In-water aquatic outcome measures to establish hydrotherapy efficacy: A systematic review

Mrs Angela Mucic1, Ms Apoorva Charukonda

1Western Health, Melbourne, Australia


Aim: To identify in-water aquatic measures used to evaluate treatment effects of hydrotherapy and to evaluate and synthesise their clinimetric properties.


Methods: A systematic search of Medline (2006-2016), EMBASE (2006-2016) and PEDro (2006–2016) databases in January and February 2016. In addition, reference lists of selected articles were searched. Citations were screened independently by two reviewers.


Results: 3459 articles were returned across the three databases. A title review and duplicate deletion narrowed the articles to 143. After abstract review and where necessary article review to exclude when studies did not use a water measure, four articles were selected. Due to the heterogeneity of the studies, no statistical data analysis was completed. Articles are reported on individually based on critical appraisal. The appraisal tools used included CASP Randomised Controlled trial Tool, CASP Diagnostic Test Study Tool, CEBM: Critical Appraisal of a Case Study and Critically Appraisal of Reliability Article.  Two had established clinimetric properties. The overall quality of the studies was low.

Significance of the findings to Allied Health: Aquatic Physiotherapy is a common treatment option used in Victorian public hospitals. There is significant evidence to support aquatic physiotherapy as a viable treatment option however, our review shows that there are no reliable or valid water based measures. Future work needs to develop in-water outcome measures and demonstrate the clinimetric properties in order to establish real-time treatment efficacy.  Alternatively, land based measures may demonstrate change and goal achievement, warranting exploration.