% CI -0.47 to -0.17; 12 trials, 1,059), each equivalent to a 5-point lower score (95% CI 3 to 8) on a 0-100 scale, and quality of life SMD -0.25 (95% CI -0.49 to -0.01; 10 trials, 971), about 7 points (95% CI 0 to 13). No serious adverse event related to aquatic exercise was reported.

Population

13 RCTs, 1,190 participants with knee/hip OA

Intervention

Aquatic (pool-based) exercise

Comparator

Usual care / no exercise

Limitations

Small effect sizes and short follow-up. Twelve of the trials were at low or unclear risk of bias on every domain except blinding of participants and personnel, which an aquatic programme cannot achieve. No included trial performed a radiographic evaluation, so the review says nothing about joint structure.