Background Aquatic exercises, the performance of structured exercises while the body is immersed in heated water, are frequently used as an adjunct therapeutic modality for patients with rheumatic diseases. Updated evidence shows that this modality is beneficial for reducing pain and disability; however, land-based exercises give comparable effects. Still aquatic exercises is highly preferred by the patients, claiming effects on pain, fatigue, stiffness and daily activities. Further, due to the fluctuations in their disease symptoms, patients have expressed a need for more frequent assessments and tighter monitoring of their disease.
Objectives To compare levels of symptoms in patients with inflammatory rheumatic diseases during periods with and without aquatic exercises.
Methods Thirty-six patients with an inflammatory rheumatic disease were included from three centres in an observational study. In all centres the patients were offered two periods with aquatic exercises, each lasting 12 weeks, during the period from September - June. In this period pain, fatigue, stiffness and ability to carry out daily activities were reported with text messages on mobile phones twice a week for a minimum of 35 weeks. The symptoms were reported across the two periods with aquatic exercises (intervention) and the two periods without (rest) in the following order: intervention – rest – intervention – rest. For each individual, we fitted a segmented linear regression model using a time series approach with autocorrelated errors. The parameter estimates were used to estimate the individual effects, and these effects were used in a paired t-test.
Results Overall, the patients reported significantly reduced levels of pain, fatigue and stiffness, and enhanced ability to carry out activities during periods with aquatic exercises compared to periods without (table).
During the study 2508 text-messages were sent out. Fifty-two (2.1%) messages were not returned, resulting in a response-rate of 97.9% for the whole group. Response-rates per. centre were 97.1%, 98.3% and 98.4%, respectively.
Conclusions Patients with inflammatory rheumatic diseases reported reduced levels of pain, fatigue and stiffness and enhanced ability to perform daily activities in periods with aquatic exercises compared to periods without aquatic exercises. The mobile phone was a highly feasible data collection tool in a multicentre study requiring frequent assessments of patient reported outcomes.
Hall J et al. Does aquatic exercise relieve pain in adults with neurologic or musculoskeletal disease? A systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil. 2008;89(5):873-83
Disclosure of Interest None declared