Tianyue Wang, Jiamin Wang, Yuheng Chen, Yanmin Ruan, Senjie Dai
Journal: Journal of orthopaedic surgery and research 2023;18(1):942
PMID: 38066577
Chronic musculoskeletal disorder is a persistent disorder lasting more than 3 months and is typically characterised by chronic pain and functional disability. In the traditional conservative treatment of chronic musculoskeletal disorders, drugs, injections, or electroshock therapy are often costly and the results are not particularly gratifying to patients. This study's aim was to investigate the efficacy and role of aquatic exercise (AE) in treating chronic musculoskeletal disorders. This study was a systematic review and meta-analysis of thirty-two studies. Results showed that patients who performed AE showed considerable improvements in pain, physical function, and quality of life compared to those who did not do exercise. In the meantime, AE showed a more significant improvement in the vital indicator of pain compared to patients conducting land-based (LE) but did not show an advantage in terms of physical function and quality of life. Authors concluded that more long-term clinical trials are required to further confirm the positive effects and improvement mechanisms of AE and the more existential advantages compared to LE as a treatment measure.
BACKGROUND
Aquatic exercise (AE) is becoming ever more popular as a physical therapy, while it is unclear what precise improvements it will produce and how effective it will be in comparison with other non-surgical therapies. The study aimed to assess whether AE positively impacts chronic musculoskeletal disorder patients in terms of pain, physical function, and quality of life.
METHODS
PRISMA guidelines were followed, and our study protocol was published online at PROSPERO under registration number CRD42023417411. We searched PubMed, Embase, Web of Science, and Cochrane library databases for English-language articles published before April 11, 2023, including studies from all relevant randomized controlled trials (RCTs). After screening, we ultimately included 32 RCTs with a total of 2,200 participants. We also performed subgroup analyses for all included studies. This meta-analysis calculated standardized mean difference (SMD) with 95% confidence interval (CI), and the variance was estimated using a random-effects model. The quality of the included studies was assessed by using the Cochrane collaborative "risk of bias" assessment tool (version 2.0). Thus ensuring that the literature included is of high quality.
RESULTS
This meta-analysis included 32 trials with 2,200 participants; these patients were all between the ages of 38-80. The study showed that compared to the no exercise (NE) group, patients in the AE group experienced a remarkable reduction in pain (SMD: -0.64, P < 0.001), a significant increase in physical function (SMD: 0.62, P < 0.001), and a statistically significant improvement in quality of life (SMD: -0.64, P < 0.001). When compared to land-based exercise (LE), AE significantly relieves patients' pain (SMD: -0.35, P = 0.03).
CONCLUSIONS
This is the first systematic review and meta-analysis to study whether AE could improve chronic musculoskeletal disorders. The evidence suggests that AE benefits pain, physical function, and quality of life in adults with chronic musculoskeletal conditions compared to NE. Furthermore, when compared to LE, AE continues to provide a better improvement in patient pain. More long-term clinical trials are needed to confirm AE's positive effects and improvement mechanisms and the more existential advantages compared to LE.
© 2023. The Author(s).
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