File
Pianna B.1, Fonseca A.C.1, Alcalde G.E.1, Bôscoa T.F.1, Gonçalves M.R.1, Arca E.A.1
1Universidade do Sagrado Coração (USC), Pró-Reitoria de Pesquisa e Pós-Graduação, Bauru, Brazil
Background: Aquatic physical therapy and exercise training on the ground are forms of effective treatments in reducing pain, improving functional capacity and quality of life in older people with knee osteoarthritis (KO). However, the literature presents diverse protocols exercises, diverse intervention times and different water temperatures. Therefore, the standardization of protocols is relevant to application in clinical practice.
Purpose: The aim of the study was to verify the influence of aquatic physical therapy and land-based exercises on chronic pain, joint stiffness, physical function, dynamic balance, flexibility and quality of life in older people with KO.
Methods: 27 volunteers completed this controlled randomized study. Older people of both sexes and with a diagnosis of KO were included. The subjects were randomly assigned into 3 groups: AG (aquatic group; N = 11); DLG (dry land group; N = 8) and CG (control group; N = 8). Then they completed 12-week intervention programs that consisted of aerobic and functional exercises in circuits lasting 40 minutes each, 3 days a week. The sit and reach test was used to evaluate their flexibility. The Timed Up and Go (TUG) was used to assess their dynamic balance. WHOQOL-bref was used to obtain a measure of quality of life. WOMAC was used to assess pain, physical function and joint stiffness. The results were expressed as mean and standard deviation. ANOVA was used to compare the moments and groups
(p ≤ 0.05).
Results: Decrease in pain and execution time of the TUG was observed in AG (10.7 ± 2.8 s to 10.1 ± 2.4 s) and DLG (9.0 ± 2.0 s to 8.3 ± 1.5 s) the pre and post intervention moments, as well as increased flexibility (AG: 15.3 ± 9.0 cm to 22.5 ± 8.0 cm; DLG: 24,1±3,2 cm to 29.3 ± 4.8 cm) was registered. Only the AG (67.3 ± 15.1% to 75.5±9.6%) had an improvement in the environmental domain of quality of life. Comparing the groups, there was improvement in physical function of the AG (30.6±9.0) in relation to the CG (44.7 ± 13.3) and the DLG (22.2 ± 12.7) to the CG in joint stiffness in the post-intervention moments.
Conclusion(s): Intervention programs have been effective in reducing pain, increased flexibility and improved dynamic balance. However, joint stiffness was higher for DLG than for CG. The environmental quality of life was higher for AG than for CG.
Implications: Given the diversity of training protocols on the effects of aquatic physical therapy on older patients with KO, these programs are an indication for treatments aimed at mitigating chronic pain, muscle training, increased flexibility, improved dynamic balance and physical function. The aquatic physical therapy and physical training in the land promoted benefits to the functional health of the population studied and can be used for prevention and rehabilitation of musculoskeletal disorders.
Funding acknowledgements: Research Fund from the Universidade do Sagrado Coração (FAP/USC).
Topic: Non-communicable diseases (NCDs) & risk factors
Ethics approval: Approved by the Ethics Committee of the Universidade do Sagrado Coração (protocol: 1.031.248) and the Clinical Trials Brazilian Registry (RBR-5zpphs).
All authors, affiliations and abstracts have been published as submitted.
