Abstract
BackgroundThe objective of this review was to summarize findings on aquatic exercise and balneotherapy and to assess the quality of systematic reviews based on randomized controlled trials.MethodsStudies were eligible if they were systematic reviews based on randomized clinical trials (with or without a meta-analysis) that included at least 1 treatment group that received aquatic exercise or balneotherapy. We searched the following databases: Cochrane Database Systematic Review, MEDLINE, CINAHL, Web of Science, JDream II, and Ichushi-Web for articles published from the year 1990 to August 17, 2008.ResultsWe found evidence that aquatic exercise had small but statistically significant effects on pain relief and related outcome measures of locomotor diseases (eg, arthritis, rheumatoid diseases, and low back pain). However, long-term effectiveness was unclear. Because evidence was lacking due to the poor methodological quality of balneotherapy studies, we were unable to make any conclusions on the effects of intervention. There were frequent flaws regarding the description of excluded RCTs and the assessment of publication bias in several trials. Two of the present authors independently assessed the quality of articles using the AMSTAR checklist.ConclusionsAquatic exercise had a small but statistically significant short-term effect on locomotor diseases. However, the effectiveness of balneotherapy in curing disease or improving health remains unclear.
Highlights
Aquatic exercise has been referred to as pool therapy, hydrotherapy, and, in earlier literature, sometimes even as balneotherapy.[1]
Twenty-eight publications were excluded either because they were not a systematic review (SR), not an SR based on randomized controlled trials (RCTs), not an SR in which water was a factor, or were not reviewed according to protocol
The SRs of aquatic exercise showed a curative effect in all studies; the SRs of balneotherapy provided no clear evidence of curative effect (Table 3)
Summary
Aquatic exercise has been referred to as pool therapy, hydrotherapy, and, in earlier literature, sometimes even as balneotherapy.[1]. Spa therapy is a very popular form of treatment for all types of arthritis in many European countries, as well as in Israel and Japan.[7,8] In addition, recent reports have demonstrated that comprehensive health education, which includes lifestyle education and exercise in combination with spa bathing, has positive effects for middleaged and elderly people.[9,10]. The objective of this review was to summarize findings on aquatic exercise and balneotherapy and to assess the quality of systematic reviews based on randomized controlled trials. Methods: Studies were eligible if they were systematic reviews based on randomized clinical trials (with or without a meta-analysis) that included at least 1 treatment group that received aquatic exercise or balneotherapy. Conclusions: Aquatic exercise had a small but statistically significant short-term effect on locomotor diseases. The effectiveness of balneotherapy in curing disease or improving health remains unclear
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