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I chose the topic of aquatic therapy vs traditional therapy for treatment of arthritis. My PICO question is, In patients with arthritis, do aquatic therapy exercise techniques, compared to traditional exercise, reduce patient’s pain more? I chose this topic because I performed a lot of aquatic therapy on many different patients at my first clinical rotation. I also had quite a few arthritis patient’s that did not benefit from traditional therapy. Taking these thoughts into consideration, I wondered if there might be a way to treat patients with arthritis in a decreased weight bearing state, such as, in the water.
For the research of this paper, I used the data base PUBMED. I used the key phrase of “land and aquatic therapy for arthritis”; with this search, I found 18 articles. I focused my search by choosing articles posted within five years, and also chose full-text articles. Focusing my search limited me to six items. Then, I read the abstract of all six articles and found which one was most relevant to my topic. The article that I chose is called “Systematic review and meta-analysis comparing land and aquatic exercise for people with hip and knee arthritis on function, mobility, and other health outcomes”. The authors of this article include: Stephanie Batterham, Sophie Heywood, and Jennifer L. Keating. The article was obtained from the journal “BMC Musculoskeletal Disorders” from June 2, 2011.
This article is about the investigation of the effects of aquatic therapy compared to land based exercise on function and mobility for people with arthritis. Here is a brief description of the article and the outcomes. Ten randomized, controlled clinical trials that compared adults with hip or knee arthritis were included. All data and calculations were performed independently by two reviewers. Both sets of data were then compared for discrepancies and these were resolved through discussion. Arthritis is a process of inflammation and degeneration associated with pain, stiffness, joint instability that significantly affect daily life. Aquatic therapy and land based exercises are frequently used to maintain function for people with arthritis. The benefits of aquatic exercise are thought to result from water’s unique characteristics including warmth that reduce pain, buoyancy that decreases loading of joints, resistance to movement through turbulence and hydrostatic pressure. The unique characteristics of exercising in water may allow people to perform exercises that they would be unable to perform on land. Aquatic exercise appears to be a useful strategy for regaining movement and function loss associated with arthritis, but it is more expensive and resource intensive than land based exercise. Land based exercise, such as, strength training and aerobic exercise lead to significant improvements in pain, physical function and general health although compliance to long term exercise is poor. For all outcomes assessed in this review, no statistically significant differences were found for outcomes following water based compared to land based exercise.
This article answered my question by saying that there is not a significant difference in aquatic exercise vs land based exercise. The overall picture is that therapy is unique to every person with arthritis. Aquatic therapy may not be warranted due to issues with cost and limited availability. This article states that aquatic therapy appears neither more nor less effective than land based exercise. For people who have significant mobility or function limitations and are unable to exercise on land, aquatic exercise appears to be a legitimate alternative that may enable people to successfully participate in exercise. Both techniques are effective in increasing overall function necessary for daily living in patients with arthritis.
In conclusion, I utilized PUBMED to find an article that answered my question of “In patients with arthritis, do aquatic therapy exercise techniques, compared to traditional exercise, reduce patient’s pain more?”. I found that both techniques work for decreasing pain and increasing mobility in patients with arthritis, however, both techniques have advantages and disadvantages. Land based therapy is effective at improving pain, physical function, and general health, but compliance is an issue. Aquatic therapy is also effective, but availability and cost is an issue. When people are unable to exercise on land, or find land based exercise difficult, aquatic programs provide an enabling alternative strategy.
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