Cochrane Corner

Aquatic exercise for the treatment of knee and hip osteoarthritis

With the increasing expectations amongst patients as a whole, and particularly in the younger population, treatments that can alleviate symptoms and delay joint arthroplasty surgery are becoming more and more important. This updated review from Denmark evaluated the effects of aquatic exercise for people with hip and/or knee arthritis, compared with no intervention.³

This review found 13 trials whose participants (n = 1190) were mostly female, with a mean age of 68 and BMI of 29.4. These participants received an average of 12 weeks of physical exercise intervention in water. The authors found a moderate quality evidence that such exercise may have ‘small’, ‘short-term’ clinically relevant benefits on patient-reported pain and disability outcome scores, with the caveat that the conclusions were drawn from a very mixed population of participants with knee and hip OA.

Given the lack of adverse effects, it seems not unreasonable to offer hydrotherapy in patients in whom symptoms are difficult to manage in any other way. This said, clearly this is not a long-term solution, and surgeons and patients can be forgiven for being sceptical given the data presented here.