Hall (1996) A randomized and controlled trial of hydrotherapy in rheumatoid arthritis

Objective. The aim of this study was to evaluate the therapeutic effects of hydrotherapy which com-bines elements of warm water immersion and exercise. It was predicted that hydrotherapy would result in a greater therapeutic benefit than either of these components separately.

Method. One hundred thirty-nine patients with chronic rheumatoid arthritis were randomly assigned to hydrotherapy, seated immersion, land exercise, or progressive relaxation. Patients attended 30-minute sessions twice weekly for 4 weeks. Physical and psychological measures were completed before and after intervention, and at a 3-month follow up.

Results. All patients improved physically and emo-tionally, as assessed by the Arthritis Impact Measure-ment Scales 2 questionnaire. Belief that pain was con-trolled by chance happenings decreased, signifying improvement. In addition, hydrotherapy patients showed significantly greater improvement in joint tenderness and in knee range of movement (women only). At follow up, hydrotherapy patients maintained the improve-ment in emotional and psychological state.

Conclusions. Although all patients experienced some benefit, hydrotherapy produced the greatest improvements. This study, therefore, provides some justification for the continued use of hydrotherapy.

Key words. Evaluation, Hydrotherapy, Rheumatoid arthritis, Warm water, Exercise