INTRODUCTION: The main feature of fibromyalgia syndrome is extensive musculoskeletal pain and tenderness. It not only has a significant impact on patients but also brings a huge burden to families and society. Exercise is considered to be the most important part of the fibromyalgia treatment, and aquatic physical therapy can be considered one of the most recommended interventions. Therefore, the effects of aquatic physical therapy on fibromyalgia patients were discussed in this article. OBJECTIVE: The purpose of this study was to evaluate the effects of aquatic physical therapy on clinical symptoms, physical function, and quality of life in patients with fibromyalgia. METHODS: Eight databases were retrieved. "Fibromyalgia", "aquatic therapy", "aquatic exercise", and "hydrotherapy" was used for retrieval. Randomized controlled trials of the effects of aquatic physical therapy on patients with fibromyalgia were included. The Cochrane risk of bias tool to assess research quality. Meta-analysis was performed by Revman version 5.3. RESULTS: Finally, 14 articles (762 patients) were included in the analysis. Compared with other exercises or no exercise, aquatic physical therapy has more significant effects. There were significant differences in visual analogue scale (MD -0.98, 95%CI -1.36 to -0.60, z = 5.03, p < 0.00001), six minute walk test (MD 38.12, 95%CI 13.65 to 62.59, z = 3.05, p = 0.002), fibromyalgia impact questionnaire total scores (MD -7.35, 95%CI -13.05 to -1.65, z = 2.53, p = 0.01), vitality of short form 36 (MD 9.53, 95%CI 0.62 to 18.43, z = 2.10, p = 0.04) and general health of short form 36 (MD 10.39, 95%CI 1.42 to 19.36, z = 2.27, p = 0.02). CONCLUSIONS: Aquatic physical therapy may have some benefits on the clinical symptoms, physical function, and quality of life of patients with fibromyalgia.

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