Authors (including presenting author) :
Ng HMH, Luk SH, Chan KH, Chan CL, Chan MC, Wong YC, Chan WC, Wong ST
Affiliation :
Physiotherapy Department, Haven of Hope Hospital
Introduction :
Hydrotherapy is utilizing the physical properties of water to provide therapeutic effects to patients. Hydrodynamic and hydrostatic properties of water such as buoyancy, resistance and compression assist in joints mobilization and muscles strengthening; reduce pain and swelling by increasing blood circulation and lymphatic drainage; challenge balance via sensory stimulation and improve cardiovascular endurance. Thermal effect from water also helps muscle relaxation, maximizing physiological and psychological effects. Hydrotherapy service in HHH has been commenced since January 2024.
Objectives :
To evaluate the effectiveness of the newly commenced hydrotherapy service in HHH for patients with chronic musculoskeletal and neurological problems on pain level and mobility respectively.
Methodology :
A pre-posttest design was adopted for this service review. Outcome measures for patients with musculoskeletal problems include Numeric Pain Rating Score (NPRS) and Numeric Global Rating of Change Scale (NGRCS). For neurological patients, outcomes include Six-Meter Timed Walk (6MTW) and Timed Up and Go Test (TUGT). Patients were referred for a course of hydrotherapy by their case therapists and received a 45-60-minute hydrotherapy session one to two times a week. Assessments were carried out on the first and 10th sessions. Wilcoxon signed rank test and paired t-test were used for the comparison.
Result & Outcome :
Results:
Thirty-seven patients with musculoskeletal pain (48.6% Low back pain, 35.1% knee pain and 16.3% others) & nine patients with stroke and Parkinson’s disease were recruited for hydrotherapy training.
Regarding those with musculoskeletal problems, the median pre and post NPRS were 6 and 3.5 (p<0.01) respectively. Patients also reported an overall improvement after the training with a mean 10-point NGRCS of 3.9 ± 1.80. For those with neurological disease, the mean change of TUGT were 4.14 seconds (95% CI = 2.92, 5.36; p<0.01) while that for 6MTW were 2.16 seconds (95% CI = 1.09, 3.21; p<0.01) respectively.
Conclusion:
Hydrotherapy demonstrated improvement over pain level and mobility for patients with chronic musculoskeletal and neurological conditions. Small sample size and patients with heterogeneous conditions are the limitations for this review. It is recommended that a larger sample size and comparison with land-based training can be considered for further study.
