OBJECTIVES: To investigate whether early postoperative aquatic physical therapy is a low risk and effective form of physical therapy to improve functional outcomes after orthopedic surgery. DATA SOURCES: Databases Medline, CINAHL, AMED, Embase and PEDro were searched from the earliest date available until October 2011. Additional trials were identified by searching reference lists and citation tracking. STUDY SELECTION: Controlled trials evaluating the effects of aquatic physical therapy on adverse events for adults less than 3 months post orthopedic surgery. Two reviewers independently applied inclusion and exclusion criteria, and any disagreements were discussed until consensus could be reached. Searching identified 5,069 potentially relevant articles, of which 8 controlled trials with 287 participants met inclusion criteria. DATA EXTRACTION: A predefined data extraction form was completed in detail for each included study by 1 reviewer and checked for accuracy by another. Methodological quality of included trials was assessed independently by 2 reviewers using the PEDro scale. DATA SYNTHESIS: Pooled analyses were performed using random effects model with inverse variance methods to calculate standardized mean differences (SMD) and 95% confidence intervals (95%CI) (continuous outcomes) and risk difference (RD) and 95%CI (dichotomous outcomes). When compared to land-based physical therapy, early aquatic physical therapy does not increase the risk of wound-related adverse events (RD 0.01, 95% CI -0.05 to 0.07) and results in improved performance of activities of daily living (ADLs) (SMD 0.33, 95% CI 0.07 to 0.58, I2 = 0%). There were no significant differences in edema (SMD -0.27, 95% CI -0.81 to 0.27, I2 = 58%) or pain (SMD -0.06, 95%CI -0.50 to 0.38, I2 = 32%). CONCLUSION: Following orthopedic surgery aquatic physical therapy improves function and does not increase the risk of wound-related adverse events, and is as effective as land-based therapy in terms of pain, edema, strength and range of motion in the early post-operative period.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher