Hydrotherapy Program Research Articles

Effectiveness of Foot Exercises together with the Hydrotherapy program on Blood Sugar Levels in Elderly People without Diabetes

Background: The elderly human population is susceptible to health problems due to decreased organ function. The risk of diabetes in old age also reduces quality of life. Preventing the risk of developing diabetes mellitus requires simple and simple exercise programs such as foot exercises and hydrotherapy. The effect of light leg exercise and hydrotherapy on carbohydrate metabolism is unknown. Objectives: To find out the impact of hydrotherapy alone or in combination with foot exercise on elderly's blood sugar levels. Methods: Parallel three-group pre and post-test designs for an experimental investigation. 21 elderly in RW 04 Karangwetan, Ungaran served as research participants, divided into control group (n=7), combination of foot exercises and hydrotherapy intervention group (n=7), and foot exercise intervention group (n=7). The intervention took place three times per week for five weeks. We used POCT to assess blood sugar levels. Results: There is no significant decrease in blood sugar levels from control group (p>0.05). There is significant decrease in blood sugar levels from foot exercise and hydrotherapy intervention group (p<0.05) and foot exercise intervention group (p<0.05). The difference in blood sugar levels showed significant results between foot exercise and hydrotherapy intervention group and control group (p=0.000) and between foot exercise intervention group and control group (p=0.004). There is no significant differences in blood sugar levels between foot exercise and hydrotherapy intervention group and foot exercise intervention group (p=0.112). Conclusion: Simple exercise activities such as foot exercises together with hydrotherapy have been proven to reduce blood sugar levels in healthy elderly populations without diabetes

The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: A protocol for systematic review and meta-analysis.

Knee osteoarthritis (OA) is a common clinical degenerative disease of the joints, which is prone to occur in middle-aged and elderly people. At present, the disease cannot be cured, it is mostly treated with drugs to relieve symptoms, improve joint function, protect cartilage, such as glucosamine, anti-inflammatory and analgesic drugs, and but the efficacy is not lasting and the recurrence rate is high. Hydrotherapy has become a long-term alternative therapy in China and is receiving increasing attention. We perform a protocol for systematic review and meta-analysis to determine the efficacy and safety of a hydrotherapy program in individuals living with knee OA. This protocol will be designed in accordance with the preferred reporting items for systematic reviews and meta-analysis protocols. It is registered on the international prospective register of systematic reviews (No. CRD42022365564). We will search the following databases: The Cochrane Skin Group Trials Register, MEDLINE, EMBASE, The Cochrane central register of controlled trials, Chinese biomedical literature database, Chinese medical current content and China national knowledge infrastructure. The risk of bias of the included studies will be appraised using the Cochrane collaboration tool. Statistical analysis will be performed using IBM SPSS Statistics (Armonk, NY). This systematic review will summarize the short- and long-term clinical outcomes of hydrotherapy for knee OA. The findings from this review will establish the quality of currently available evidence, which will determine the need for further studies to establish the true effect size of hydrotherapy in knee OA.

Hydrotherapy for Patients With External Fixation: Effect on Infectious Events

Surgery to achieve long bone lengthening and deformity correction in skeletally immature patients is traditionally performed through external fixators. The incidence of infection during treatment is high. Hydrotherapy is highly beneficial during external fixation management, but the infection rates may impact its utilization. The objective of this paper is to document the incidence and duration of infection in patients who participated in a full hydrotherapy program when performed under medical supervision and in accordance with strict follow-up protocols. In this retrospective study, we documented the key characteristics of patients who participated in hydrotherapy after lower limb external fixation surgery including age, sex, diagnosis and surgery site, the incidence and duration of pin site infections, and the percentage of cases, which were able to comply with a full hydrotherapy protocol. The hydrotherapy pool met all daily water quality metrics. Thirty-four children (19 males and 15 females) had a mean±SD age of 10.9±4.6 years. Of the cases, 80% were unilateral and 20% were bilateral. Diagnoses included congenital hereditary (eg, achondroplasia), congenital nonhereditary conditions (eg, fibular hemimelia), and acquired conditions (eg, traumatic). The location of osteotomy site was quite evenly spread between the femur and the tibia/fibula. Three out of the 34 patients were unable to receive hydrotherapy due to continuous secretions; 2 patients did not miss any sessions. The mean number of treatments was 3 per week. During the entire period, a total of 1200 treatments were performed for these patients with only 32 cancellations (about 3%) due to secretions or other signs of infection. Spearman correlation coefficients showed significantly high correlations between the duration of external fixation and the duration of hydrotherapy. There are no significant correlations between infections and other factors (sex, age segment, whether the problem is unilateral or /bilateral, diagnosis, and duration of treatment). This is the first report, to our knowledge, that documents the low prevalence of infectious events during hydrotherapy treatment and demonstrates its feasibility. Level III; retrospective, comparative study.

The effectiveness of a specialized hydrotherapy program based on Halliwick concept in the transition from supine to sitting of children with cerebral palsy: a randomised control trial

<p class="abstract"><strong>Background:</strong> Halliwick concept focus on people with disabilities, to participate in water activities and move independently. Many studies found a considerable improvement and positive outcomes in children that were included in hydrotherapy programs. The aim of this study was to investigate the Halliwick hydrotherapy in combination with on-land intervention, versus only on-land treatment, on the supine-sitting transition and head symmetry.</p><p class="abstract"><strong>Methods:</strong> 54 children with cerebral palsy (CP), two groups, the intervention group-water (N=28) (1 water and 1 on land treatment) and the control group-on land (N=26) (2 treatments on land). The duration was 3 months and the assessment via gross motor function measure (GMFM), parameter B, questions 18-37, and head angle via the Kinovea software.</p><p class="abstract"><strong>Results:</strong> In GMFM before intervention the mean value of the intervention group was 69.632 (±13.1269), while for the control group was 61.227 (±20.4681) and after for intervention group was 75.757 (±12.3766), 6.125% improvement, while for control group was 65.308 (±20.6663), 4.081% improvement. In the sitting head angle before intervention, the mean value of intervention group was 19.36 (±9.639) while for the control group was 20.15 (± 11.199) and after for the intervention group was 13.93 (±7.333), 5.43<sup>o</sup> improvement, while for control group was 16.46 (±9.205), 3.69<sup>o</sup> improvement.</p><p class="abstract"><strong>Conclusions: </strong>The addition of intervention in water in combination with intervention on land in the rehabilitation program of children with cerebral palsy can lead to a statistically significant increase in the effectiveness of the therapeutic program.</p>

The effect of hydrotherapy according to Halliwick concept on children with cerebral palsy and the evaluation of their balance: a randomised clinical trial

<p><strong>Background:</strong> Hydrotherapy according to Halliwick concept is a physiotherapeutic intervention technique for disabled patients and for children with neurodevelopmental disorders. Assessing the balance in children with cerebral palsy (CP) is an extremely complex process and more difficult to evaluate the results of some therapeutic interventions in these patients. The purpose of this study is to investigate the effect of Halliwick based Hydrotherapy on the support base in children with CP. Several studies have proven the beneficial effects of hydrotherapy in the respiratory system of children, but few are studies that report the effect on the balance of children with CP.</p><p><strong>Methods:</strong> The study involved 16 children diagnosed with CP. The 10 children were following a Halliwick Concept hydrotherapy program and the 6 children classical physiotherapy program for 3 months. Their balance was assessed with the Berg, GMFM, and footprint plate. The assessment was performed at the start of the program (pre-test) and after 3 months (post-test).</p><p><strong>Results</strong>: Τhere is a statistically significant change between the 1<sup>st</sup> and 2<sup>nd</sup> measurement with the BERG and GMFM tools and better for the water intervention group. The change in the support base between the 1st and 2nd measurement was better in the water intervention group but not statistically significant.</p><p><strong>Conclusions:</strong> The results of the study showed that hydrotherapy according to Halliwick has positive effects on gross mobility and the balance of children with CP. It also appears to have a positive effect on changing the support base compared to classical physiotherapy.</p>

Health management of patients with COVID-19: is there a room for hydrotherapeutic approaches?

With highly variable types of coronavirus disease 2019 (COVID-19) symptoms in both severity and duration, there is today an important need for early, individualized, and multidisciplinary strategies of rehabilitation. Some patients present persistent affections of the respiratory function, digestive system, cardiovascular function, locomotor system, mental health, sleep, nervous system, immune system, taste, smell, metabolism, inflammation, and skin. In this context, we highlight here that hydrothermal centers should be considered today as medically and economically relevant alternatives to face the urgent need for interventions among COVID-19 patients. We raise the potential benefits of hydrotherapy programs already existing which combine alternative medicine with respiratory care, physical activity, nutritional advice, psychological support, and physiotherapy, in relaxing environments and under medical supervision. Beyond the virtues of thermal waters, many studies reported medical benefits of natural mineral waters through compressing, buoyancy, resistance, temperature changes, hydrostatic pressure, inhalations, or drinking. Thermal institutions might offer individualized follow-up helping to unclog hospitals while ensuring the continuity of health care for the different clinical manifestations of COVID-19 in both post-acute and chronic COVID-19 patients. Our present review underlines the need to further explore the medical effectiveness, clinical and territorial feasibility, and medico-economic impacts of the implementation of post-COVID-19 patient management in hydrotherapeutic establishments.

The effect of hydrotherapy on the functioning and quality of life of children and young adults with cerebral palsy

Background: Cerebral palsy (CP) is the most common cause of paralysis in infancy and childhood. There is evidence that the integration of hydrotherapy in the treatment program can significantly contribute to the rehabilitation of children and young people with CP by improving their functional limitations and overall, their quality of life. The purpose of this review was to present recent research data on the contribution and efficacy of hydrotherapy in the rehabilitation of children and young adults with CP. The Google Scholar and PubMed databases were searched with the following keywords: cerebral palsy, hydrotherapy, rehabilitation. This review included 11 articles. The results of our research show that hydrotherapy, both as an individual treatment and in combination with a standard land-based exercise program, can significantly contribute to the improvement of gross mobility, the improvement of exercise endurance and the improvement of the quality of life of people with CP. Ideal dosage of hydrotherapy programs, according to the research included in the review is 2-3 sessions per week for more than six weeks. However, it should be noted that the literature is still limited and further research is needed.

The effect of hydrotherapy on the symptoms and functional characteristics of multiple sclerosis patients

Aim: A review of the literature on the effect of hydrotherapy on the symptoms of fatigue, pain, spasticity as well as on the balance and gait of people with Multiple Sclerosis (MS). Method: Search databases such as MEDLINE, Cochrane Library, Science Direct and PEDro were used to search the literature. The inclusion criteria were studies that included physiotherapy and mainly hydrotherapy as a means of rehabilitation in MS. Results: Hydrotherapy programs significantly reduced the symptoms of fatigue, pain, spasticity as well as significantly improved balance and gait in patients with MS, as reflected in the evaluation tests. Conclusions: Hydrotherapy is proposed as a safe, effective and enjoyable method of rehabilitation in patients with MS to reduce symptoms and improve balance and gait.

Efficacy of hydrotherapy treatment for the management of chronic low back pain.

The study investigated the influence of hydrotherapy method-based McKenzie and Williams among patients with non-specific low back pain (NSLBP). Semi-experimental pretest-posttest with a control group design trial was conducted at Health Service Center, Qazvin, Iran. Twenty-eight NSLBP patients (16 men and 12 women, age: 42.5 ± 7years) were recruited. Hydrotherapy program developed based on McKenzie and Williams therapy was performed individually 3days per week for 20 sessions. Therefore, the study compared a hydrotherapy group (based on McKenzie and Williams therapy) to a control group. Participants attended a hydrotherapy program under the supervision of a hydrotherapist. The Numeric Pain Rating Scale (NPRS), Roland-Morris Disability Questionnaire (RMDQ), and Straight Leg Raise Test (SLRT) were measured at the beginning, middle, and at the end of the 20 sessions to determine pain and functionality of the patient's improvement. Overall, NPRS, RMDQ, and SLRT scores were improved in hydrotherapy group in the 10th session and 20th session compared with baseline (p ≤ 0.001) and control group (p ≤ 0.001). No difference in the treatment variables between the 10th session and the 20th session was observed (p > 0.05). The results indicated that the NSLBP symptom was improved after 10 sessions of hydrotherapy program developed based on McKenzie and Williams therapy.

The Effectiveness of 6 Months Hydrotherapy Program Based on Halliwick Concept on the Respiratory System of Down Syndrome Children

The aim of the study was to investigate the effect of a hydrotherapy program on FVC, FEV, PEF, RR and SaO2 on children with Down syndrome over six months and to compare it with a conventional respiratory physiotherapy program. Eighteen children, with Down Syndrome, aged 6 - 11 years (9.53 ± 0.454), divided into two groups of nine, the intervention group (IG), that participated in the hydrotherapy program and the control group (CG) participated in the classical physiotherapy program. We calculated mean values of FVC, FEV, PEF, RR and SaO2 before and after six months intervention for both groups. There was a statistically significant improvement in all factors for both groups. However, were statistically more significant for the intervention group (IG). Based on a specific protocol of intervention in the water and at the same time with a group of children who participated in a similar program of classical respiratory physiotherapy, it was found to be statistically more important than the second group in improving respiratory function. We recommend the use of hydrotherapy as a complementary therapy that should be part of the weekly program of these children in addition to the existing treatments they attend.

Effects Of Aquatic-based Exercise On Perceived-fatigue In People With Multiple Sclerosis: A Systematic Review And Meta-analysis

Multiple sclerosis (MS) is a chronic, immune-mediated and neurodegenerative disease of the central nervous system. Since signs and symptoms associated with MS extend to several dimensions, people with MS (PwMS) can experience symptoms at both physical and cognitive dimensions. Among them, perceived fatigue is one of the most disabling symptoms, affecting the majority of the MS population. Hydrotherapy is a novel therapeutic option to improve the perceived-fatigue in PwMS, PURPOSE: To analyze the effects of aquatic-based exercise on perceived-fatigue in PwMS using a meta-analytic procedures and systematic review. METHODS: Clinical trials comparing aquatic exercise to no exercise treatments were searched on four scientific databases up to June 2019. The standard mean differences (SMD +) was calculated for the outcome perceived-fatigue. Firstly, general fatigue was evaluated, from which three sub-dimensions were also assessed (physical, psychosocial, and cognitive). The methodological quality of the included studies was assessed employing the PEDro scale. RESULTS: A total of 148 articles were initially identified, from which only 5 fulfilled all the inclusion criteria, other than inclusion of a control group and an experimental group, and a hydrotherapy program. General fatigue, assessed mainly through the Modified Fatigue Impact Scale, showed a significant decrease (SMD+ = -2.15 [95% CI = -3.44 to -0.87]; p<0.01; I2=91%). Regarding fatigue sub-dimensions, physical fatigue achieved a significant improvement in the experimental group compared to the controls (SMD+ = -2.15 [95% CI = -3.72 to -0.58]; p<0.01; p<0.01; I2=92%). Psychosocial fatigue (SMD+ = -1.13 [95% CI = -1.86 to -0.40; p<0.01; I2=76%) and cognitive fatigue were also significantly improved compared to the control group (SMD+ = -0.57 [95% CI = -0.88 to -0.25]; p<0.01; I2=0%). CONCLUSIONS: Aquatic-based exercise significantly decreases all dimensions of perceived-fatigue in PwMS. Based on these findings, it would be useful for future studies to address the dose-response characterization of aquatic-based exercise programs (i.e. intensity, volume, frequency, training length, etc.) in order to optimize the physical exercise interventions for PwMS.

The short-term effects of hydrotherapy on pain and self-perceived functional status in individuals living with osteoarthritis of the knee joint.

BackgroundPeople living with knee osteoarthritis (OA) commonly present with difficulty in walking long distances, ascending and descending stairs or rising from sitting. These functional limitations have been shown to have a negative effect on their overall activities of daily living.ObjectivesThe aim of this study was to determine the effects of a 4-week hydrotherapy programme on measures of pain and self-perceived functional status in individuals living with knee OA.MethodA total of 18 participants with chronic knee OA participated in this study. Participants completed 4 weeks of hydrotherapeutic intervention provided by an independent physiotherapist. Outcome measures for the study included pain assessed using the visual analogue scale (VAS) and self-perceived functional status using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Outcome measures were assessed at baseline and after the 4 weeks of intervention.ResultsThe 4-week hydrotherapy programme resulted in a significant decrease in pain and a significant improvement in self-perceived functional status in all participants. There was a statistically significant mean decrease in VAS scores of 3.72 (± 2.45), p ≤ 0.05, with a 95% confidence interval ranging from 2.506 to 4.938. There was also a statistically significant mean decrease in WOMAC scores of 29.5 (± 15.51), p ≤ 0.05. with a 95% confidence interval ranging from 21.788 to 37.212.ConclusionThis study demonstrated that a 4-week hydrotherapeutic exercise programme results in significantly reduced pain and improved self-perceived functional status in individuals living with knee OA.Clinical implicationsFour weeks of hydrotherapy exercises twice a week in a heated pool can significantly decrease pain and improve functional status in individuals with knee OA.

The effectiveness of hydrotherapy in patients with osteoarthritis of the knee

Introduction:Osteoarthritis is a chronic degenerative disease that affects articular cartilage. Its signs and symptoms include morning stiffness, pain, decreased range of motion in the affected joint, limitations in functional activities, deformity with osteophyte formation, swelling and stiffness in the drive. Hydrotherapy is widely used by thrust account, dipping and reduced gravity, which is the differential treatment. Objectives: To analyze through literature reviews and case studies the effectiveness of hydrotherapy in patients with osteoarthritis of the knee. Methods: A literature review was performed from items available in Scielo databases, PubMed, Lilacs, Medline in August 2017, selecting articles published from 2012 to 2017. Results and Discussion: Initially found 55 studies with the proposed theme, among them, 47 were excluded according to the exclusion criteria. Selecting articles 8, 4 case studies and literature reviews 4. Results report that hydrotherapy helps both assisting in relieving the symptoms and the execution of activities of daily living. Conclusion: Later the acquired data, it can be concluded that the hydrotherapy program on rehabilitation of patients with osteoarthritis patients, was effective in terms of reducing the manifestations of pain and increase in range of motion of the knee. The pool exercises in technique is an excellent environment for rehabilitation of these patients due to buoyant force decrease the force of gravity, therefore, reduces the burden on the injured cartilage when immersed to the chest,Minimizing major changes and making the execution of the exercise less painful as they would be in the ground and thus more comfortable.

Effects of a 16-week hydrotherapy program on three-dimensional scapular motion and pain of women with fibromyalgia: A single-arm study

BackgroundAlthough hydrotherapy is widely used to treat women with fibromyalgia, no studies have investigated the effects of this intervention on scapular kinematics in this population. This study verified the effectiveness of a hydrotherapy program on scapular kinematics, pain and quality of life in women with fibromyalgia. MethodsTwenty women completed the study and performed three evaluations before treatment (to establish a baseline), and two other evaluations (after 8 and 16weeks of hydrotherapy) at the end of treatment. Three-dimensional kinematics of the scapula was evaluated during arm elevation in two different planes with the Flock of Birds® system. Patients also answered quality of life and Fibromyalgia Impact Questionnaires and had pain assessed with a digital algometer. Treatment consisted of 2 weekly hydrotherapy sessions, lasting 45min each, for 16weeks. Data were analyzed with a two-way ANOVA (for kinematics results) and one-way ANOVA (for the other variables). Effect size was assessed with Cohen's d coefficient for all quantitative variables. ResultsAlthough an important improvement was achieved in terms of pain and quality of life (P<0.05, effect sizes varied from −1.93 to 1.61 depending on the variable), scapular kinematics did not change after treatment (P>0.05, effect sizes from −0.40 to 0.46 for all kinematic variables). InterpretationThe proposed program of hydrotherapy was effective to improve quality of life, pain intensity and fibromyalgia impact in women with fibromyalgia. However, scapular kinematics did not change after the period of treatment. Although symptoms improved after the treatment, the lack of changes in scapular kinematics may indicate these women have an adaptive movement pattern due to their chronic painful condition.

Underwater gait analysis in Parkinson’s disease

Although hydrotherapy is one of the physical therapies adopted to optimize gait rehabilitation in people with Parkinson disease, the quantitative measurement of gait-related outcomes has not been provided yet. This work aims to document the gait improvements in a group of parkinsonians after a hydrotherapy program through 2D and 3D underwater and on land gait analysis. Thirty-four parkinsonians and twenty-two controls were enrolled, divided into two different cohorts. In the first one, 2 groups of patients underwent underwater or land based walking training; controls underwent underwater walking training. Hence pre-treatment 2D underwater and on land gait analysis were performed, together with post-treatment on land gait analysis. Considering that current literature documented a reduced movement amplitude in parkinsonians across all lower limb joints in all movement planes, 3D underwater and on land gait analysis were performed on a second cohort of subjects (10 parkinsonians and 10 controls) who underwent underwater gait training. Baseline land 2D and 3D gait analysis in parkinsonians showed shorter stride length and slower speed than controls, in agreement with previous findings. Comparison between underwater and on land gait analysis showed reduction in stride length, cadence and speed on both parkinsonians and controls. Although patients who underwent underwater treatment exhibited significant changes on spatiotemporal parameters and sagittal plane lower limb kinematics, 3D gait analysis documented a significant (p<0.05) improvement in all movement planes. These data deserve attention for research directions promoting the optimal recovery and maintenance of walking ability.

The Effects of a Motorized Aquatic Treadmill Exercise on Isometric Strength of Knee and Cardiorespiratory Fitness in Subacute Stroke Patients

To assess the effects of a 4 week hydrotherapy program performed on a motorized aquatic treadmill on isometric muscle strength, cardiorespiratory fitness, and functional outcome (motor function, balance, activities of daily living [ADL], and quality of life [QOL]) in patients suffering subacute stroke.

Impact of a structured aquatic therapy program on patients with knee osteoarthritis

Osteoarthritis is a pervasive, chronic rheumatic, multifactorial, degenerative joint disease, afflicting 10% of the population over 65 years of age. It affects both genders, and in women the incidence is higher after menopause. This disease comprises 65% of the causes of disability, exceeded only by cardiovascular and mental disorders. The rehabilitation of patients with osteoarthritis is a complex process that involves specialized procedures Objective: To evaluate the effects of a hydrotherapy program on the ability to perform activities of daily living in patients with osteoarthritis. Method: This is a prospective study where twenty-six patients with knee osteoarthritis history underwent a treatment program in aquatic therapy, often twice a week lasting 50 minutes each session. The program consisted of four phases, namely: warming up, stretching, strengthening, and relaxation. These patients were evaluated before and after treatment. Assessments were done with the goniometer, EVA pain scale, and Six Minute Walk Test. Results: There was significant improvement in range of motion when performing flexion of the affected knees, as well as a significant decrease in pain and a significant improvement in the ability to perform the activities of daily living, assessed by the distance walked in the six-minute walk test. Conclusion: There was an improved ability to perform ADLs and inn physical capacity, as well as reduced pain and increased range of motion

Impact of a structured aquatic therapy program on patients with knee osteoarthritis

Osteoarthritis is a pervasive, chronic rheumatic, multifactorial, degenerative joint disease, afflicting 10% of the population over 65 years of age. It affects both genders, and in women the incidence is higher after menopause. This disease comprises 65% of the causes of disability, exceeded only by cardiovascular and mental disorders. The rehabilitation of patients with osteoarthritis is a complex process that involves specialized procedures Objective: To evaluate the effects of a hydrotherapy program on the ability to perform activities of daily living in patients with osteoarthritis. Method: This is a prospective study where twenty-six patients with knee osteoarthritis history underwent a treatment program in aquatic therapy, often twice a week lasting 50 minutes each session. The program consisted of four phases, namely: warming up, stretching, strengthening, and relaxation. These patients were evaluated before and after treatment. Assessments were done with the goniometer, EVA pain scale, and Six Minute Walk Test. Results: There was significant improvement in range of motion when performing flexion of the affected knees, as well as a significant decrease in pain and a significant improvement in the ability to perform the activities of daily living, assessed by the distance walked in the six-minute walk test. Conclusion: There was an improved ability to perform ADLs and inn physical capacity, as well as reduced pain and increased range of motion

Assessing cardiac baroreflex function with carotid neck collar technique in heart failure

Baroreflex dysfunction has been demonstrated in fibromyalgia syndrome (FMS). However, there are few studies evaluating the effectiveness of hydrotherapy programs on cardiovascular autonomic control in this population. This study evaluates the effects of a 16-week hydrotherapy program on baroreflex sensitivity (BRS) in women with FMS. Eight women with FMS took part in the study. The electrocardiogram, non-invasive finger blood pressure and respiratory activity were continuously recorded for all participants during 15 min in supine and 15 min in orthostatic (active standing) positions, before and after a 16week hydrotherapy program (Post16). The BRS was estimated via cross-spectral analysis, computed as the square root of the ratio of the low frequency (LF) band power of heart period on the LF power of systolic arterial pressure (αLF). The hydrotherapy program comprised 32 sessions of 45 min of pool exercises twice a week, for 16 weeks. At baseline there was no significant difference for the αLF index between supine and orthostatic positions (p N 0.05). At Post16, there was a significant decrease of the αLF during orthostatic stimulus compared to the supine position (p b 0.05). There was no significant difference between baseline and Post16 for αLF in supine position (p N 0.05). However, the αLF was lower at Post16 during orthostatic posture compared to the baseline (p b 0.05). The variation of αLF between supine and orthostatic postures (ΔαLF) was higher at Post16, compared to the baseline (ΔαLF baseline: -1.7 ± 3.5; Post16: -6.9 ± 5.7; p b 0.05). A 16-week hydrotherapy program improved the cardiac baroreflex control response to the orthostatic stimulus in women with FMS.

Baroreflex sensitivity assessment in patients with type 2 diabetes during orthostatic challenge

Baroreflex dysfunction has been demonstrated in fibromyalgia syndrome (FMS). However, there are few studies evaluating the effectiveness of hydrotherapy programs on cardiovascular autonomic control in this population. This study evaluates the effects of a 16-week hydrotherapy program on baroreflex sensitivity (BRS) in women with FMS. Eight women with FMS took part in the study. The electrocardiogram, non-invasive finger blood pressure and respiratory activity were continuously recorded for all participants during 15 min in supine and 15 min in orthostatic (active standing) positions, before and after a 16week hydrotherapy program (Post16). The BRS was estimated via cross-spectral analysis, computed as the square root of the ratio of the low frequency (LF) band power of heart period on the LF power of systolic arterial pressure (αLF). The hydrotherapy program comprised 32 sessions of 45 min of pool exercises twice a week, for 16 weeks. At baseline there was no significant difference for the αLF index between supine and orthostatic positions (p N 0.05). At Post16, there was a significant decrease of the αLF during orthostatic stimulus compared to the supine position (p b 0.05). There was no significant difference between baseline and Post16 for αLF in supine position (p N 0.05). However, the αLF was lower at Post16 during orthostatic posture compared to the baseline (p b 0.05). The variation of αLF between supine and orthostatic postures (ΔαLF) was higher at Post16, compared to the baseline (ΔαLF baseline: -1.7 ± 3.5; Post16: -6.9 ± 5.7; p b 0.05). A 16-week hydrotherapy program improved the cardiac baroreflex control response to the orthostatic stimulus in women with FMS.