Julio Henric V M Centurião, Karen Obara, Carla T Silva, Luana Paixão, Mariana F Silva, Josilainne M Dias, Jefferson R Cardoso
{"title":"Effects of aquatic exercises in patients after total hip arthroplasty: A systematic review.","authors":"Julio Henric V M Centurião, Karen Obara, Carla T Silva, Luana Paixão, Mariana F Silva, Josilainne M Dias, Jefferson R Cardoso","doi":"10.1002/pri.2043","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) is a surgical procedure that can alter physical function and quality of life.</p><p><strong>Objectives: </strong>The aim was to verify the effects of aquatic exercises compared with exercises on land, control or other modalities, in patients undergoing THA on the primary outcomes: self-reported physical function, quality of life and pain; and secondary outcomes: muscle strength, functional capacity and gait.</p><p><strong>Design: </strong>Systematic review that followed the PRISMA Statement and PROSPERO registered. The search was performed in the following databases: Web of Science, Embase, Medline, Cinahl, Lilacs, SPORTDiscus, Cochrane Library, Scopus, SciELO, and PEDro, from 1945 to 2022. The risk of bias assessment was performed using the Risk of Bias 2 (RoB2) from the Cochrane Collaboration.</p><p><strong>Results: </strong>Three randomized controlled trials (RCTs) were included, with a total of 364 participants. In the selection process, two publications from the same study were found. The RoB2 assessment classified one RCT as \"high risk of bias\" and the others as \"low risk of bias\". Therefore, the analysis of the results considered only studies with a low risk of bias. For the self-reported physical function outcome, evaluated by WOMAC, improvement was observed in favor of aquatic exercises, when started on the 14th postoperative day. Pain improved after 24th week postoperative, in favor of exercise (effect size between 0.2 and 0.4). Quality of life, verified only by one RCT, improved at each time point evaluated (effect size between 0.01 and 0.10). The functional capacity showed no difference between the groups. This was the first systematic review to assess the benefits of aquatic exercises specifically in THA and it was possible to infer that the exercises initiated after 14 days of postoperative are safer. The protocol should include proprioceptive, coordination, and resistance exercises. The session can last around 30 min and is held three times a week.</p><p><strong>Conclusion: </strong>Decision making for treatment in the postoperative of THA may include aquatic exercises as a safe and efficacious alternative to improve self-reported physical function, pain, quality of life, and muscle resistance.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":" ","pages":"e2043"},"PeriodicalIF":1.5000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physiotherapy Research International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/pri.2043","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/21 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Total hip arthroplasty (THA) is a surgical procedure that can alter physical function and quality of life.
Objectives: The aim was to verify the effects of aquatic exercises compared with exercises on land, control or other modalities, in patients undergoing THA on the primary outcomes: self-reported physical function, quality of life and pain; and secondary outcomes: muscle strength, functional capacity and gait.
Design: Systematic review that followed the PRISMA Statement and PROSPERO registered. The search was performed in the following databases: Web of Science, Embase, Medline, Cinahl, Lilacs, SPORTDiscus, Cochrane Library, Scopus, SciELO, and PEDro, from 1945 to 2022. The risk of bias assessment was performed using the Risk of Bias 2 (RoB2) from the Cochrane Collaboration.
Results: Three randomized controlled trials (RCTs) were included, with a total of 364 participants. In the selection process, two publications from the same study were found. The RoB2 assessment classified one RCT as "high risk of bias" and the others as "low risk of bias". Therefore, the analysis of the results considered only studies with a low risk of bias. For the self-reported physical function outcome, evaluated by WOMAC, improvement was observed in favor of aquatic exercises, when started on the 14th postoperative day. Pain improved after 24th week postoperative, in favor of exercise (effect size between 0.2 and 0.4). Quality of life, verified only by one RCT, improved at each time point evaluated (effect size between 0.01 and 0.10). The functional capacity showed no difference between the groups. This was the first systematic review to assess the benefits of aquatic exercises specifically in THA and it was possible to infer that the exercises initiated after 14 days of postoperative are safer. The protocol should include proprioceptive, coordination, and resistance exercises. The session can last around 30 min and is held three times a week.
Conclusion: Decision making for treatment in the postoperative of THA may include aquatic exercises as a safe and efficacious alternative to improve self-reported physical function, pain, quality of life, and muscle resistance.
期刊介绍：
Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.
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