Kristal Loo
December 2003

Aquatic Therapy and Arthritis

Introduction

Aquatic therapy has physical, social, and emotional benefits within a single activity. The intervention approaches used would be health promotion, maintenance, and prevention while working within the client’s areas of occupation of play, leisure, and social participation.

Evidence-Based Practice Question

Is there a self-perceived increase in ROM, functional ability, and self-esteem in adults with arthritis living in the community, after participating in an aquatic fitness program as a leisure activity?

Criteria for Evidence Selection

In searching for evidence, the following areas were examined: the effects of aquatic therapy on an arthritic patient, how leisure activities and exercise were affected if person has arthritis, and the role an occupational therapist plays in aquatic therapy. The boundaries were any articles within the last ten years, written in English, with any type of study design or data collection.

Summary of Evidence

Participation in an aquatic fitness program will maintain or increase AROM, independence, self-esteem, endurance, and immune function while decreasing morning stiffness, edema, stress, depression, and pain for a person with arthritis. An OT has a role in promoting exercise. The aquatic program is a great place for social interaction as a leisure activity that may be a meaningful occupation, therefore improving client quality of life.

Implications for Consumers

Participating in an aquatic fitness program promotes better health, meaning less time in the hospital. There is an increase or maintenance of strength, endurance, and range of motion which decreases the cost of assistance, aids needed for safety, and possible surgeries.

Implications for Practitioners

Involvement in a community program offers the prevention, maintenance and health promotion needed by people with arthritis. Community resources should be utilized, especially after insurance coverage expires.

Implications for Researchers

The research is sparse and dated. More research in whether participation in an aquatic program increases self-esteem and quality of life needs to be conducted. There should be more longitudinal studies from onset through disease process.

Recommendations for Best Practice

Consider intensity of exercises so as not to exacerbate the stress on joints. Remember that a warmer temperature of the water (approximately 91.3° ) is therapeutic to muscles and joints. Encourage movement through all joints in the body. Use a varied routine from session to session to prevent boredom and avoid using repetitive motions to hinder discomfort.

References

Caldwell, J. R. (1996). Exercise in the elderly: An overview. Exercise Programming for Older Adults, 20, 3-8.

Getch, M. R., Connell, K. J., Sinacore, J. M., & Prohaska, T. R. (1996). A survey of exercise beliefs and exercise habits among people with arthritis. Arthritis Care and Research, 9, 82-88.

Minor, M. A., (1996). Arthritis and exercise: The times they are a-changin’. Arthritis Care and Research, 9, 79-81.

Soukup Fischer, M., Kratz, A., Jimenez, B., Watson, C., Spence, C., Sanford, T., Goertz, H., & Scolaro, M. (2001). Aquatic therapy an occupational perspective. OT Practice, 6, 14-16.

Templeton, M. S., Booth, D. L., & O’Kelly, W. D. (1996). Effects of aquatic therapy on joint flexibility and functional ability in subjects with rheumatic disease. Journal of Orthopedic Sports Physical Therapy, 23, 376-381.

Wikstrom, I., Isacsson, A., & Jacobsson, L. T. H. (2001). Leisure activities in rheumatoid arthritis: Change after disease onset and associated factors. British Journal of Occupational Therapy, 64, 87-92.