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Jumping into the deep-end: results from a pilot impact evaluation of a community-based aquatic exercise program

Abstract

This multi-center quasi-experimental pilot study aimed to evaluate changes in pain, joint stiffness, physical function, and quality of life over 12 weeks in adults with musculoskeletal conditions attending ‘Waves’ aquatic exercise classes. A total of 109 adults (mean age, 65.2 years; range, 24–93 years) with musculoskeletal conditions were recruited across 18 Australian community aquatic centers. The intervention is a peer-led, 45 min, weekly aquatic exercise class including aerobic, strength, flexibility, and balance exercises (n = 67). The study also included a control group of people not participating in Waves or other formal exercise (n = 42). Outcomes were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and EuroQoL five dimensions survey (EQ-5D) at baseline and 12 weeks. Satisfaction with Waves classes was also measured at 12 weeks. Eighty two participants (43 Waves and 39 control) completed the study protocol and were included in the analysis. High levels of satisfaction with classes were reported by Waves participants. Over 90 % of participants reported Waves classes were enjoyable and would recommend classes to others. Waves participants demonstrated improvements in WOMAC and EQ-5D scores however between-group differences did not reach statistical significance. Peer-led aquatic exercise classes appear to improve pain, joint stiffness, physical function and quality of life for people with musculoskeletal conditions. The diverse study sample is likely to have limited the power to detect significant changes in outcomes. Larger studies with an adequate follow-up period are needed to confirm effects.

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References

  1. Hoy DG, Smith E, Cross M, Sanchez-Riera L, Blyth FM, Buchbinder R, Woolf AD, Driscoll T, Brooks P, March LM (2015) Reflecting on the global burden of musculoskeletal conditions: lessons learnt from the Global Burden of Disease 2010 Study and the next steps forward. Ann Rheum Dis 74(1):4–7

  2. Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81(9):646–656

    PubMed  PubMed Central  Google Scholar 

  3. Escorpizo R et al (2009) Content comparison of worker productivity questionnaires in arthritis and musculoskeletal conditions using the International Classification of Functioning, Disability, and Health framework. J Occup Rehabil 19(4):382–397

    Article  PubMed  Google Scholar 

  4. Walker JG, Littlejohn GO (2007) Measuring quality of life in rheumatic conditions. Clin Rheumatol 26(5):671–673

    Article  PubMed  PubMed Central  Google Scholar 

  5. Briggs AM et al (2014) Models of care for musculoskeletal health in Australia: now more than ever to drive evidence into health policy and practice. Aust Health Rev 38(4):401–405

    Article  PubMed  Google Scholar 

  6. Dziedzic K, Jordan JL, Foster NE (2008) Land- and water-based exercise therapies for musculoskeletal conditions. Best Practice & Research in Clinical Rheumatology 22(3):407–418

    Article  Google Scholar 

  7. Barker A et al (2014) Effectiveness of aquatic exercise for musculoskeletal conditions: a meta-analysis. Arch Phys Med Rehabil 95(9):1776–1786

  8. Hall J et al (2004) Cardiorespiratory responses to aquatic treadmill walking in patients with rheumatoid arthritis. Physiother Res Int 9(2):59–73

    Article  PubMed  Google Scholar 

  9. Becker BE (2009) Aquatic therapy: scientific foundations and clinical rehabilitation applications. PM R 1(9):859–872

    Article  PubMed  Google Scholar 

  10. Bartels EM, Lund H, Hagen KB, Dagfinrud H, Christensen R, Danneskiold-Samsøe B. Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD005523. doi:10.1002/14651858.CD005523.pub2

  11. Hall J et al (1996) A randomized and controlled trial of hydrotherapy in rheumatoid arthritis. Arthritis Care Res 9(3):206–215

    CAS  Article  PubMed  Google Scholar 

  12. Suomi R, Collier D (2003) Effects of arthritis exercise programs on functional fitness and perceived activities of daily living measures in older adults with arthritis. Arch Phys Med Rehabil 84(11):1589–1594

    Article  PubMed  Google Scholar 

  13. Cochrane T, Davey RC, Matthes Edwards SM (2005) Randomised controlled trial of the cost-effectiveness of water-based therapy for lower limb osteoarthritis. Health Technol Assess 9(31):1–114

  14. Fransen M et al (2007) Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes. Arthritis Rheum 57(3):407–414

    Article  PubMed  Google Scholar 

  15. Hinman RS, Heywood SE, Day AR (2007) Aquatic physical therapy for hip and knee osteoarthritis: results of a single-blind randomized controlled trial. Phys Ther 87(1):32–43

    Article  PubMed  Google Scholar 

  16. Lim JY, Tchai E, Jang SN (2010) Effectiveness of aquatic exercise for obese patients with knee osteoarthritis: a randomized controlled trial. PM & R 2(8):723–731

  17. Lund H et al (2008) A randomized controlled trial of aquatic and land-based exercise in patients with knee osteoarthritis. J Rehabil Med 40(2):137–144

    Article  PubMed  Google Scholar 

  18. Silva LE et al (2008) Hydrotherapy versus conventional land-based exercise for the management of patients with osteoarthritis of the knee: a randomized clinical trial. Phys Ther 88(1):12–21

    Article  PubMed  Google Scholar 

  19. Stener-Victorin E, Kruse-Smidje C, Jung K (2004) Comparison between electro-acupuncture and hydrotherapy, both in combination with patient education and patient education alone, on the symptomatic treatment of osteoarthritis of the hip. Clinical Journal of Pain 20(3):179–185

    Article  PubMed  Google Scholar 

  20. Wang TJ et al (2007) Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. J Adv Nurs 57(2):141–152

    Article  PubMed  Google Scholar 

  21. Wang TJ et al (2011) Comparing the efficacy of aquatic exercises and land-based exercises for patients with knee osteoarthritis. J Clin Nurs 20(17–18):2609–2622

    Article  PubMed  Google Scholar 

  22. Evcik D et al (2008) Effectiveness of aquatic therapy in the treatment of fibromyalgia syndrome: a randomized controlled open study. Rheumatol Int 28(9):885–890

    Article  PubMed  Google Scholar 

  23. Tomas-Carus P et al (2008) Eight months of physical training in warm water improves physical and mental health in women with fibromyalgia: a randomized controlled trial. J Rehabil Med 40(4):248–252

    Article  PubMed  Google Scholar 

  24. Tomas-Carus P et al (2007) Aquatic training and detraining on fitness and quality of life in fibromyalgia. Med Sci Sports Exerc 39(7):1044–1050

    Article  PubMed  Google Scholar 

  25. Dundar U et al (2009) Clinical effectiveness of aquatic exercise to treat chronic low back pain: a randomized controlled trial. Spine 34(14):1436–1440

  26. Han G et al (2011) The effects on muscle strength and visual analog scale pain of aquatic therapy for individuals with low back pain. Journal of Physical Therapy Science 23(1):57–60

    Article  Google Scholar 

  27. Victora CG, Habicht JP, Bryce J (2004) Evidence-based public health: moving beyond randomized trials. Am J Public Health 94(3):400–405

    Article  PubMed  PubMed Central  Google Scholar 

  28. Cadmus L et al (2010) Community-based aquatic exercise and quality of life in persons with osteoarthritis. Med Sci Sports Exerc 42(1):8–15

    Article  PubMed  Google Scholar 

  29. Belza B et al (2002) Does adherence make a difference? Results from a community-based aquatic exercise program. Nurs Res 51(5):285–291

    Article  PubMed  Google Scholar 

  30. Patrick DL et al (2001) Economic evaluation of aquatic exercise for persons with osteoarthritis. Med Care 39(5):413–424

    CAS  Article  PubMed  Google Scholar 

  31. Ung, L. (2009) Report on the evaluation of the Warm Water Exercise (WAVES) Program 2008–2009. Arthritis Victoria: Melbourne

  32. Thabane L et al (2010) A tutorial on pilot studies: the what, why and how. BMC medical research methodology 10(1).

  33. Roos EM, Klassbo M, Lohmander LS (1999) WOMAC osteoarthritis index. Reliability, validity, and responsiveness in patients with arthroscopically assessed osteoarthritis. Western Ontario and MacMaster Universities. Scand J Rheumatol 28(4):210–215

    CAS  Article  PubMed  Google Scholar 

  34. Janssen MF et al (2008) Comparing the standard EQ-5D three-level system with a five-level version. Value Health 11(2):275–284

    Article  PubMed  Google Scholar 

  35. Clemens S, Begum N, Harper C, Whitty JA, Scuffham PA (2014) A comparison of EQ-5D-3L population norms in Queensland, Australia, estimated using utility value sets from Australia, the UK and USA. Qual Life Res 23(8):2375–81. doi:10.1007/s11136-014-0676-x

  36. US Department of Health and Human Services (2008), 2008 Physical Activity Guidelines for Americans. Washington, D. C.

  37. Bennell KL et al (2014) Exercise in osteoarthritis: moving from prescription to adherence. Best Practice & Research in Clinical Rheumatology 28(1):93–117

    Article  Google Scholar 

  38. Howat G, Crilley G (2007) Customer Service Quality, Satisfaction, and Operational Performance: A proposed model for Australian public aquatic centres. Annals of Leisure Research 10(2):168–195

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Correspondence to Anna L Barker.

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Barker, A.L., Talevski, J., Morello, R.T. et al. Jumping into the deep-end: results from a pilot impact evaluation of a community-based aquatic exercise program. Clin Rheumatol 35, 1593–1601 (2016). https://doi.org/10.1007/s10067-015-3096-6

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  • DOI: https://doi.org/10.1007/s10067-015-3096-6

Keywords

  • Aquatic exercise
  • Arthritis
  • Musculoskeletal
  • Osteoarthritis