Patients with arthritis of the hip or knee
seem to benefit from water-based exercise

Only way to treat condition is to alleviate patients’ symptoms
Osteoarthritis is a long-term, or chronic disease that affects the cartilage of certain joints. There is protective cartilage that normally covers healthy joints and prevents bones from rubbing against one another, but in osteoarthritis, this cartilage gradually wears away. When this occurs, bones eventually start grinding against each other, which causes pain, stiffness, tenderness and loss of movement. Osteoarthritis can occur in any joint of the body, but it’s most common in the hips and knees. There is currently no cure for osteoarthritis, so the only way to treat it is to find ways to reduce symptoms and prevent it from getting worse. Many treatment options are available to manage patients with hip or knee osteoarthritis, some of which are more effective than others. One treatment used by some is called aquatic exercise, in which patients perform a series of exercises while being immersed in water that’s between 90-97°F. The hot water is believed to reduce pain and stiffness, and performing exercises underwater puts less impact on joints. Aquatic exercise may therefore be more beneficial than land-based exercises for these patients. To investigate this matter, a high-quality study called a Cochrane review was conducted on aquatic exercise for hip and knee osteoarthritis. Cochrane reviews look over all the available evidence on a topic, and are considered to be the highest standard when it comes to recommendations based on research.

Five databases searched for high-quality studies
To gather data for the review, researchers searched through five major medical databases for studies on aquatic exercise for hip or knee osteoarthritis. They only accepted randomized-controlled trials (RCTs), which are very powerful individual studies in which patients are randomly assigned to different treatment groups. This search led to a total of 13 RCTs being accepted for the Cochrane review. These 13 RCTs contained data on 1,190 patients who had either hip or knee osteoarthritis—or both—and were either treated with aquatic exercise or not treated at all. After being collected, these 13 RCTs were analyzed in detail to determine what type of effect aquatic exercise had on patients.

Aquatic exercise leads to better quality of life and less pain and disability
After analyzing these RCTs, researchers found that patients who went through a course of aquatic exercise experienced greater improvements than those who did not receive any treatment. This was based on the fact that in general, patients in aquatic exercise groups reported less pain, less disability and a greater quality of life after completing of their treatment than patients in the groups that were not treated. Researchers also rated the quality of the studies used in this review, and overall, the evidence was considered to be of moderate quality. Based on these findings, it seems that aquatic exercise can produce noteworthy benefits in patients with hip or knee osteoarthritis. This may be due to the soothing effect of the warm water and the fact that less stress is placed on joints during these exercises. Aquatic exercise should therefore be considered a safe and effective treatment for hip and knee osteoarthritis, but research in the future should continue to look into this treatment with larger studies to learn more about it.

-Summarized by Greg Gargiulo.

-As reported in the March ’16 issue of the Cochrane Database of Systematic Reviews