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What is the evidence for water-based exercise in treating osteoarthritis of the knee?

Meta-Analysis

Verhagen, A. P., et al. (2012). "Aquatic exercise & balneotherapy in musculoskeletal conditions." Best Pract Res Clin Rheumatol 26(3): 335-343.
What's this
AMSTAR Rating
2

Summary

Patient Population:

No patient population information was provided.

Intervention:

Aquatic exercise (water-based exercise, aquatic therapy or hydrotherapy) and Balneotherapy (seated immersion or spa therapy).

Comparison:

Various forms of exercise in the treatment of osteoarthritis of the hip and knee.

Outcome:

  1. Pain: aquatic exercise vs. placebo – significant difference in favour of exercise (SMD=0.19, 95% CI 0.04, 0.3).
  2. Function: aquatic exercise vs. placebo – significant difference in favour of exercise (SMD=0.26, 95% CI 0.11, 0.4).
  3. Aquatic exercise vs. land-based exercise: no clear evidence if one is more effective than the other.
  4. Balneotherapy: no clear evidence that balneotherapy is effective. Conclusions are hampered by low power, high risk of bias and “poor data presentation”.

Guideline Recommendations

Source Recommendation
ACR (2019) Strongly recommended

Outcomes Assessed

  • Benefit
  • Harm
  • Inconclusive

Aquatic Exercise vs. Placebo

Pain

Function

Aquatic Exercise vs. Land-Based Exercise

Overall Outcome

Balneotherapy

Overall Outcome

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