Effects of water therapy on disease activity, functional capacity, spinal mobility and severity of pain in patients with ankylosing spondylitis: a systematic review and meta-analysis

Abstract

Purpose To evaluate the efficacy of water therapy for disease activity, functional capacity, spinal mobility, and pain in patients with ankylosing spondylitis. Methods PubMed, Ovid, web of science, Cochrane library, Physiotherapy Evidence Database, CNKI, VIP, Wan Fang, and Open Grey were searched for randomized controlled trials that investigated the effects of water therapy on patients with ankylosing spondylitis. Two researchers independently screened the literature databases and then assessed methodological qualities using the Physiotherapy Evidence Database scale and extracted data. Outcomes included were disease activity, functional capacity, spinal mobility, and pain. Results A total of eight studies (n = 383) met the inclusion criteria. Analysis demonstrated that water therapy had a significant effect on disease activity and pain, but not on spinal mobility, or functional capacity in patients with ankylosing spondylitis. Conclusion Water therapy can benefit patients with ankylosing spondylitis by reducing disease activity and alleviating pain. More well-designed randomized controlled trials are needed to confirm the results. IMPLICATIONS FOR REHABILITATION Water therapy can reduce disease activity and pain in patients with ankylosing spondylitis, but cannot improve functional capacity or spinal mobility. Due to its analgesic effect both during and after treatment, water therapy remains an alternative for patients with ankylosing spondylitis when land-based therapy is not well tolerated.