As the name suggests, Aquatic Therapy (AT) is a water-based mode of Physical Therapy (PT) that is used to facilitate functional goals and parameters of physical fitness for people in nearly every age group, activity level, and medical condition. More specifically, AT has been shown to improve endurance, strength, flexibility, balance, circulation, and to help with edema control. Perhaps the biggest advantage of AT is that the buoyancy forces from water take the load off your joints, decompress your nerves, and allow you to perform functional movements that you would not be able to do on land (i.e., improve mobility). Another positive aspect of AT is the possible therapeutic, relaxing effect from simply being in the water, which can improve your experience with PT.
In addition to the wonderful effects that AT confers for general physical fitness and wellness, a quick “dive” into the AT literature reveals that is has positive effects for a variety of specific groups:
Orthopedic populations-
Lasting functional change has been found with AT in orthopedic oriented populations. AT has been shown to improve the pain, joint stiffness, muscular strength, and quality of life for patients with hip and knee osteoarthritis (1). When combined with land-based therapy, AT improves knee range of motion, edema, and functional performance in patients who undergo knee replacement (2). For those with upper (3) and lower (4) extremity injuries, there is evidence that AT improves joint mobility, muscular strength, proprioception, core activation, and quality of life. Considering pain and injury relating to the spine, some studies have shown that AT decreases perceived pain for those with lumbar stenosis (5), increases perceived physical function for those with low-back pain (6), and improves quality of life, relaxation, and mood for those with neck pain (7).
Neurologic populations-
Physical therapists must use extra caution when working with patients with nervous system conditions, making AT a wonderful option for these situations. For example, research has demonstrated that AT has a positive effect on stiffness and functional performance for patients with fibromyalgia (8) and walking ability + balance for those with Parkinson’s disease (9). For patients with multiple sclerosis, there is evidence that AT has a positive effect on fatigue resistance and quality of life (10), in addition to increasing muscular strength and power (11). Considering those who have suffered acute injury or trauma, AT is also a powerful tool for the rehabilitation of strokes (12) and spinal cord injuries (13).
Higher level athletic populations-
Based on the brief review of literature above, AT may come across as a method of PT that is reserved for those with injuries or serious musculoskeletal disorders. However, it is important to point out that AT can be used to improve the mobility and strength for healthy, athletic populations who have suffered various sports-related injuries (14). For example, when compared to traditional land training, AT similarly improved balance and stability in collegiate athletes who were recovering from an ankle sprain (15). Alternatively, AT can be used to improve and/or sustain the cardiovascular and muscular fitness for athletes who endure overuse injuries such as tendinitis or stress fractures (16).
As you can see, AT is an effective form of PT with far-reaching benefits for a variety of populations from knee replacements, to spinal-cord injuries, to ankle sprains. Everyone can benefit from some form of AT, and for those interested in experiencing AT in a group-exercise setting, please see the details below for the brand-new Water Wellness class offered through Revolutions in Fitness.
References
1. Hinman RS, Heywood SE, Day AR (2007). Aquatic physical therapy for hip and knee osteoarthritis: Results of a single-blind randomized controlled trial. Physical Therapy 87: 32-43.
2. Gibson AJ, Shields N (2015). Effects of aquatic therapy and land-based therapy versus land-based therapy alone on range of motion, edema, and function after hip or knee replacement: A systematic review and meta-analysis. Physical Therapy Canada 67: 133-141.
3. Watts KE, Gangaway JMK (2007). Evidence-based treatment of aquatic physical therapy in the rehabilitation of upper-extremity orthopedic injuries. The Journal of Aquatic Physical Therapy 15: 1926.
4. Fappiano M, Gangaway JMK (2008). Aquatic physical therapy improves joint mobility, strength, and edema in lower extremity orthopedic injuries. The Journal of Aquatic Physical Therapy 16: 10-15.
5. Homayouni K, Naseri M, Zaravar F, et al. (2015). Comparison of the effect of aquatic physical therapy and conventional physical therapy in patients with lumbar spinal stenosis: A randomized controlled trial. Journal of Musculoskeletal Research 18:https://doi.org/10.1142/S0218957715500025.
6. Ariyoshi M, Sonoda K, Nagata K, et al. (1999). Efficacy of aquatic exercises for patients with low-back pain. The Kurume Medical Journal 46: 91-96.
7. Corvillo I, Armijo F, Alvarez-Badillo A, et al. (2019). Efficacy of aquatic therapy for neck pain: A systematic review. International Journal of Biometeorology 64: 915-925.
8. Lima TB, Dias JM, Mazuquin BF, et al. (2013). The effectiveness of aquatic physical therapy in the treatment of fibromyalgia: A systematic review with meta-analysis. Clinical Rehabilitation 27: 892-908.
9. Pompeu JE, Gimenes RO, Pereira RP, et al. (2013). Effects of aquatic physical therapy on balance and gait of patients with Parkinson’s disease. Journal of Health Science Institution 31: 201-204.
10. Amedoro A, Berardi A, Conte A, et al. (2020). The effect of aquatic physical therapy on patients with multiple sclerosis: A systematic
review and meta-analysis. Multiple Sclerosis and Related Disorders 41: 1-7.
11. Gehlsen GM, Grigsby SA, Winant DM (1984). Effects of an aquatic fitness program on the muscular strength and endurance of patients with multiple sclerosis. Physical Therapy & Rehabilitation Journal 64: 653-657.
12. Giurati S, Servadio A, Temperoni G, et al. (2021). The effect of aquatic physical therapy in patients with stroke: A systematic review and meta-analysis. Topics in Stroke Rehabilitation 28: 19-32.
13. Li C, Khoo S, Adnan A (2017). Effects of aquatic exercise on physical function and fitness among people with spinal cord injury. Medicine: Baltimore 96: e6328.
14. Prins J, Cutner D (1999). Aquatic therapy in the rehabilitation in the rehabilitation of athletic injuries. Clinics in Sports Medicine 18: 447-461.
15. Asimenia G, Paraskevi M, Polina S (2013). Aquatic training for ankle instability. Foot & Ankle Specialist 6: 346-351.
16. Thein JM, Brody LT (1998). Aquatic-based rehabilitation and training for the elite athlete. Journal of Orthopedic & Sports Physical Therapy 27: 32-41.