From the Guidelines
Hydrotherapy is a conditionally recommended treatment in physical therapy, particularly for patients with arthritis, fibromyalgia, and other conditions, but land-based physical therapy interventions are preferred over aquatic therapy interventions due to greater accessibility 1.
Introduction to Hydrotherapy
Hydrotherapy is a therapeutic approach that utilizes water for rehabilitation and healing, providing unique benefits due to water's physical properties. The buoyancy of water reduces gravitational forces on the body, decreasing joint compression and allowing patients with weight-bearing restrictions or pain to move more freely. Water resistance provides natural, multidirectional resistance that strengthens muscles without the need for weights. Hydrostatic pressure helps reduce swelling and edema by creating a compressive force on the body.
Benefits and Techniques
Common hydrotherapy techniques include:
- Aquatic walking or jogging
- Deep water running
- Resistance exercises using water dumbbells or jets
- Relaxation techniques Hydrotherapy is particularly beneficial for patients with:
- Arthritis
- Fibromyalgia
- Back pain
- Neurological conditions
- Post-surgical rehabilitation
- Sports injuries A typical session lasts 30-45 minutes, beginning with a warm-up, followed by specific therapeutic exercises, and ending with a cool-down period.
Precautions and Benefits
Precautions include avoiding hydrotherapy with:
- Open wounds
- Acute infections
- Fever
- Severe cardiac conditions
- Incontinence The physiological benefits of hydrotherapy include:
- Increased circulation
- Muscle relaxation
- Pain reduction
- Improved range of motion Psychologically, the warm water environment reduces anxiety and promotes relaxation, making hydrotherapy both physically and mentally therapeutic for many patients. According to the EULAR revised recommendations for the management of fibromyalgia, physical therapy with individualized graded physical exercise, which can be combined with hydrotherapy, is recommended if there is insufficient effect from initial treatment 1.
Recommendation
In adults with active ankylosing spondylitis, land-based physical therapy interventions are conditionally preferred over aquatic therapy interventions due to greater accessibility, although hydrotherapy can be used by those with access to a swimming pool or hydrotherapy tub 1.
From the Research
Hydrotherapy in Physical Therapy
Hydrotherapy, also known as aquatic therapy, is a form of physical therapy that uses water to help patients recover from injuries or manage chronic conditions. The use of hydrotherapy in physical therapy has been studied extensively, with research showing its benefits for various conditions, including musculoskeletal diseases, fibromyalgia, and stroke rehabilitation.
Benefits of Hydrotherapy
- Hydrotherapy has been shown to have beneficial effects on musculoskeletal conditions, such as osteoarthritis, rheumatoid arthritis, and low back pain 2.
- Aquatic exercise training has been found to improve multidimensional function, self-reported physical function, pain, stiffness, and muscle strength in adults with fibromyalgia 3.
- Hydrotherapy has also been shown to be effective in improving walking, balance, emotional status, and health-related quality of life in patients with stroke 4, 5.
Comparison with Land-Based Therapy
- Studies have compared the effects of hydrotherapy with land-based therapy, with some showing that hydrotherapy is more effective in improving balance, walking, and muscular strength in patients with stroke 4.
- However, other studies have found that the benefits of hydrotherapy are equivalent to those of land-based therapy, highlighting the need for individualized adaptation to each patient's needs 6.
Types of Hydrotherapy
- Established concepts of water-based therapy, such as the Halliwick, Ai Chi, Watsu, or Bad Ragaz Ring methods, have been found to be effective in stroke rehabilitation 4.
- Aquatic treadmill walking has been found to be less effective than other forms of hydrotherapy 4.