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The effectiveness of aquatic physical therapy in the treatment of fibromyalgia: a systematic review with meta-analysis [with consumer summary]
Lima TB, Dias JM, Mazuquin BF, da Silva CT, Nogueira RMP, Marques AP, Lavado EL, Cardoso JR
Clinical Rehabilitation 2013 Oct;27(10):892-908
systematic review

OBJECTIVE: To assess the effectiveness of aquatic physical therapy in the treatment of fibromyalgia. DATA SOURCES: The search strategy was undertaken using the following databases, from 1950 to December 2012: Medline, Embase, CINAHL, LILACS, SCIELO, WEB OF SCIENCE, Scopus, SPORTDiscus, Cochrane Library Controlled Trials Register, Cochrane Disease Group Trials Register, PEDro and DARE. REVIEW METHODS: The studies were separated into groups: group I -- aquatic physical therapy x no treatment, group II -- aquatic physical therapy x land-based exercises and group III -- aquatic physical therapy x other treatments. RESULTS: Seventy-two abstracts were found, 27 of which met the inclusion criteria. For the functional ability (Fibromyalgia Impact Questionnaire), three studies were considered with a treatment time of more than 20 weeks and a mean difference (MD) of -1.35 (-2.04 to -0.67), p = 0.0001 was found in favour of the aquatic physical therapy group versus no treatment. The same results were identified for stiffness and the 6-minute walk test where two studies were pooled with an MD of -1.58 (-2.58 to -0.58), p = 0.002 and 43.5 (metres) (3.8 to 83.2), p = 0.03, respectively. CONCLUSION: Three meta-analyses showed statistically significant results in favour of the aquatic physical therapy (Fibromyalgia Impact Questionnaire, stiffness and the 6-minute walk test) during a period of longer than 20 weeks. Due to the low methodological rigor, the results were insufficient to demonstrate statistical and clinical differences in most of the outcomes.

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A brief summary and a critical assessment of this review may be available at DARE