It was determined that the inclusion of aquatic training is an important consideration as part of a comprehensive training and or rehabilitation program.
Medical treatment to date has included nine months of aquatic and land-based physical therapy. Problems identified include weak and insensate bilateral lower extremities, notably weak hip and knee extensors, plantarflexors, dorsiflexors and hip abductors.
This patient led me to seek out the efficacy of aquatic therapy, however the research is lacking in studies concerning cauda equina syndrome and aquatic therapy, as the condition is rare.
As this clinic has the only pool in town, and many patients are referred here specifically for aquatic treatment, I was interested in what the research has to say about aquatic therapy.
Knee osteoarthritis OA was the most commonly occurring diagnosis with randomized control trials, so I decided to seek out what the literature reports for such patients. Clinical Question Is aquatic therapy more effective than land-based exercises at affecting the pain, strength and mobility deficits associated with knee osteoarthritis?
Clinical Bottom Line Based on the results of the outcomes from Lund et al. Overall, these two high-quality studies provided limited evidence to suggest that either type of therapy may be beneficial compared to a control group receiving no additional exercise training. The evidence is limited due to inconsistent results and small amounts of significant differences between groups.
Three months after treatment completion, Lund et al. The study by Lund et al. This was the only major threat to internal validity between the studies. Immediately after treatment completion, Wang et al.
Although pain level was not shown to be statistically different from the control group, a clinically significant decrease in pain level was demonstrated within both exercise groups.
Despite limited significance, these contradicting results suggest that if either therapy is effective at addressing impairments associated with knee OA, they are likely similarly effective compared to no therapy. As it has been shown that exercise has a wide range of benefits for patients with knee OA, these studies may suggest, or at least not deny, an encouraged use of aquatic therapy for appropriate patients, if available, to compliment land-based exercises.
Results are difficult to generalize to the population due to the amount of exclusionary criteria for subjects allowed into these studies.
Most patients have more complicated medical histories or have tried previous treatment. Furthermore, the subjects in the study by Wang et al.
As they likely represent the greater population, their functional level is also likely higher than a majority of patients seen in clinics. While the clinical effectiveness of an aquatic or land-based exercise class for addressing pain, function and knee extension for patients with knee OA is not clear, the financial and time costs of treatment appear to be consistent with methods commonly available and the protocols employed would be readily applied in a clinical setting.
The literature is not lacking high-quality randomized controlled studies RCTs on this topic; however the methods employed are consistently inconsistent.
Further research is necessary to adequately answer this clinical question, specifically more controlled studies to address the length and timeframe of a successful program, the type of exercises, increased power of the statistics with more subjects, and more studies with control groups to minimize outside factors from skewing results.
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+ In a research paper that was released in a issue of Pediatric Physical Therapy, the authors studied the responses of 37 children who were of infant or. The use of water for various treatments (hydrotherapy) is probably as old as mankind.
Hydrotherapy is one of the basic methods of treatment widely used in the system of natural medicine, which is also called as water therapy, aquatic therapy, pool therapy, and balneotherapy. The critically appraised topics (CATs) on this site were created by students in the Pacific University School of Physical Therapy doctoral degree program.
The physical therapy profession recognizes the use of evidence-based practice (EBP) as central to providing high-quality care and decreasing unwarranted variation in practice.
EBP includes the integration of best available research, clinical expertise, and patient values and circumstances related to patient and client management, practice.
Aquatic therapy has become increasingly popular for the rehabilitation of equine musculoskeletal injuries; unfortunately, there has been no scientific evaluation of its effectiveness for the treatment of OA and its associated alterations in musculoskeletal function in horses.
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