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The optimal frequency of aquatic physiotherapy for individuals with chronic musculoskeletal pain: a randomised controlled trial [with consumer summary]
Cuesta-Vargas AIW, M, Gonzalez-Sanchez M, Kuisma R
Disability and Rehabilitation 2015;37(4):311-318
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: To establish whether there was a difference in health-related quality of life (HRQoL) in people with chronic musculoskeletal disorders (PwCMSKD) after participating in a multimodal physiotherapy program (MPP) either two or three sessions a week. METHODS: Total of 114 PwCMSKD participated in this prospective randomised controlled trial. An individualised MPP, consisting of exercises for mobility, motor-control, muscle strengthening, cardiovascular training, and health education, was implemented either twice a week (G2: n = 58) or three times a week) (G3: n = 56) for 1 year. OUTCOMES: HRQoL physical and mental health state (PHS/MHS), Roland Morris disability Questionnaire (RMQ), Neck-Disability-Index (NDI) and Western Ontario and McMaster Universities' Arthritis Index (WOMAC) were used to measure outcomes of MPP for people with chronic low back pain, chronic neck pain and osteoarthritis, respectively. Measures were taken at baseline, 8 weeks (8 w), 6 months (6 m), and 1 year (1 y) after starting the programme. RESULTS: No statistically significant differences were found between the two groups (G2 and G3), except in NDI at 8 w (-3.34, CI 95% -6.94 to 0.84, p = 0.025 (scale 0 to 50)). All variables showed improvement reaching the following values (from baseline to 1 y) G2 PHS 57.72 (baseline 41.17, improvement 16.55%), MHS 74.51 (baseline 47.46, 27.05%), HRQoL 0.90 (baseline 0.72, 18%), HRQoL-VAS 84.29 (baseline 58.04, 26.25%), RMQ 4.15 (baseline 7.85, 15.42%), NDI 3.96 (baseline 21.87, 35.82%), WOMAC 7.17 (baseline 25.51, 19.10%). G3 PHS 58.64 (baseline 39.75, 18.89%), MHS 75.50 (baseline 45.45, 30.05%), HRQoL 0.67 (baseline 0.88, 21%), HRQoL-VAS 86.91 (baseline 52.64, 34.27%), RMQ 4.83 (baseline 8.93, 17.08%), NDI 4.91 (baseline 23.82, 37.82%), WOMAC 6.35 (baseline 15.30, 9.32%). CONCLUSIONS: No significant differences between the two groups were found in the outcomes of a MPP except in the NDI at 8 weeks, but both groups improved in all variables during the course of 1 year under study.

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