Hydrotherapy helpful for OA knee

[Mary Z]

Title: Knee Osteoarthritis: A Randomized Controlled Trial Comparing
Hydrotherapy and Continuous Short-Wave Diathermy
Category: 7. Osteoarthritis—clinical aspects
Author(s): Tara Cusack1, Mary F. McAteer1, Leslie E. Daly1, Conor J.
McCarthy2. 1University College Dublin, Dublin, Ireland; 2Mater
Misericordiae University Hospital, Dublin, Ireland
Presentation Number: 1335
Poster Board Number: 111
Purpose Osteoarthritis, a common disorder increasing in prevalence
with advancing age, is particularly debilitating when the knees are
affected. This study examined the influence of hydrotherapy or
continuous short-wave diathermy (CSWD) on osteoarthritic symptoms,
functional abilities and quality of life.
Methods Sixty-seven patients aged between 50-70 years with a confirmed
diagnosis of knee osteoarthritis, newly referred for physical therapy,
were included. All patients received self-management education
composed of advice and home exercises. Patients were randomized, in
accordance with the factorial study design to one of four groups,
combined hydrotherapy and CSWD (n=17), hydrotherapy only (n=17), CSWD
only (n=18) and a control group (n=15) that received neither
intervention. A visual analogue pain scale (VAS) (0-10cm), hand-held
goniometry, the six-minute walk test and the arthritis impact
measurement scales 2 (AIMS2) were completed at baseline and at eight
weeks. Independent t-tests (SPSS 11) were used for between-group
comparisons. Structured interviews, undertaken to assess patients’
perceptions of their treatment, were tape-recorded, transcribed and
analyzed using a phenomenological approach.
Results Sixty patients completed the programme, n=15 in each group. At
eight weeks pain had decreased significantly (p<0.01) more in the
hydrotherapy group than the no-hydrotherapy group. The distance walked
over six minutes and the physical and symptomatic components of the
AIMS2 improved to a greater degree in the hydrotherapy group, however
these changes were not statistically significant (Table). CSWD did not
change the measured outcomes significantly although the no-CSWD group
reported a greater degree of pain relief and demonstrated a greater
increase in distance walked over six minutes than the CSWD group
(Table). Post-treatment interviews revealed that 77% (23/30) of
hydrotherapy patients found hydrotherapy to be the most beneficial
component of their programme, while 20% (6/30) of patients identified
CSWD as being most beneficial. Patients reported that the
self-management component assisted them in gaining knowledge and
coping skills.
Table: Mean changes in the hydrotherapy versus the no-hydrotherapy
groups and the CSWD versus the no-CSWD groups from baseline to 8
weeks. Significance p<0.01* Hydrotherapy CSWD
Yes No p= Yes No p=
Pain (VAS) (cm) 1.67 0.12 0.006* 0.65 1.14 0.40
Six-minute walk test (m) 31.5 16.1 0.33 17.0 30.7 0.38
AIMS 2 Physical 0.31 0.11 0.22 0.23 0.18 0.73
Symptom 1.07 0.57 0.34 0.94 0.70 0.65

Conclusions This study does not support the inclusion of CSWD as part
of a treatment programme for patients with knee osteoarthritis.
Hydrotherapy however, as a component of a physical therapy programme,
was effective in decreasing pain significantly.

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