Faculty Scholarly Dissemination Grants


The Effectiveness Of Aquatic Therapy Following Total Hip Or Total Knee Arthroplasty: A Systematic Review


Physical Therapy


College of Health Professions

Date Range



Medicine and Health Sciences


THE EFFECTIVENESS OF AQUATIC THERAPY FOLLOWING TOTAL HIP OR TOTAL KNEE ARTHROPLASTY: A SYSTEMATIC REVIEW INTRODUCTION: Joint replacement procedures are becoming an ever increasing entity in healthcare today. Between the years 2007 and 2010, a total of 915,562 total knee arthroplasties (TKA) were performed. Additionally, there were an estimated 230,000 total hip arthroplasties (THA) performed in 2007 alone. Aquatic therapy can provide an alternative intervention for patients who may have difficulty with land based physical therapy or for whom land based physical therapy may not be appropriate. The purpose of this systematic review is to determine if aquatic therapy is an effective intervention for patients post-TKA and/or THA. METHODS: The databases that offered the most pertinent data were CINAHL Plus with Full Text, ProQuest Medical Library, and SPORTDiscus with Full Text. The search terms were aquatics OR aquatic therapy OR pool therapy OR hydrotherapy AND total knee arthroplasty OR total knee replacement OR TKA OR total hip arthroplasty OR total hip replacement OR THA AND randomized. This systematic review included the following inclusion criteria: (1) patients who have had a TKA or THA, (2) an intervention group who participated in aquatic therapy, (3) a comparison group who did not participate in aquatic therapy, (4) outcome measures that included pain, functional status, and/or quality of life, and (5) randomized controlled trials. Evidence level was determined by The Oxford Center for Evidence-Based Medicine 2011 Levels of Evidence. The methodological rigor of each included study was evaluated using the PEDro scale. RESULTS: Through a database search, a total of 1508 articles were found. After removal of duplicates and screening of records as shown by the PRISMA 2009 flow diagram, all but six studies were eliminated and included into the qualitative synthesis. Four of the six studies found several statistically significant differences in favor of aquatic therapy. One study found no significant differences between aquatic therapy and land therapy. The remaining study found no significant differences between specific aquatic therapy, non-specific aquatic therapy, and land therapy. DISCUSSION: This systematic review indicated that aquatic therapy was not an inferior intervention as compared to the control groups. In general, aquatic therapy participants demonstrated similar if not superior outcomes as compared to land-based therapy. Aquatic therapy may provide long-term positive outcomes after the cessation of treatment. CONCLUSION: Aquatic therapy should be considered as an alternate intervention medium for improving function, pain, and quality of life, in individuals following total-knee or total-hip joint replacement.

Conference Name

Michigan Physical Therapy Association Fall meeting

Conference Location

Kalamazoo, Michigan

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