EFFECTS OF AQUATIC EXERCISES IN PATIENTS UNDERGOING TOTAL KNEE OR HIP ARTHROPLASTY: A SYSTEMATIC REVIEW

M. Fahmy^1,2, A. Abdelhamed^1,2, A. Elaraby³, A. Elfeky³, M. Shahien³

¹Misr University for Science and Technology, Physical Therapy, Giza, Egypt, ²Misr University for Science and Technology, Student Research Unit, Giza, Egypt, ³Cairo University, Physical Therapy, Cairo, Egypt

Background: Hip or knee replacements are common surgeries conducted regularly to old people who have a higher risk of loss of balance. While hydrotherapy is considered one of the safest and most effective interventions in many orthopedic injuries, the existing evidence regarding its value after hip or knee replacement is still conflicting. Therefore, this study aims to systemically review previous studies evaluating the effect of hydrotherapy in the rehabilitation of orthopedic patients after knee or hip replacement.

Purpose: To the best of the authors' knowledge, the effectiveness of hydrotherapy for patients undergoing total knee or hip arthroplasty is unclear. Therefore, it is now required to do a systematic review to examine all the evidence and clarify the effects of hydrotherapy on WOMAC and ROM. the results of this study could influence clinical decision-making on arthroplasty treatment.

Methods: We searched six online databases: PubMed, Web of Science (WOS), Scopus, the Physiotherapy Evidence Database (PEDro), Virtual health library (VHL), and Cochrane Central Register of Controlled Trials (CENTRAL). We performed an eligibility screening against our inclusion criteria and included 4 randomized clinical trials. Data from these articles were extracted and reviewed.

Results: Four RCTs were included in this study. Our results showed that regarding WOMAC scores, two studies reported no significant difference for the aquatic exercise compared to the control group, and the third study showed no significant difference between both groups. While the last study concluded that concerning knee flexion ROM, the integrated group which combined land and aquatic exercises showed significant improvement compared to the control group.

Conclusions: Hydrotherapy could be used to improve the knee flexion ROM after total knee replacement. However, its efficacy on the WOMAC scores is contradictory.

Implications: Future investigations of hydrotherapy in managing hip or knee replacement patients must focus on refining the design of the clinical trial including a larger sample size.

Funding acknowledgements: The work was unfunded.

Keywords:
hip arthroplasty
aquatic exercises
knee arthroplasty

Topics:
Musculoskeletal: lower limb
Orthopaedics
Older people

Did this work require ethics approval? No

Reason: The proposed abstract is for a systematic review, which is secondary research. Moreover, there was no direct patient-therapist contact or any interventional or experimental research. Which requires no ethical approval.