Hydrotherapy outcome measures for people with arthritis: A systematic review

Abstract

Exercise has been shown to be effective in decreasing pain, improving function and performance of activities of daily living in people with arthritis. While hydrotherapy is often suggested as an exercise intervention, there is little evidence that it is more effective than other forms of exercise. Scoping the literature identified that a large variety of outcome measures were used. This study aimed to identify the patient reported outcome measures used for assessing the effectiveness of hydrotherapy for people with arthritis. A systematic literature review was conducted following a search of the major health databases. Upon meeting the inclusion criteria each study was quality rated using a modified scoring tool. In the 24 studies identified 35 patient reported outcome measures were used: most common were the visual analogue pain scale and the Western Ontario and McMaster Universities Osteoarthritis Index. Twenty-five patient reported outcome measures were used only once. Six of the patient reported outcome measures were arthritis-specific and eight generic measures had been validated for an arthritic population. Importantly, no patient reported outcome measure had been evaluated specifically for hydrotherapy interventions. The selection of outcome measures for hydrotherapy research appears inconsistent. This may account for the lack of high quality evidence for this intervention. Further research is warranted to develop a valid, reliable and responsive outcome measure specifically for people with arthritis undertaking hydrotherapy.