The effectiveness of aquatic physical therapy in the treatment of fibromyalgia: a systematic review with meta-analysis.
By Tarcisio Brandão Lima, et al.
Objective: To assess the effectiveness of aquatic physical therapy in the treatment of fibromyalgia.
Data sources: The search strategy was undertaken using the following databases, from 1950 to December 2012: MEDLINE, EMBASE, CINAHL, LILACS, SCIELO, WEB OF SCIENCE, SCOPUS, SPORTDiscus, Cochrane Library Controlled Trials Register, Cochrane Disease Group Trials Register, PEDro and DARE.
Review methods: The studies were separated into groups: Group I - aquatic physical therapy × no treatment, Group II - aquatic physical therapy × land-based exercises and Group III - aquatic physical therapy × other treatments.
Results: Seventy-two abstracts were found, 27 of which met the inclusion criteria. For the functional ability (Fibromyalgia Impact Questionnaire), three studies were considered with a treatment time of more than 20 weeks and a mean difference (MD) of -1.35 [-2.04; -0.67], P = 0.0001 was found in favour of the aquatic physical therapy group versus no treatment. The same results were identified for stiffness and the 6-minute walk test where two studies were pooled with an MD of -1.58 [-2.58; -0.58], P = 0.002 and 43.5 (metres) [3.8; 83.2], P = 0.03, respectively.
Conclusion: Three meta-analyses showed statistically significant results in favour of the aquatic physical therapy (Fibromyalgia Impact Questionnaire, stiffness and the 6-minute walk test) during a period of longer than 20 weeks. Due to the low methodological rigor, the results were insufficient to demonstrate statistical and clinical differences in most of the outcomes.
Source: Clinical Rehabilitation, July 1, 2013. By Tarcisio Brandão Lima, Josilainne Marcelino Dias, Bruno Fles Mazuquin, Carla Tassiana da Silva, Regiane Mazzarioli Pereira Nogueira, Amélia Pasqual Marques, Edson Lopes Lavado and Jefferson Rosa Cardoso. 1PAIFIT Research Group, Universidade Estadual de Londrina, Brazil.