BACKGROUND AND PURPOSE: Currently, there is a lack of objective data that supports the effectiveness of combining aquatic physical therapy with land based therapy. The purpose of this study was to determine the effectiveness of combining aquatic physical therapy with land based therapy verses solely land based therapy on pain, range of motion (ROM), swelling, as well as symptoms and function via the KOOS questionnaire in 30 patients that have under-gone unilateral TKA. SUBJECTS: 30 subjects who have under-gone unilateral TKA were randomly assigned to either the integrated (aquatic and land) group, or the control (land) group (15 subjects in each group). METHODS: Outcomes measured for comparison included pain, swelling, ROM and in addition symptoms and function via the Knee Injury and Osteoarthritis Outcome Scores questionnaire (KOOS). RESULTS: Immediately after exercise cessation (6 weeks), a significant improvement of knee flexion ROM was observed in the integrated group. No effect was observed in pain, swelling, and KOOS. At 6-months after cessation of treatment, the follow-up KOOS questionnaire demonstrated a significant improvement in the symptomatic category favoring the integrated group CONCLUSION: These findings suggest that after undergoing a unilateral TKA an individual would benefit from a treatment program consisting of both aquatic and land exercises that would greatly encourage improvements in ROM after a 6-weeks as well as improved symptomatic KOOS reports after 6-months.

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