The Effects of Aquatic Therapy vs. Land-Based Therapy on Range of Motion and Pain Perception: A Systematic Review and Meta-Analysis

Aquatic therapy is described as activity in water based on hydrodynamic principles for therapeutic purposes. It can be used for muscle strengthening, flexibility, cardiovascular fitness, and improved psychological effects due to the properties of water. Buoyancy of water helps compensate for the gravity present in dry land and is, therefore, highly useful for therapy. These characteristics of the aquatic environment allow for individuals of many types of populations successfully perform exercise in an aquatic environment, in comparison to dry land. The purpose of this review is to compare the effectiveness of aquatic exercise interventions with traditional land-based therapies on the improvement of pain perception and range of motion across multiple patient populations. This review conducted a systematic review and meta-analysis to evaluate the effects of aquatic therapy versus land-based therapy on range motion and pain perception. This report complies with the PRISMA checklist for reporting systematic reviews. Nine studies were identified and included in the review and analysis. Significant improvements were detected in both groups across studies. It was found that aquatic therapy was superior to land therapy in the reduction of pain across all studies. Two studies showed greater increases in knee flexion range of motion (ROM) in their land groups, whereas two different studies showed greater increases in knee flexion ROM in their aquatic groups. Aquatic therapy was found superior in increasing knee extension ROM. Land therapy was superior in increasing lumbar flexion ROM. This systematic review and meta-analysis concluded that the type of therapy does have an effect on outcomes, and most studies were favorable for aquatic therapy. There were consistent differences between therapy groups across outcomes and studies; however, there is not enough available data to be significant. There is a great need for further research in this area of therapy