Clinical and psychological effects of hydrotherapy in rheumatic diseases

Abstract

Objectives: To assess the objective and subjective effects of a hydrotherapy programme for patients with rheumatoid arthritis (RA) or osteoarthritis (OA). Methods: Ninety patients entered a four-consecutive-day hydrotherapy programme. Seventy-two patients completed this programme. At the end of the four-day course, 22 patients were randomized to continue hydrotherapy for a further six weeks and eight patients were observed and acted as a control group. Results: Throughout the study there were no changes in functional assessment or range of movement of target joints. The most significant changes in the four-day course were improvements in self-efficacy for function and pain with resulting improvements in pain and stiffness scores. Those patients continuing hydrotherapy maintained the improvements achieved as a result of the four- day course, while in the control group most of the variables had returned to pretreatment values by four weeks.

Conclusion: These results suggest that hydrotherapy has beneficial effects in patients with RA and OA through improvements in self-efficacy.

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References

Fam AG Spa treatment in arthritis: a rheumatologist's view. J Rheumatol 1991; 18: 1775-77.

Semble EL , Loeser RF , Wise CM Therapeutic exercise for rheumatoid arthritis and osteoarthritis. Semin Arthritis Rheum 1990; 20: 32-40.

Baldwin J. Pool therapy compared with individual home exercise therapy for juvenile rheumatoid arthritis patients. Physiotherapy 1978; 64: 230-31.

Glass J. Physical medicine in rheumatology. Aust N Z J Med 1978; 8 (suppl): 168-71.

Robinson H. , Haldeman J. Evaluation of a province-wide physiotherapy monitoring service. J Rheumatol 1980; 7: 387-89.

Danneskiold-Samsoe B. , Lyngberg K. , Risum T. , Telling M. The effect of water exercise therapy given to patients with rheumatoid arthritis. Scand J Rehabil Med 1987; 19: 31-35.

Cosh JA The rheumatologist and the spa - a personal view. R Soc Health J 1982; 102: 189-92.

Ekblom B. , Lovgren O. , Alderin M. , Fridstrom M. , Satterstrom G. Physical performance in patients with rheumatoid arthritis. Scand J Rheumatol 1974; 3: 121-25.

Beals CA , Lampman RM , Banwell BF , Braunstein EM , Albers JW , Castor CW Measurement of exercise tolerance in patients with rheumatoid arthritis and osteoarthritis. J Rheumatol 1985; 12: 458-61.

10.

Minor MA , Hewett JE , Webel RR , Dreisinger TE , Kay DR Exercise tolerance and disease-related measures in patients with rheumatoid arthritis and osteoarthritis. J Rheumatol 1988; 15: 905-11.

11.

Ekblom B. , Lovgren O. , Alderin M. , Fridstrom M. , Satterstrom G. Effect of short-term physical training in patients with rheumatoid arthritis I. Scand J Rheumatol 1975; 4: 80-86.

12.

Ekblom B. , Lovgren O. , Alderin M. , Fridstrom M. , Satterstrom G. Effect of short-term physical training on patients with rheumatoid arthritis: a six month follow-up study. Scand J Rheumatol 1975; 4: 87-91.

13.

Nordemar R. , Ekblom B. , Zachrisson L. , Lundquist K. Physical training in rheumatoid arthritis: a controlled long-term study I. Scand J Rheumatol 1981; 10: 17-23.

14.

Harkcom TM , Lampman RM , Banwell BF , Castor CW Therapeutic value of graded aerobic exercise training in rheumatoid arthritis . Arthritis Rheum 1985; 28: 32-39.

15.

Dial C. , Windsor RA A formative evaluation of a health education-water exercise programme for Class II and III adult rheumatoid arthritis patients. Patient Couns Health Educ 1985; 7: 33-42.

16.

Minor MA , Hewett JE , Webel RR , Anderson SK , Kay DR Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and osteoarthritis. Arthritis Rheum 1989; 32: 1396-405.

17.

Ropes MW , Bennett GA , Gobb S. , Jacox R. , Jessor RA 1958 revision of diagnostic criteria for rheumatoid arthritis. Arthritis Rheum 1959; 2: 16-20.

18.

Zung WW , Durham NC A self-rating depression scale. Arch Gen Psychiatry 1965 ; 12: 63-70.

19.

Crown S. , Crisp AH A short clinical diagnostic self-rating scale for psychoneurotic patients . Br J Psychiatry 1966; 112: 917-23.

20.

Pilowsky I. , Spence N. The manual of the illness behaviour questionnaire. Adelaide : University of Adelaide Press, 1981.

21.

Lorig K. , Chastain L. , Ung E. Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheum 1989 ; 32: 37-44.

22.

Fries JF , Sprtz P. , Kraines RG , Holman HR Measurement of patient outcome in arthritis. Arthritis Rheum 1980; 23: 137-45.

23.

Wade DT , Legh-Smith J. , Hewer RL Social activities after stroke: measurement and natural history using the Frenchay Activities Index. Int Rehabil Med 1985; 7: 176-81.

24.

Bandura A. Self-efficacy: toward a unifying theory of behavioural change. Psychol Rev 1977; 84: 191-215.

25.

Lee E. , Desu M. A computer program for comparing K samples with right censored data. Comput Programs Biomed 1972; 2: 315-21.

26.

Lorig KR , Mazonson PD , Holman HR Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. Arthritis Rheum 1993; 36: 439-46.