Hydrotherapy for Rheumatoid Arthritis

A randomized and controlled trial to evaluate the therapeutic effects of hydrotherapy on chronic rheumatoid arthritis patients

By Jane Hall MPhil, MCSP, Research Physiotherapist; Suzanne M. Skevington PhD, Senior Lecturer; Peter J. Maddison MD, Professor of Bone and Joint Medicine; Chapman MSc (Health Psychol), MSc (Clin Psychol), BSc, Research Officer
The aim of this study was to evaluate the therapeutic effects of hydrotherapy which combines elements of warm water immersion and exercise. It was predicted that hydrotherapy would result in a greater therapeutic benefit than either of these components separately.

One hundred thirty-nine patients with chronic rheumatoid arthritis were randomly assigned to hydrotherapy, seated immersion, land exercise, or progressive relaxation. Patients attended 30-minute sessions twice weekly for 4 weeks. Physical and psychological measures were completed before and after intervention, and at a 3-month follow up.

All patients improved physically and emotionally, as assessed by the Arthritis Impact Measurement Scales 2 questionnaire. Belief that pain was controlled by chance happenings decreased, signifying improvement. In addition, hydrotherapy patients showed significantly greater improvement in joint tenderness and in knee range of movement (women only). At followup, hydrotherapy patients maintained the improvement in emotional and psychological state.

Although all patients experienced some benefit, hydrotherapy produced the greatest improvements. This study, therefore, provides some justification for the continued use of hydrotherapy.

Authors information:

  • Jane Hall MPhil, MCSP, Research Physiotherapist, Royal National Hospital for Rheumatic Diseases, Bath, UK.
  • Suzanne M. Skevington PhD, Senior Lecturer, School of Social Sciences, University of Bath, and Senior Research Fellow, Royal National Hospital for Rheumatic Diseases, Bath, UK.
  • Peter J. Maddison MD, Professor of Bone and Joint Medicine, University of Bath, and Consultant Rheumatologist, Royal National Hospital for Rheumatic Diseases, Bath, UK.
  • Chapman MSc (Health Psychol), MSc (Clin Psychol), BSc, Research Officer, School of Social Sciences, University of Bath, and Royal National Hospital for Rheumatic Diseases, Bath, UK.
References: PMID: 8971230
[PubMed – indexed for MEDLINE]; Arthritis & Rheumatism Volume 9, Issue 3, pages 206–215, June 1996; onlinelibrary.wiley.com. Article first published online 14 DEC 2005.