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Systematic review and meta-analysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes.

Batterham SI, Heywood S, Keating JL - BMC Musculoskelet Disord (2011)

Bottom Line: Standardised mean differences between groups for key outcomes were calculated.Meta-analyses were performed for function, mobility and indices that pooled health outcomes across multiple domains.No differences in outcomes were observed for the two rehabilitation strategies in meta-analysis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physiotherapy, Monash University Peninsula Campus, McMahons Rd, Frankston, Australia.

ABSTRACT

Background: Aquatic and land based exercise are frequently prescribed to maintain function for people with arthritis. The relative efficacy of these rehabilitation strategies for this population has not been established.This review investigated the effects of aquatic compared to land based exercise on function, mobility or participants' perception of programs for people with arthritis.

Methods: Medline, CINAHL, AMED and the Cochrane Central Register of Controlled Clinical Trials were searched up to July 2010. Ten randomised, controlled clinical trials that compared land to aquatic exercise for adults with arthritis were included. Study quality was assessed with the PEDro scale. Data relevant to the review question were systematically extracted by two independent reviewers. Standardised mean differences between groups for key outcomes were calculated. Meta-analyses were performed for function, mobility and indices that pooled health outcomes across multiple domains.

Results: No differences in outcomes were observed for the two rehabilitation strategies in meta-analysis. There was considerable variability between trials in key program characteristics including prescribed exercises and design quality. Components of exercise programs were poorly reported by the majority of trials. No research was found that examined participant preferences for aquatic compared to land based exercise, identifying this as an area for further research.

Conclusion: Outcomes following aquatic exercise for adults with arthritis appear comparable to land based exercise. When people are unable to exercise on land, or find land based exercise difficult, aquatic programs provide an enabling alternative strategy.

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Related in: MedlinePlus

Meta-analysis of walking ability without data for Suomi and Collier [19]and Wyatt, et al., [27]showing a non significant difference between the two rehabilitation strategies.
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Figure 5: Meta-analysis of walking ability without data for Suomi and Collier [19]and Wyatt, et al., [27]showing a non significant difference between the two rehabilitation strategies.

Mentions: For mobility outcomes a smaller scores indicated better health. The pooled SMD was 0.03 (95% CI = -0.16, 0.21) indicating no statistically significant difference between exercise strategies. Suomi and Collier and Wyatt et al. both reported data that indicated significant between group differences at baseline [22,30]. When data were pooled without data from these trials heterogeneity improved (I2 = 0%) but conclusions were unchanged (Figure 5). No significant difference between groups (n = 198 aquatic, 197 land based) was found (SMD = 0.04 (95% CI = -0.15, 0.24)).


Systematic review and meta-analysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes.

Batterham SI, Heywood S, Keating JL - BMC Musculoskelet Disord (2011)

Meta-analysis of walking ability without data for Suomi and Collier [19]and Wyatt, et al., [27]showing a non significant difference between the two rehabilitation strategies.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3141607&req=5

Figure 5: Meta-analysis of walking ability without data for Suomi and Collier [19]and Wyatt, et al., [27]showing a non significant difference between the two rehabilitation strategies.
Mentions: For mobility outcomes a smaller scores indicated better health. The pooled SMD was 0.03 (95% CI = -0.16, 0.21) indicating no statistically significant difference between exercise strategies. Suomi and Collier and Wyatt et al. both reported data that indicated significant between group differences at baseline [22,30]. When data were pooled without data from these trials heterogeneity improved (I2 = 0%) but conclusions were unchanged (Figure 5). No significant difference between groups (n = 198 aquatic, 197 land based) was found (SMD = 0.04 (95% CI = -0.15, 0.24)).

Bottom Line: Standardised mean differences between groups for key outcomes were calculated.Meta-analyses were performed for function, mobility and indices that pooled health outcomes across multiple domains.No differences in outcomes were observed for the two rehabilitation strategies in meta-analysis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physiotherapy, Monash University Peninsula Campus, McMahons Rd, Frankston, Australia.

ABSTRACT

Background: Aquatic and land based exercise are frequently prescribed to maintain function for people with arthritis. The relative efficacy of these rehabilitation strategies for this population has not been established.This review investigated the effects of aquatic compared to land based exercise on function, mobility or participants' perception of programs for people with arthritis.

Methods: Medline, CINAHL, AMED and the Cochrane Central Register of Controlled Clinical Trials were searched up to July 2010. Ten randomised, controlled clinical trials that compared land to aquatic exercise for adults with arthritis were included. Study quality was assessed with the PEDro scale. Data relevant to the review question were systematically extracted by two independent reviewers. Standardised mean differences between groups for key outcomes were calculated. Meta-analyses were performed for function, mobility and indices that pooled health outcomes across multiple domains.

Results: No differences in outcomes were observed for the two rehabilitation strategies in meta-analysis. There was considerable variability between trials in key program characteristics including prescribed exercises and design quality. Components of exercise programs were poorly reported by the majority of trials. No research was found that examined participant preferences for aquatic compared to land based exercise, identifying this as an area for further research.

Conclusion: Outcomes following aquatic exercise for adults with arthritis appear comparable to land based exercise. When people are unable to exercise on land, or find land based exercise difficult, aquatic programs provide an enabling alternative strategy.

Show MeSH
Related in: MedlinePlus