Systematic Review and Evidence-Based Clinical Recommendation for Aquatic Exercises for Individuals with Multiple Sclerosis
The use of aquatic training for individuals with multiple sclerosis (MS) has received attention in recent years. Although there is limited number of studies that examined the effects of aquatic exercises for individuals with MS, those that have been conducted consistently demonstrate positive outcomes. However, there is no review that synthesized research findings for individuals with MS.
The purpose of this review was to examine the evidence concerning the effectiveness of aquatic exercises in individuals with MS. Safety concerns, potential benefits and practical application are discussed.
This is a systematic review, we identified eleven studies that met the selection criteria, these studies included a total of 141 participants with MS. Electronic databases and hand searches were undertaken to locate studies published in English. The databases searched included PubMed, PsychINFO, CINAHL, OVID, PEDro, ProQuest. The key words searched were multiple sclerosis, aquatic, and hydrotherapy. The initial search resulted in a retrieval of a total of 83 potential articles. We screened those articles for duplicate and selection criteria.
A total of eleven studies that examined the effectiveness of aquatic exercises for individuals with MS were identified. Of the eleven studies, three were randomized controlled trials, five were single subject design and three were case studies. Across all studies, a total of 141 individuals with MS were investigated. The sample size for each published report ranged from 1 to 22 participants. All of the identified studies (100%) reported that aquatic training resulted in positive outcomes. Research on the effects of aquatic training for individuals with MS suggests that aquatic training is effective for improving flexibility and range of motion, cardiovascular endurance, fatigue level, muscle strength, mobility function (including gait and balance), quality of life and psychological well-being. None of the studies identified any exacerbation or reported adverse change in neurologic status.
To our knowledge this is the first systematic review to examine the effects of aquatic exercise for individuals with MS. There is limited number of studies that examined the effectiveness of aquatic exercises in MS. The results from all the studies indicate that individuals with MS benefit from aquatic training to improve physical functions and enhance quality of life. Although there is limited number of studies evaluating the effectiveness of aquatic exercise for individuals with MS, those studies consistently demonstrate positive outcomes. There is a need for more studies with a longer-term follow-up to determine if any gains are retained for long term. The available literature suggests the beneficial effects of aquatic exercises with no adverse outcomes, and supports its use as a reasonable treatment option for individuals with MS.