Hydrotherapy Sessions Research Articles

The added value of supervised hydrotherapy sessions to a 12-week exercise program after breast cancer treatment: a three-arm pseudo-randomized pilot study

Sufficient physical activity after breast cancer treatment is crucial for improvement of a wide range of health-related outcomes and survival. The first aim of this pilot study was to explore whether adding supervised hydrotherapy sessions to a standard 12-week exercise program consisting of already two supervised sessions of land-based exercises has beneficial effects on physical and mental functioning and quality of life in breast cancer survivors. As a secondary aim, the added value of a third supervised training session with land-based exercises to the same standard exercise program was investigated. Breast cancer patients who finished primary cancer treatment were allocated to one of the three 12-week exercise programs, i.e. a standard exercise program with two supervised land-based exercise sessions per week (control group) or the same standard program with an additional weekly supervised hydrotherapy session (hydrotherapy-group) or land-based exercise session (land-based exercise group). The efficacy of the three programs was tested by comparing changes in physical and mental functioning and quality of life from pre- until post-intervention. Twenty-six (41%) patients were allocated to the control group, 21 (33%) to the hydrotherapy-group and 16 (26%) to the land-based exercise group. The results show no differences in any outcome between the three groups. Comparing the two exercise programs with three supervised sessions, results show a significantly larger improvement in the self-reported moderate (median (IQR) +1240 (412;3330) vs. +50(-1088;1125);p=0.020) and total physical activity level (+2982 (878;5457) vs. +370(-576;1718);p=0.008) in the hydrotherapy-group compared to the land-based exercise group. The opposite was found for the outcome ‘physical symptoms’, a subscale from the health-related quality of life questionnaire with a larger improvement in the land-based exercise group compared to the hydrotherapy-group (+3(0.6;4.8) vs. +0.6(-0.8;2.1); p=0.008). In conclusion, the results of this pilot study indicate that adding a third weekly supervised session to a 12-week exercise program consisting of already two weekly supervised sessions had no added value for the improvement of physical and mental functioning and quality of life after breast cancer treatment. If a third supervised session is organized, hydrotherapy may be a valuable exercise modality since moderate and total physical activity levels seem to improve more compared to an exercise program with three supervised land-based exercise sessions. For self-reported physical symptoms although, a land-based exercise program seems more beneficial. Because of the limited sample size and pilot study design all obtained findings need to be interpreted with caution.

Feasibility of a Hydrotherapy and Self-Management Education Program for Breast Cancer Patients with Shoulder Impairment

<h3>Research Objectives</h3> To evaluate the feasibility and acceptability of a multidimensional hydrotherapy and self-management education program for breast cancer patients. Secondary objectives were to explore change on shoulder disability measured by validated patient reported outcomes and therapist measured shoulder range of motion (ROM) and grip strength. <h3>Design</h3> This retrospective cohort study analyzed pre- and post-intervention data collected between January 2017 and March 2020. <h3>Setting</h3> Outpatient rehabilitation clinic in Toronto, Canada. <h3>Participants</h3> A total of 114 participants' charts were reviewed during the study period. Participant selection utilized a clinically referred sample of breast cancer patients with moderate to severe shoulder impairment and deemed medically fit to participate in aquatic based therapies. <h3>Interventions</h3> Six weekly, small group (n=3-7), supervised, hydrotherapy and educational sessions targeting shoulder mobility, scar management, lymphedema, and pain. <h3>Main Outcome Measures</h3> Feasibility was defined as ≥ 60% retention and ≥ 80% session attendance. Acceptability was defined as ≥ 80% satisfaction (≥ 4 on a 5 point Likert scale). <h3>Results</h3> A total of 88 (82.2%) participants attended at least 80% of the education sessions and 78 (76.5%) attended at least 80% of the aquatic sessions. 60 (96.8%) participants reported satisfaction with educational material; 44 (95.7%) reported satisfaction with hydrotherapy sessions. Statistically significant improvements were observed in DASH, SPADI, grip strength, and most ROM measures. <h3>Conclusions</h3> Combined hydrotherapy and self-management education appears to be a feasible and acceptable rehabilitation intervention for breast cancer survivors with shoulder impairment. While this could represent a potential adjunct to traditional land based therapies, future prospective randomized control trials are required to confirm causation and to explore the effect on functional outcome measures. <h3>Author(s) Disclosures</h3> None

Impact of Hydrotherapy on Antioxidant Enzyme Activity in an Elderly Population.

Oxidative stress is defined as the imbalance between reactive species and antioxidant agents. One of the effects of oxidative stress is the normal process of cellular aging that stems from the accumulation of tissue damage. Epidemiological studies show that regular physical exercise prevents the injuries caused by aging. The objective was to evaluate whether the practice of hydrotherapy, in an elderly population, positively influenced the activity of the enzymes superoxide dismutase, glutathione peroxidase and reductase that act by reducing reactive species in the body. The study involved 37 participants aged ≥ 60 years, of both sexes, divided into experimental and control groups. The experimental group performed 15 hydrotherapy sessions. Enzyme activity was evaluated in two moments: T0-before the first session, and T1-after the last session, with blood collections conducted in both. In T1, there was a significant increase vs. T0 of glutathione peroxidase activity (57.72 ± 19.99 vs. 48.14 ± 17.22 U/g Hb) and glutathione reductase activity (100.18 ± 30.85 vs. 78.44 ± 21.26 U/L). Both sexes tended to show higher values at T1. We concluded that hydrotherapy proved to be a positive stimulus for the enzymatic antioxidant activity of the elderly, suggesting that a regular and moderate practice of physical exercise induces better and higher quality of life.

Percepção de mulheres sobre a fisioterapia aquática na pós-menopausa: um estudo qualitativo

Abstract Introduction: The transition from reproductive to post-reproductive life is part of the female life cycle that impacts well-being, with menopause as a significant milestone. Regular physical activity should be encouraged to mitigate the symptoms of menopause and prevent age-related problems. Hydrotherapy is one such alternative, since immersion in heated water facilitates exercises that would be difficult to perform on land. Objective: Assess women’s perception about the effect of hydrotherapy on the signs and symptoms of postmenopause. Methods: A qualitative study in which participants underwent 48 hydrotherapy sessions and answered a semistructured interview. Results: The participants were eight women, aged 55.75 ± 8.55 years, menopausal for 8.5 ± 7.98 years, with vasomotor symptoms (100%), mood swings (87.5%), sleep disorders (87.5%), vaginal dryness (62.5%), low sex drive (62.5%) and chronic pain (100%). Conclusion: Women’s perception about the effects of hydrotherapy on the signs and symptoms of postmenopause include less pain and muscle tension, a decline in the signs and symptoms, better quality of life and sexual pleasure, and an improvement in biopsychosocial factors such as anxiety and stress through better social interaction.

A comparison of apparent neck and back angles before, during and after canine hydrotherapy

Research examining canine hydrotherapy is distinctly lacking despite the increasing use of hydrotherapy as a rehabilitation tool and as part of a fitness programme. Due to this paucity of research, the aim of this study was to examine differences in apparent neck and back angles of dogs both before, during and after hydrotherapy sessions. Anecdotally, these are the anatomical locations where concern of injury risk lies. Thirty-one dogs were filmed trotting both prior to and post participation in hydrotherapy as well as during the hydrotherapy session. Data were then analysed using Dartfish software. There was no significant difference in the neck angle of the dogs between swimming and trotting (P=0.859) however, dogs had a significantly greater back angle when swimming compared to trotting (P=0.05). The use of buoyancy aids during hydrotherapy, showed no significant difference in neck or back angles compared with no buoyancy aids. This study begins to provide evidence on the effect of hydrotherapy on canine kinematics. It can be used to inform rehabilitation and fitness regimes for dogs with the aim to improve the long-term health and welfare of dogs.

623 Procedural Pain Management in Burn Patients – A Quality Improvement Project

Abstract Introduction Achieving adequate burn pain control in patients is paramount as inadequate control can lead to PTSD, suicidal ideation, and depression. The pain accompanying hydrotherapy can be extreme and challenging to manage. The purpose of this quality improvement project was to assess our burn center’s current nurse-driven procedural pain control protocol during hydrotherapy. Methods Burn patients admitted from June to August 2020 who underwent hydrotherapy were observed during the procedure. Demographics, comorbidities, injury related data, and pain and sedation medication data were collected. Pain scores (1–10), patient and nurse satisfaction scores (1–10) were collected before, during, and after hydrotherapy. A single patient could be surveyed for up to three times. Paired t-tests and one-way ANOVA were performed to assess significant differences between pre- and post-procedure patient pain scores and satisfaction ratings across encounters, respectively. P &amp;lt; 0.05 was considered significant. Results Twenty-eight patients and 48 hydrotherapy events were surveyed. Patients were predominately male (23, 82.1%), middle aged (44.8 ± 19.6), and had a TBSA of 11.9 ± 10.5%. Analyzing only the first hydrotherapy sessions, time from initial opioid dose to hydrotherapy varied greatly as did the opioid morphine equivalent dose (OME) provided prior to hydrotherapy (Table 1). Only 13 (46.4%) subjects received versed during hydrotherapy. Pain scores post-procedure significantly increased compared to pre-procedure scores (5.39 vs. 6.32; p = 0.035). There was no significant difference in patients’ or nurse’s satisfaction scores regarding pain control nor with nurse’s rating of ease of procedure when comparing scores across the three encounters (Table 1). No adverse events (SaO2 &amp;lt; 92% or deep sedation RAS &amp;lt; 2) were observed across all encounters. Conclusions Our results suggest that procedural pain control during hydrotherapy, while safe, has opportunities for improvement. Pre-procedural medication timing remains imprecise and widely divergent. Satisfaction scores, while high, also have room for improvement. Finally, pre-procedural pain control is unacceptable (mean 5.39) and requires attention.

Aquatic exercise in patients with haemophilia: Electromyographic and functional results from a prospective cohort study.

Recurrent joint bleeds in haemophilia patients often cause musculoskeletal changes leading to functional capacity impairment. In this study, we assessed the effects of aquatic activities performed to improve functional capacity in these patients. The interventional protocol consisted of 24 hydrotherapy sessions during three months, in comparison with 24 swimming sessions. The pre- and post-intervention assessment consisted of Functional Independence Score, haemophilia joint health score (HJHS), Pediatric Haemophilia Activities List (PedHAL), surface electromyography (SEMG) of thigh muscles to assess muscle electric activity, and load cell on extensor and flexor thigh muscles to evaluate muscular strength. Forty-seven haemophilia patients were enrolled in this study, and 32 (23 severe haemophilia A, one moderate haemophilia A and 8 severe haemophilia B), median age 12y (6 to 40y), concluded the aquatic intervention. We observed a statistically significant increase with substantial improvement in functional capacity in the pre- and post-intervention evaluation of hydrotherapy in comparison with the swimming protocol, with HJHS (p=.006 and p=.001 respectively), PedHAL (Sum score) (p=.022 and p=.001) and score FISH (p=.021). The swimming group revealed significant improvements in muscular strength, in all muscles tested (p=.005 and p=.001). SEMG signal amplitude reached significantly higher levels in all muscles evaluated after both interventions except for the vastus medialis (right) in the hydrotherapy group. Our results concluded that both swimming and hydrotherapy were associated with physical improvement in haemophilia patients; however, only hydrotherapy lead to a more significant improvement in functional capacity.

Supersaturated Hydrogen-Rich Water Hydrotherapy for Recovery of Acute Injury to the Proximal Phalanges on the 5th Toe: A Case Report

Background: Traditional treatments of soft tissue injuries (STIs) and some musculoskeletal injuries (MSK-Is) involves therapies such as the RICE protocol, which consists of rest, ice, compression and elevation for several days following acute trauma. Designed to improve comfort and reduce pain following traumatic injury, questions exist on the efficacy of RICE protocol; if it may in fact delay the rate of healing; and if it has any beneficial effect at all. Recently, a growing body of evidence has suggested molecular hydrogen therapy (H2) as a potential adjuvant, or first line treatment, for numerous MSK-Is, STIs, and afflictions affecting the skin, both through topical administration and oral consumption. Case report: The recovery of a middle-aged male who suffered an injury to the proximal phalanges of the 5th toe of the right foot while kickboxing. The participant received four 25-minute hydrogen-rich hydrotherapy sessions in a super saturated solution with an average concentration approaching 8mg/L, on days 1,3,5,7 following injury. Recovery noted a rapid reduction in pain and swelling, a dramatic improvement in range of motion and ability to bear weight, and an ability to conduct limited activities after first treatment, including walking and modified exercise (i.e., boxing). Conclusion: This case is yet another indication that high-concentration hydrogen-rich hydrotherapy may be a helpful first line treatment in terms of reduction of pain and improvement in function following injury, in addition to the evidence suggesting benefit in reducing chronic indications caused by acute or chronic stress.

Case Report

Background and Purpose: This case report describes the hydrotherapy sessions received in conjunction with a rehabilitation program designed for a patient recovering from coronavirus disease 2019 (COVID-19) with intensive care unit (ICU)–acquired muscle weakness. The primary purpose of this case report was to examine the effects of hydrotherapy in a patient recovered from COVID-19 with ICU-acquired muscle weakness in the absence of any cross-infection. Case Description: The subject was a 29-year-old man in recovery after contracting COVID-19 infection and ICU-acquired muscle weakness. On admission to the orthopedic rehabilitation ward at Sheba Medical Center, the patient tested negative for COVID-19 according to the polymerase chain reaction test. Intervention: The patient received 4 hydrotherapy sessions that involved exercising in warm water (31°C-35°C) to improve muscle strength in a non- or low–weight-bearing capacity. A standard physical therapy program was also provided to the patient. Outcome: Following 2 weeks of rehabilitation that included 4 hydrotherapy sessions combined with a standard physiotherapy regimen, the patient was discharged home and able to walk outdoors independently for at least 30 minutes. Aside from the inclusion of specific personal protective equipment and social distancing (2 m), no additional requirements were necessary to our standard pool hygiene and no adverse infections were reported. Discussion: The results of this case report showed that hydrotherapy is a useful modality in the rehabilitation of ICU-acquired muscle weakness developed as a result of COVID-19.

Hydrotherapy in the evaluation of enzymatic antioxidants in an elderly population

Abstract Introduction Oxidative stress is the imbalance between reactive species produced in the body during metabolic reactions and antioxidant agents that have the ability to neutralize or prevent the formation of these species. One of the effects of oxidative stress is the normal and physiological process of cell aging that arises from the accumulation of tissue damage caused by free radicals. Objectives To assess whether the activity of enzymes superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GR) are influenced by the hydrotherapy sessions. Methodology 37 subjects aged 60 years old and above, of both genders, were divided into two groups (experimental and control). The experimental group underwent 15 hydrotherapy sessions supervised by a physical therapist. Two peripheral venous blood samples were collected at two different times: T0, instant before the intervention and T1, instant after the last session. The activity of SOD, GPx and GR enzymes were determined, respectively, with the Ransod superoxide dismutase, Ransel glutathione peroxidase and glutathione reductase commercial kits, from Randox Laboratories Limited, United Kingdom. The assay was performed as described in the kits and the sample results were obtained by spectrophotometric reading. Results SOD activity at T1 tended to decrease slightly compared to T0 (1437.64 ± 593.46 vs 1421.41 ± 705.39 U/g Hb). At T1, there was a statistically significant increase in GPx activity (48.14 ± 17.22 vs 57.72 ± 19.99 U/g Hb) and in GR activity (78.44 ± 21.26 vs 100.18 ± 30.85 U/L). Regarding gender, both genders tended to have higher values of GPx and GR at T1. Conclusion According to the obtained results, we conclude that the practice of hydrotherapy presents as a positive stimulus in the antioxidant activity of aged individuals suggesting that a regular and moderate practice of exercise induces a higher quality of life.

Effects of a projector-based hybrid virtual reality on pain in young children with burn injuries during hydrotherapy sessions: A within-subject randomized crossover trial

AimThe aim of this study was to examine the effect of a water-friendly Projector-Based Hybrid Virtual Reality (VR) dome environment combined with standard pharmacological treatment on pain in young children undergoing burn wound care in hydrotherapy. MethodsThis study was a prospective, within-subject crossover trial of 38 children aged 6 months to 7 years old (mean age=1.8 years old). Each hydrotherapy procedure was divided into two equivalent wound care segments (No hybrid VR during one segment vs. Hybrid VR during the other segment, treatment order was randomized). Pain was measured using the 0–10 FLACC (Face, Legs, Activity, Cry Consolability scale) and the 0–10 NRS-obs (Numerical Rating Scale-obs). ResultsProjector-Based Hybrid VR significantly reduced procedural pain levels measured by the FLACC (p=0.026) and significantly increased patients' comfort levels (p=0.002). Patients' pain levels rated by the nurses using the NRS-obs were non-significant between both groups (p=0.135). No side effects were reported. ConclusionProjector-Based Hybrid VR helped in reducing the pain related to hydrotherapy procedures in young children with burn wound injuries. This is the first study using virtual reality distraction with young children, and our findings are especially important because a large percentage of pediatric burn patients are very young. Additional research and development are recommended. Trial registrationClinicalTrials.gov, NCT02986464, registered on June 12, 2016.

Hidrotherapy

Objective. The aim of this study was to compare the evolution of daily life activities of patients suffering from sequels of strokes who were submitted to hydrotherapy, conventional kinesiotherapy and those with no physiotherapeutic intervention. Method. A total of 152 patients of both genders were selected according to their arrival in the service and were submitted to hydrotherapy in isolation or together with classical kinesiotherapy, over six months. The 45-minute hydrotherapy and classical kinesiotherapy sessions were performed at least three times weekly. Functional activity was evaluated every three months to identify: the dependence, semi-dependence or independence on routine activities. Analysis of the functional activity was assessed by means of the Barthel index. Results. Of the 152 patients, 118 satisfied inclusion criteria. The participants were divided into three groups: 72 (61%) underwent conventional kinesiotherapy, 32 (27.1%) hydrotherapy followed by conventional kinesiotherapy and 14 (11.9%) had no physiotherapeutic interventions. The conventional kinesiotherapy with hydrotherapy group improved in relation to both the degree of independence and lighter motor sequels (p=0.001). The neurological deficit remained greater in the non-treatment group than in the others (p=0.01). Conclusion. The hydrotherapy may be considered a good coadjuvant procedure for patients with sequels due to stroke.

Ambulatory Balneological Treatment for Rheumatic Diseases; an Effective Option?

Balneological treatment procedures include balneotherapy (passive immersion in mineral/thermal water), peloid therapy/mud therapy (therapeutic applications of medical peloids or muds), hydropinotherapy (drinking cures of mineral water), mineral water inhalation therapy (inhalation of mineral water aerosols) and hydrotherapy (tap water passive immersion or aquatic exercise in tap water). These modalities have traditionally been derived in spa resorts and usually applied to the patients who travelled to those resorts during their stay at the spa facility/hotel. The efficacy and safety of these balneological treatments administered at spa resorts for a variety of rheumatic diseases have been relatively well studied in randomized controlled trials. And the reported results mainly indicate the beneficial effects and good safety profile of balneotherapy and/or mud therapy in patients with musculoskeletal diseases; however, the availability of these treatments only at regional spa resorts where the mineral water and peloid natural origin is found limit and restrict the widespread use of these treatments despite promising evidence on efficacy. To overcome this challenge innovative approaches have been explored to provide such balneological treatments outside of the traditional settings for patients who would benefit from but could not afford this kind of treatment. Hydrotherapy (tap water immersion) and peloidotherapy or mineral mud therapy (packed clay artificially mixed with mineral water) are provided in our university clinic setting as ambulatory care; however, the evidence on effectiveness of this type of hydrotherapy and peloidotherapy applications with an outpatient basis allowing the patients to continue their daily routine is limited. Interestingly these new therapeutic options are totally reimbursed by the social healthcare insurance system in Turkey. The rational here is based on the clinical evidence from studies evaluating spa therapy regimens (balneotherapy and/or mud therapy at health resorts) that require travelling and staying at resorts leading to change in environmental/social milieu but increasing the expenses. With the aim to report the results of original studies testing the efficacy and effectiveness of this new type of balneological treatment approaches, we included two recently published publications from our department; an RCT comparing two different balnelogical treatment regimens (intermittent or continuous hydrotherapy plus peloidotherapy sessions) for knee osteoarthritis yielding comparable results; improvements in pain and function for both groups and a retrospective study of outpatient balneological treatment consisting of hydrotherapy and mud therapy in elderly patients with osteoarthritis providing initial evidence for the potential therapeutic effects and safety of such treatment. Considering these promising results from the two initial clinical studies evaluating this new type of balneological treatment approach - combination of hydrotherapy and peloidotherapy- which can be given in routine outpatient practice at all possible settings/clinics, further clinical trials are needed to test the effects of such treatment in patients with different rheumatic and musculoskeletal diseases.

Elderly Women’s Experience of the Role of Hydrotherapy in Health: Content Analysis

Living to an old age is considered by many elderly women to bring about a decreased quality of life. Hydrotherapy allows individuals to engage in certain physical activities that cannot be done outside the water. The purpose of this study was to explore elderly women’s experience of the role of hydrotherapy in their health and was conducted in selected pools of Guilan province in Iran in 2015-2016. Twenty-three elderly women were selected using a purposeful sampling strategy. The data was gathered through semi-structured interviews; Researchers used a qualitative design, based on a content analysis approach. Analysis results were identified as 3 main themes and 12 subthemes. Improved physical health: reduced consumption of painkillers, improved balance, pleasant breathing, easy menopause; Moving toward ability: increased independence, role fulfillment, application of efficient strategies, will to health; Psychological and social relief: sense of liveliness, reduced stress, peaceful sleep and re-emergence in society. “Competence development” was identified as the central code. Results indicate that participation in hydrotherapy by elderly women supported the benefit of advising them to participate in hydrotherapy sessions, as well as government’s cooperation with regard to creating proper conditions for improving the health and life quality of this valuable population.

Diagnóstico e tratamento do embolismo fibrocartilaginoso em um cão de pequeno porte: Relato de caso

Myelopathy due to fibrocartilaginous embolism is characterized by an infarction of the spinal cord caused by fibrocartilaginous embolism identical to the nucleus pulposus of the intervertebral disc. Of rare occurrence and described mainly in adult and large dogs, it can also be found in small dogs. The present report occurred in a two and a half year old canine, West Highland White Terrier, who was treated at a veterinary hospital with sudden tetraparesis, where he remained hospitalized for twenty one days and after being discharged, treatment for sixty days. The diagnosis was made through clinical signs, biochemical tests to exclude differential diagnoses and computed tomography that identified the thrombus in the cervical region. The treatment consisted of nursing care, physiotherapy, hydrotherapy and acupuncture sessions. After 180 days of spinal cord injury, the animal had the right front limb without full elbow flexion as a sequel of a probable brachial plexus injury, with sensitivity to deep pain, walkking with the aid of a walker and rising alone.

Stress Reduction in Chronic Patients’ Professional Carers Through Hydrotherapy

ObjetivoCuidadoras em trabalho institucional para pessoas com deficiências profundas exercem atividades fundamentais, mas desgastantes, observadas constantemente por todos os memberos da instituição (diretores, funcionários e até voluntários), provocando altos níveis de stress. O objetivo foi realizar uma atividade que reduza o stress em cuidadoras de pacientes crónicos institucionalizados.MétodoParticiparam 11 cuidadoras formais de uma instituição residencial para atendimento de pessoas com paralisia cerebral severa, que responderam ao Inventário de Sintomas de Stress para Adultos de Lipp – ISSL, antes e após sessões de hidroterapia semanais.ResultadosOs resultados demostraram que todas as participantes apresentaram elevado grau de stress antes das sessões e houve redução dos sintomas na maioria das participantes após a hidroterapia. São discutidas as necessidades destas profissionais com formação escolar básica, sem cursos técnicos e muito exigidas pelas instituições.ConclusãoQuanto melhores forem as suas condições de trabalho, melhor será a sua relação com os assistidos, que são os motivos reais da existência das instituições.

Efeitos da Hidroterapia na Capacidade Vital Forçada de Paciente com Esclerose Lateral Amiotrófica

Objective. To evaluate the effects of a hydrotherapy program on forced vital capacity of patients with Amyotrophic Lateral Sclerosis (ALS). Method. Case study of a patient diagnosed with ALS, male and 58 years old, who underwent hydrotherapy sessions with empha­sis on training of respiratory muscles and chest mobility, 6 months, 2 times a week, in sessions lasting 40 minutes. Evaluation of forced vital capacity (FVC%) was performed with spirometer before, during and after the hydrotherapy program. Results. FVC, before the program was 100.7% of predicted. After conducting 25 sessions of hydro­therapy demonstrated FVC was 69% predicted. Finally, at the 49th session in FVC was 55.5%. Conclusion. Despite the decline in FVC, expected due to disease progression, the patient was able to perform hydrotherapy sessions without signs and/or symptoms of respiratory distress. It is suggested reproduction study in a larger number of sub­jects, using the control group, with the aim of generating indicators on the interference in the forced vital capacity in patients with ALS.

AB0912 The introduction of ankylosing spondylitis annual review clinics at a london teaching hospital

BackgroundNational U.K recommendations1 have led to the introduction of annual review clinics for patients with rheumatoid arthritis. We considered the benefits of ankylosing spondylitis annual review clinics.ObjectivesReview the diagnosis of...

Kneipp hydrotherapy for menopausal symptoms—Results of a pilot study

Objective The aim of this prospective randomized controlled study was to investigate whether Kneipp hydrotherapy with short cold water stimuli helps alleviate menopausal symptoms such as hot flashes, insomnia, or depressed mood. No prior studies investigating this topic could be identified. Material and methods The study included 80 women (mean age 55.0±4.93 years) with menopausal symptoms (minimum score of 10 points on the Menopause Rating Scale II (MRS II), a validated 11-item questionnaire). Patients were randomized either into group 1, which immediately started 6 weeks of daily home-based hydrotherapy or group 2, which waited for 6 weeks before beginning the same intervention. The treatment consisted of at least two self-applied hydrotherapy sessions daily. Every patient received professional group instruction before beginning hydrotherapy. After 6 weeks of treatment, all patients were asked to continue for another 6 weeks. Results A total of 60 women completed the study. Mean baseline MRS II scores were comparable between the two groups (group 1: 20.8±6.0; group 2: 21.1±5.8 n.s.). After 6 weeks, means for MRS II showed improvements in favour of the intervention compared to the waiting list group (group1: Δ 6weeks : −6.1±6.6; group 2: Δ 6weeks : −4.0±3.0; group comparison, P =0.33, Mann–Whitney U Test).Group comparison of the relative differences between MRS II scores before and after intervention just failed to reach significance only by a small margin (group1: Δ 6weeks : 31.9±30.4%; group 2: Δ 6weeks : 18.9±14.8%; group comparison, P =0.052, Mann–Whitney U Test). After 12 weeks of therapy, both groups demonstrated marked improvements of 41.3% (group 2) and 41.5% (group 1) in MRS II scores (total score difference before and after hydrotherapy: −7.4±5.5, P Conclusion Cold stimuli such as those applied in Kneipp hydrotherapy appear to have moderate effects in alleviating of menopausal symptoms. Patient acceptance of hydrotherapy was remarkably high. Further studies are needed to examine the mode of action of hydrotherapy and long-term effects of hydrotherapy.

Efeito da hidroterapia, utilizando o Método dos Anéis de Bad Ragaz, no tratamento da artrite reumatóide juvenil: um estudo de caso

O objetivo neste estudo foi avaliar o efeito de um programa de hidroterapia, utilizando o Método dos Anéis de Bad Ragaz (MABR), na postura e na qualidade de vida de um portador de artrite reumatóide juvenil (ARJ), com 18 anos de idade. Foram realizadas avaliações pré e pós-tratamento, incluindo análise de amplitude de movimento (AD M), avaliação postural, exames de flexibilidade para cadeias musculares, avaliação da dor e rigidez matinal, e da qualidade de vida. O tratamento consistiu de dez sessões de hidroterapia (MABR), com duração de 45 minutos, duas vezes por semana. Após o tratamento, observou-se melhora na AD M, postura, flexibilidade muscular e escores da maioria dos domínios do questionário de qualidade de vida Short Form 36 Questionnaire (SF-36). Concluiu-se que o MABR possibilitou ao portador de ARJ melhora da flexibilidade, da postura e de qualidade de vida, diminuição da dor e amplitude de movimento, sendo recurso de grande valia para o tratamento dessa doença.