PURPOSE: To evaluate the effectiveness of hydrotherapy (HT) on pain and function in children with juvenile idiopathic arthritis (JIA). METHODS: Eligible studies were randomized clinical trials published in English, which recruited children with JIA and had 2 groups with 1 receiving HT alone and the other receiving a comparison/control intervention. Risk of bias was assessed using the Cochrane Risk of Bias 2. Overall quality of evidence was assessed with the Grading of Recommendations Assessments, Development, and Evaluation. Meta-analyses were performed for outcomes when possible. RESULTS: Meta-analyses comparing HT to standard care demonstrated statistically significant effects on pain and VO2max favoring HT. No significant differences were found for function (CHAQ), peak knee extensor torque, or 6-minute walk test. The overall level of evidence ranged from very low to moderate. CONCLUSIONS: Hydrotherapy improved VO2max and reduced pain in individuals with JIA compared to standard care.
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