Clinical and psychological effects of hydrotherapy in rheumatic diseases

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.