Aquatic training and detraining on fitness and quality of life in fibromyalgia. [Comparison between aquatic-biodanza and stretching for improving quality of life and pain in patients with fibromyalgia]. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial. Cost-utility of an 8-month aquatic training for women with fibromyalgia: a randomized controlled trial Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia. Aquatic Physical Therapy for Hip and Knee Osteoarthritis: Results of a Single-Blind Randomized Controlled Trial Multicenter randomized controlled trial comparing early versus late aquatic therapy after total hip or knee arthroplasty. Improvements of muscle strength predicted benefits in HRQOL and postural balance in women with fibromyalgia: an 8-month randomized controlled trial. Eight months of physical training in warm water improves physical and mental health in women with fibromyalgia: a randomized controlled trial. A randomized controlled trial of deep water running: clinical effectiveness of aquatic exercise to treat fibromyalgia. Clinical Effectiveness of Aquatic Exercise to Treat Chronic Low Back Pain: A Randomized Controlled Trial Evaluation of an aquatics programme on fitness parameters of individuals with a brain injury Effects of an aquatic physical exercise program on glycemic control and perinatal outcomes of gestational diabetes: study protocol for a randomized controlled trial Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. Thalassotherapy for fibromyalgia: a randomized controlled trial comparing aquatic exercises in sea water and water pool Controlled trial of hypnotherapy in the treatment of refractory fibromyalgia. Immediate changes in spinal height and pain after aquatic vertical traction in patients with persistent low back symptoms: a crossover clinical trial. Efficacy and feasibility of a combination of body awareness therapy and qigong in patients with fibromyalgia: a pilot study. Fatigue and quality of life of women with multiple sclerosis: a randomized controlled clinical trial. Results of a multidisciplinary program for patients with fibromyalgia implemented in the primary care Electroconvulsive therapy in patients with depression and fibromyalgia Aquatic Exercise Therapy for People With Parkinson Disease: A Randomized Controlled Trial. The PICO project: aquatic exercise for knee osteoarthritis in overweight and obese individuals
PURPOSE To evaluate the effects of a 12-wk period of aquatic training and subsequent detraining on health-related quality of life ( HRQOL ) and physical fitness in females with fibromyalgia . METHODS Thirty-four females with fibromyalgia were r and omly assigned into two groups : an exercise group , who exercised for 60 min in warm water , three times a week ( N = 17 ) ; and a control group , who continued their habitual leisure-time activities ( N = 17 ) . HRQOL was assessed using the Short Form 36 question naire and the Fibromyalgia Impact Question naire . Physical fitness was measured using the following tests : Canadian Aerobic Fitness , h and grip dynamometry , 10-m walking , 10-step stair climbing , and blind one-leg stance . Outcomes were measured at baseline , after treatment , and after 3 months of detraining . RESULTS After 12 wk of aquatic exercise , significant positive effects of aquatic training were found in physical function , body pain , general health perception , vitality , social function , role emotional problems and mental health , balance , and stair climbing . After the detraining period , only the improvements in body pain and role emotional problems were maintained . CONCLUSION The present water exercise protocol improved some components of HRQOL , balance , and stair climbing in females with fibromyalgia , but regular exercise and higher intensities may be required to preserve most of these gains OBJECTIVE To determine the level of improvement , as regards pain , impact on fibromyalgia and depression , achieved by patients with fibromyalgia by comparing aquatic biodanza and stretching exercises . DESIGN R and omised controlled trial with two intervention groups . LOCATION Five health centres ( Almeria ) . PATIENTS A total of 82 fibromyalgia patients between 18 and 65 years old , diagnosed by American College of Rheumatology criteria , were included , with 12 patients declining to take part in the study . The 70 remaining patients were r and omly assigned to two groups of 35 patients each : aquatic biodanza and stretching exercises .  Those who did not attend in at least 14 sessions or changed their treatment during the studio were excluded . The final sample consisted of 19 patients in aquatic biodanza group and 20 in stretching group . The limitations of the study included , the open evaluation design and a sample size reduced by defaults . MAIN MEASURES The outcome measures were sociodemographic data , quality of life ( Fibromyalgia Impact Question naire ) , pain ( McGill-Melzack question naire ; and Visual Analogue Scale ) , pressure algometry ( Wagner FPI10 algometer ) and depression ( Beck Inventory ) . These were carried out before and after a 12-week therapy . RESULTS The mean age of the sample was 55.41 years . The mean period from diagnosis was 13.44 years . The sample consisted mainly of housewives . There were significant differences ( P<.05 ) between groups , in pain ( P<.01 ) , fibromyalgia impact ( P<.01 ) , and depression ( P<.04 ) after the treatment . CONCLUSIONS The biodanza aquatic exercises improve pain and quality of life in fibromyalgia patients OBJECTIVES To evaluate the effects of a 16-week exercise therapy in a chest-high pool of warm water through applicable tests in the clinical practice on the global symptomatology of women with fibromyalgia ( FM ) and to determine exercise adherence levels . DESIGN A r and omized controlled trial . SETTING Testing and training were completed at the university . PARTICIPANTS Middle-aged women with FM ( n=60 ) and healthy women ( n=25 ) . INTERVENTION A 16-week aquatic training program , including strength training , aerobic training , and relaxation exercises . MAIN OUTCOME MEASURES Tender point count ( syringe calibrated ) , health status ( Fibromyalgia Impact Question naire ) ; sleep quality ( Pittsburgh Sleep Quality Index ) ; physical ( endurance strength to low loads tests ) , psychologic ( State Anxiety Inventory ) , and cognitive function ( Paced Auditory Serial Addition Task ) ; and adherence 12 months after the completion of the study . RESULTS For all the measurements , the patients showed significant deficiencies compared with the healthy subjects . Efficacy analysis ( n=29 ) and intent-to-treat analysis ( n=34 ) of the exercise therapy was effective in decreasing the tender point count and improving sleep quality , cognitive function , and physical function . Anxiety remained unchanged during the follow-up . The exercise group had a significant improvement of health status , not associated exclusively with the exercise intervention . There were no changes in the control group . Twenty-three patients in the exercise group were exercising regularly 12 months after completing the program . CONCLUSIONS An exercise therapy 3 times a week for 16 weeks in a warm pool could improve most of the symptoms of FM and cause a high adherence to exercise in unfit women with heightened FM symptomatology . The therapeutic intervention 's effects can be assessed through applicable tests in the clinical practice Introduction Physical therapy in warm water has been effective and highly recommended for persons with fibromyalgia , but its efficiency remains largely unknown . Should patients or health care managers invest in this therapy ? The aim of the current study was to assess the cost-utility of adding an aquatic exercise programme to the usual care of women with fibromyalgia . Methods Costs to the health care system and to society were considered in this study that included 33 participants , r and omly assigned to the experimental group ( n = 17 ) or a control group ( n = 16 ) . The intervention in the experimental group consisted of a 1-h , supervised , water-based exercise sessions , three times per week for 8 months . The main outcome measures were the health care costs and the number of quality -adjusted life-years ( QALYs ) using the time trade-off elicitation technique from the EuroQol EQ-5D instrument . Sensitivity analyses were performed for variations in staff salary , number of women attending sessions and time spent going to the pool . The cost effectiveness acceptability curves were created using a non-parametric bootstrap technique . Results The mean incremental treatment costs exceeded those for usual care per patient by € 517 for health care costs and € 1,032 for societal costs . The mean incremental QALY associated with the intervention was 0.131 ( 95 % CI : 0.011 to 0.290 ) . Each QALY gained in association with the exercise programme cost an additional € 3,947/QALY ( 95 % CI : 1,782 to 47,000 ) for a health care perspective and € 7,878/QALY ( 3,559 to 93,818 ) from a societal perspective . The curves showed a 95 % probability that the addition of the water-based programme is a cost-effective strategy if the ceiling of inversion is € 14,200/QALY from a health care perspective and € 28,300/QALY from a societal perspective . Conclusion The addition of an aquatic exercise programme to the usual care regime for fibromyalgia in women  is cost effective in terms of both health care costs and societal costs . However , the characteristics of facilities ( distance from the patients ' homes and number of patients that can be accommo date d per session ) are major determinants to consider before investing in such a programme . Trial registration Current controlled trials IS RCT N53367487 OBJECTIVES To compare the cognitive function performance in patients with fibromyalgia ( FM ) with respect healthy controls and to evaluate the short-term efficacy of exercise therapy in a warm , chest-high pool on pain and cognitive function in women with FM . METHODS Sixty middle-aged women with FM were r and omly assigned to either an exercise training group ( n = 35 ) to perform 3 sessions per week of aquatic training ( 32 degrees C ) including mobility , aerobic , strengthening , and relaxation exercises for 16 weeks , or a control group ( n = 25 ) . Twenty-five healthy women matched for age , weight , body mass index , and educational and physical activity levels were recruited .  Pain was assessed in patients using a syringe calibrated like a pressure dolorimeter , and a visual analog scale . The severity of FM was evaluated using the Fibromyalgia Impact Question naire . Cognitive function was measured in healthy individuals and patients using several st and ardized neuropsychological tests . All patients were measured at baseline and post-treatment . RESULTS At baseline , the healthy group evidence d cognitive performance that was significantly superior to the group of patients with FM in all of the neuropsychological tests . The exercise group significantly improved their pain threshold , tender point count , self-reported pain , severity of FM , and cognitive function , while in the control group the differences were not significant . CONCLUSION An exercise therapy three times per week for 16 weeks in a warm-water pool is an adequate treatment to decrease the pain and severity of FM well as to improve cognitive function in previously unfit women with FM and heightened painful symptomatology Background and Purpose Aquatic physical therapy is frequently used in the management of patients with hip and knee osteoarthritis ( OA ) , yet there is little research establishing its efficacy for this population . The purpose of this study was to evaluate the effects of aquatic physical therapy on hip or knee OA . Subjects A total of 71 volunteers with symptomatic hip OA or knee OA participated in this study . Methods The study was design ed as a r and omized controlled trial in which participants r and omly received 6 weeks of aquatic physical therapy or no aquatic physical therapy . Outcome measures included pain , physical function , physical activity levels , quality of life , and muscle strength . Results The intervention result ed in less pain and joint stiffness and greater physical function , quality of life , and hip muscle strength . Totals of 72 % and 75 % of participants reported improvements in pain and function , respectively , compared with only 17 % ( each ) of control participants . Benefits were maintained 6 weeks after the completion of physical therapy , with 84 % of participants continuing independently . Discussion and Conclusion Compared with no intervention , a 6-week program of aquatic physical therapy result ed in significantly less pain and improved physical function , strength , and quality of life . It is unclear whether the benefits were attributable to intervention effects or a placebo response OBJECTIVE To evaluate if the timing of aquatic therapy influences clinical outcomes after total knee arthroplasty ( TKA ) or total hip arthroplasty ( THA ) . DESIGN Multicenter r and omized controlled trial with 3- , 6- , 12- , and 24-month follow-up . SETTING Two university hospitals , 1 municipal hospital , and 1 rural hospital . PARTICIPANTS Patients ( N=465 ) undergoing primary THA ( n=280 ) or TKA ( n=185 ) : 156 men , 309 women . INTERVENTION Patients were r and omly assigned to receive aquatic therapy ( pool exercises aim ed at training of proprioception , coordination , and strengthening ) after 6 versus 14 days after THA or TKA . MAIN OUTCOME MEASURES Primary outcome was self-reported physical function as measured by the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) at 3- , 6- , 12- , and 24-months postoperatively . Results were compared with published thresholds for minimal clinical ly important improvements . Secondary outcomes included the Medical Outcomes Study 36-Item Short-Form Health Survey , Lequesne-Hip/Knee-Score , WOMAC-pain and stiffness scores , and patient satisfaction . RESULTS Baseline characteristics of the 2 groups were similar . Analyzing the total study population did not result in statistically significant differences at all follow-ups . However , when performing sub analysis for THA and TKA , opposite effects of early aquatic therapy were seen between TKA and THA . After TKA all WOMAC subscales were superior in the early aquatic therapy group , with effect sizes of WOMAC physical function ranging from .22 to .39 . After THA , however , all outcomes were superior in the late aquatic therapy group , with WOMAC effect sizes ranging from .01 to .19 . However , the differences between treatment groups of these subanalyses were not statistically significant . CONCLUSIONS Early start of aquatic therapy had contrary effects after TKA when compared with THA and it influenced clinical outcomes after TKA . Although the treatment differences did not achieve statistically significance , the effect size for early aquatic therapy after TKA had the same magnitude as the effect size of nonsteroidal anti-inflammatory drugs in the treatment of osteoarthritis of the knee . However , the results of this study do not support the use of early aquatic therapy after THA . The timing of physiotherapeutic interventions has to be clearly defined when conducting studies to evaluate the effect of physiotherapeutic interventions after TKA and THA OBJECTIVE To evaluate whether changes in muscle strength due to 32 weeks of supervised aquatic training predicted improvements on health-related quality of life ( HRQOL ) . METHODS Thirty women with FM aged 50.8 + /- 8.7 years were r and omly assigned to an experimental group ( n = 15 ) , performing 3 weekly sessions of 60 min of warm-water exercise ; or to a control group ( n = 15 ) . HRQOL was evaluated using the Short Form 36 Health Survey ( SF-36 ) . Maximal unilateral isokinetic strength was measured at 60 degrees/s and 210 degrees/s in the knee extensors and flexors in concentric action and at 60 degrees/s in knee extensors eccentric action . Postural balance was evaluated using the one-leg stance , eyes closed . RESULTS After 32 weeks of water exercise therapy , statistically significant improvements occurred in concentric knee flexors and extensors strength at 60 degrees/s , in eccentric knee extensors and in postural balance . The treatment led to additional improvements in physical function , role physical problems , body pain , general health , vitality , role emotional problems and mental health dimensions of SF-36 . Gains in the concentric knee flexors strength predicted improvements in role of physical problems , whereas those in concentric knee extensors did the same for mental health and role emotional problems . Gains in eccentric knee extensors strength predicted improvements in postural balance . CONCLUSIONS A long-lasting exercise therapy in warm water produced relevant gains in muscle strength at low velocities of movements , some of which predicted improvements in physical problems , emotional problems , mental health and balance . TRIAL REGISTRATION International St and ard R and omized Controlled Trial Number IS RCT N53367487 , information available in http://www.controlled-trials.com/IS RCT N53367487 OBJECTIVE To evaluate the feasibility of 8 months of supervised exercise therapy in warm water and its effects on the impact of fibromyalgia on physical and mental health and physical fitness in affected women . METHODS Thirty women with fibromyalgia were r and omly assigned to an exercise therapy group ( n = 15 ) or a control group ( inactive ) ( n = 15 ) . The impact of fibromyalgia on physical and mental health was assessed using the Fibromyalgia Impact Question naire and the anxiety state with State-Trait Anxiety Inventory . Physical fitness was measured using the following tests : Canadian Aerobic Fitness ; h and -grip dynamometry ; 10-metre walking ; 10-step stair-climbing and blind 1-leg stance . RESULTS After 8 months of training , the exercise therapy group improved compared with the control group in terms of physical function ( 20 % ) , pain ( 8 % ) , stiffness ( 53 % ) , anxiety ( 41 % ) , depression ( 27 % ) , Fibromyalgia Impact Question naire total scores ( 18 % ) , State-Trait Anxiety Inventory score ( 22 % ) , aerobic capacity ( 22 % ) , balance ( 30 % ) , functional capacity for walking ( 6 % ) , stair-climbing with no extra weight ( 14 % ) and stair-climbing 10 kg-weighted ( 25 % ) . CONCLUSION Eight months of supervised exercise in warm water was feasible and led to long-term improvements in physical and mental health in patients with fibromyalgia at a similar magnitude to those of shorter therapy programmes OBJECTIVE To compare the clinical effectiveness of aerobic exercise in the water with walking/jogging for women with fibromyalgia ( FM ) . METHODS Sixty sedentary women with FM , ages 18 - 60 years , were r and omly assigned to either deep water running ( DWR ) or l and -based exercises ( LBE ) . Patients were trained for 15 weeks at their anaerobic threshold .  Visual analog scale of pain , Fibromyalgia Impact Question naire ( FIQ ) , Beck Depression Inventory , Short Form 36 Health Survey ( SF-36 ) , and a patient 's global assessment of response to therapy ( PGART ) were measured at baseline , week 8 , and week 15 . Statistical analysis included all patients . RESULTS Four patients dropped out from each group . Both groups improved significantly at week 15 compared with baseline , with an average 36 % reduction in pain intensity . For PGART , 40 % of the DWR group and 30 % of the LBE group answered " much better " at posttreatment . FIQ total score and FIQ depression improvements in the DWR group were faster ( week 8) than the LBE group and kept improving ( week 15 ; P < 0.05 ) . Only the DWR group showed improvements in SF-36 role emotional ( P = 0.006 ) . No significant between-group differences were observed for peak oxygen uptake and other outcomes . CONCLUSION DWR is a safe exercise that has been shown to be as effective as LBE regarding pain . However , it has been shown to bring more advantages related to emotional aspects . Aerobic gain was similar for both groups , regardless of symptom improvement . Therefore , DWR could be studied as an exercise option for patients with FM who have problems adapting to LBE or lower limbs limitations Study Design . This study was a prospect i ve , r and omized , controlled study . Objective . To compare the effectiveness of aquatic exercise interventions with l and -based exercises in the treatment of chronic low back pain ( CLBP ) . Summary of Background Data . L and -based exercise and physiotherapy are the main treatment tools used for CLBP . Clinical experience indicates that aquatic exercise may have advantages for patients with musculoskeletal disorders . Methods . A total of 65 patients with CLBP were included in this study . Patients were r and omly assigned to receive aquatic exercise or l and -based exercise treatment protocol . Aquatic exercise program consisted of 20 sessions , 5 × per week for 4 weeks in a swimming pool at 33 ° C . L and -based exercise ( home-based exercise ) program were demonstrated by a physiotherapist on one occasion and then they were given written advice The patients were assessed for spinal mobility , pain , disability , and quality of life . Evaluations were performed before treatment ( week 0 ) and after treatment ( week 4 and week 12 ) . Results . In both groups , statistically significant improvements were detected in all outcome measures ( except modified Schober test ) compared with baseline . However , improvement in modified Oswestry Low Back Pain Disability question naire and physical function and role limitations due to physical functioning subpart of Short-Form 36 Health Survey were better in aquatic exercise group ( P < 0.05 ) . Conclusion . It is concluded that a water-based exercises produced better improvement in disability and quality of life of the patients with CLBP than l and -based exercise The primary objective was to determine the effect of an aquatic exercise programme on the physical fitness of people with a brain injury . A pre-test – post-test r and omized-groups design was conducted . Sixteen out patients with a brain injury were included in the study . Eight participants were assigned to an aquatic exercise group and eight to a control group . The components of physical fitness measured included cardiovascular endurance , body composition , muscular strength and endurance and flexibility . Measurements were taken pre- and post-programme . Results indicated an increase in components of physical fitness for the experimental group but not the control group . Increases in fitness were reported as having a positive impact on the functional capacity of individuals in the exercise group as well as enhancing the individual 's ability to complete activities of daily living successfully . Results indicate that aquatic exercise may positively impact the primary and secondary physical injuries caused by a brain injury Background Gestational diabetes mellitus ( GDM ) is increasing worldwide and has been associated with adverse perinatal outcomes and high risk for chronic disease both for the mother and for the child . Physical exercise is feasible for diabetic pregnant women and contributes to better glycemic control and to a decrease in adverse perinatal outcomes . However , there are no r and omized controlled trials ( RCT ) assessing the effects of aquatic physical exercise on GDM control and adverse maternal and fetal outcomes . Methods / Design An RCT will be conducted at Instituto de Medicina Integral Prof Fern and o Figueira ( IMIP ) , Brazil . A total of 72 pregnant women will be studied ; 36 gestational diabetics will undergo an aquatic physical exercise program in a thermal pool , 3 times per week over 2 months . The primary endpoint will be glucose level control and use of insulin ; secondary endpoints will be the following maternal and fetal outcomes : weight gain during pregnancy , blood pressure , pre-eclampsia diagnosis , intrauterus growth restriction , preterm birth , Cesarean section , macrosomia and maternal or neonatal intensive care admission . Endpoints between intervention and control group will analyzed by t test for unpaired data and χ2 test , and the level of significance will set at < 0.05 . Discussion The physical proprieties of water make aquatic exercises ideal for pregnant women . An aquatic physical exercise program developed for GDM women will be trialed in a thermal pool and under the supervision of physiotherapist to ensure compliance . It is expected that this study will provide evidence as to the effect of aquatic physical exercise on GDM control . Trial registration Clinical Trial.gov , NCT01940003 AIM This paper reports a study of the effects of aquatic exercise on physical fitness ( flexibility , strength and aerobic fitness ) , self-reported physical functioning and pain in adults with osteoarthritis of the hip or knee . BACKGROUND Osteoarthritis is a common cause of disability and a primary reason for hip and knee joint replacement . Exercise is important for preventing and /or managing the functional limitations associated with joint disease . Aquatic exercise is thought to be beneficial and is often recommended for people with osteoarthritis ; however , few studies have examined the effects on people with osteoarthritis , and these have yielded inconsistent results . METHODS A two-group r and omized controlled trial with a convenience sample was used . Participants were recruited from community sources and r and omly assigned to a 12-week aquatic programme or a non-exercise control condition . Data for 38 participants were collected at baseline , week 6 , and week 12 during 2003 and 2004 . Instruments were a st and ard plastic goniometer , a h and held dynamometer , the 6-minute walk test , the multidimensional Health Assessment Question naire , and a visual analogue scale for pain . RESULTS Repeated measures analysis of variance showed that aquatic exercise statistically significantly improved knee and hip flexibility , strength and aerobic fitness , but had no effect on self-reported physical functioning and pain . The exercise adherence rate was 81.7 % , and no exercise-related adverse effect was observed or reported . CONCLUSIONS Beneficial short-term effects of aquatic exercise were found in adults with osteoarthritis of the hip or knee . Although the programme may not offer pain relief or self-reported improvements in physical functioning , results suggest that aquatic exercise does not worsen the joint condition or result in injury . Nurses engaging in disease management and health promotion for these patients should consider recommending or implementing aquatic classes for patients The aim of this study was to evaluate the effectiveness of aerobic exercise in water pool compared with aerobic exercise performed in sea by women with fibromyalgia ( FM ) . A total of 46 patients were r and omly allocated into two groups : pool group ( 23 patients ) and sea group ( 23 patients ) that performed the same aerobic exercise program . Patients were evaluated baseline and after 12 weeks using : VAS , number of tender points , FIQ , SF-36 , PSQI , and BDI . Both groups improved significantly in post-treatment for all the evaluated variables . There were no significant differences between two groups , except for BDI ( F = 2.418 , P < 0.0001 ) . Aerobic exercise program performed in water ( pool or sea ) was effective for patients with FM . However , sea water exercises have been shown to bring more advantages related to emotional aspects . Then , exercise performed sea water ( thalassotherapy ) is an option for effective treatment with low cost for patients with FM In a controlled study , 40 patients with refractory fibromyalgia were r and omly allocated to treatment with either hypnotherapy or physical therapy for 12 weeks with followup at 24 weeks . Compared with the patients in the physical therapy group , the patients in the hypnotherapy group showed a significantly better outcome with respect to their pain experience , fatigue on awakening , sleep pattern and global assessment at 12 and 24 weeks , but this was not reflected in an improvement of the total myalgic score measured by a dolorimeter . At baseline most patients in both groups had strong feelings of somatic and psychic discomfort as measured by the Hopkins Symptom Checklist . These feelings showed a significant decrease in patients treated by hypnotherapy compared with physical therapy , but they remained abnormally strong in many cases . We conclude hypnotherapy may be useful in relieving symptoms in patients with refractory fibromyalgia OBJECTIVE To investigate the effect of aquatic vertical traction on spinal height , pain intensity , and central ization response compared with a l and -based supine flexion position for patients with low back pain and signs of nerve root compression . DESIGN Single-blind , repeated- measures crossover design . SETTING Outpatient physical therapy clinic . SUBJECTS Ninety-eight subjects were recruited using consecutive sampling , with 28 men and 32 women of a mean ± st and ard deviation ( SD ) age of 59.6 ± 11.6 years completing testing . INTERVENTION Each subject participated in 2 sessions that consisted of loaded walking for 15 minutes , followed by either 15 minutes of l and -based supine position or 15 minutes of aquatic vertical traction .  MEASUREMENTS Spinal height change , measured using a commercial stadiometer , was determined after completing loaded walking and after each intervention . RESULTS The mean ± SD height change of 4.99 ± 2.88 mm after aquatic vertical traction was similar to that of 4.21 ± 2.53 mm after the l and -based supine flexion ( P = .0969 ) . Paired t-test indicated that both interventions result ed in significant increased height ( P < .0001 ) . Decreases in pain  after aquatic intervention ( 2.7 ± 2.1 cm ) were significantly greater than decreases after l and intervention ( 1.7 ± 1.7 cm ; P = .0034 ) , and central ization of symptoms was more pronounced after aquatic vertical suspension compared with the supine l and -based flexion condition ( P < .0001 ) . A significant correlation between height change and both pain reduction ( r = 0.39 ; P = .001 ) and central ization ( r = 0.29 ; P = .013 ) was observed for the aquatic intervention only . CONCLUSION Although both the aquatic and l and interventions produced significant increases in overall spinal height , the aquatic intervention produced greater pain relief and central ization response in subjects with low back pain and signs of nerve root compression OBJECTIVE To evaluate the effects of body awareness therapy combined with qigong for patients with fibromyalgia . DESIGN A controlled r and omized pilot study . SUBJECTS Thirty-six female patients with fibromyalgia were r and omized to either qigong plus body awareness therapy ( n = 19 ) or a control group ( n = 17 ) . METHODS The programme was conducted once a week over a period of 3 months . The outcome measures were an observational method called the Body Awareness Rating Scale , the Fibromyalgia Impact Question naire and 2 tests of physical function . An interview was conducted with the patients in the treatment group . RESULTS Seven patients in each group ( 39 % ) were lost to the post-test examination . The inter-group analysis revealed a significant improvement in movement harmony for the treatment group ( p = 0.03 ) , while no differences were found in the Fibromyalgia Impact Question naire or the functional tests . The intra-group analysis revealed an improvement in movement harmony for the treatment group ( p = 0.01 ) , while the total score of the Fibromyalgia Impact Question naire deteriorated ( p = 0.04 ) in the control group . The interviews indicated that several patients had experienced exacerbation of symptoms while st and ing still , and /or difficulty in concentrating on the movements . CONCLUSIONS Although improvement in movement harmony occurred in the patients completing the treatment programme , no improvement was found for fibromyalgia symptoms or physical function AIM The aim of this study was to determine the effects of aquatic exercise on fatigue and the quality of life in women with multiple sclerosis ( MS ) . METHODS This r and omized controlled clinical trial was carried out in a multiple sclerosis clinic in Iran , where 37 outpatient women with MS were r and omized into an exercise group ( N.=18 ) and a control group ( N.=19 ) . In the exercise group , aquatic exercise was performed for 45 minutes , 3 times per week for 8 weeks . The control group did not receive any interventions ( aquatic exercise ) and were asked to maintain their normal treatments . The severity and perception of fatigue and quality of life ( QoL ) were measured using the Fatigue Severity Scale ( FSS ) , Modified Fatigue Impact Scale ( MFIS ) , and Multicultural Quality of Life Index ( MQLIM ) question naires . RESULTS The repeated measure ANOVA demonstrated significant effects of aquatic exercise on the changes in the scores of physical and psychosocial fatigue perception , QoL , and fatigue severity ( P=0.001 ) . However , its effect was not significant for cognitive fatigue perception ( P>0.05 ) . General linear models show that the percentages of variation , as explained by the aquatic exercises , were highest in the QoL and the physical and psychosocial fatigue perceptions .  CONCLUSION Aquatic exercise can improve the QoL and decrease fatigue severity and fatigue perception , specifically in the physical and psychosocial domain for MS patients . However , it was not effective in improving cognitive fatigue perception Purpose . Fibromyalgia is a syndrome of unknown origin with a high prevalence . Multimodal approaches seem to be the treatment of choice in fibromyalgia . A multidisciplinary program was developed and implemented for patients with fibromyalgia in the primary care setting . The program included education ( seven sessions ) and physical therapy ( 25 sessions ) . Method . Patients were referred to the program by their general practitioner or by a medical specialist . A prospect i ve non-controlled treatment study was performed , patients were evaluated before , after and three months after the program ( single group time series design ) . The following measurements were performed : The Fibromyalgia Impact Question naire , R AND 36 , the Pain Coping and Cognition List , the Tampa scale for kinesiophobia , two physical tests and a qualitative evaluation .  Data of 65 patients with fibromyalgia were analysed , of whom 97 % were female . The mean age was 44 and the mean duration of pain was nine years . Results . Data of 65 patients with fibromyalgia were analysed , patients significantly improved on the domains feeling good , pain , fatigue , stiffness , quality of life , catastrophizing and on the physical tests . Conclusion . The multidisciplinary program fibromyalgia implemented in primary care seems feasible and the results are promising The effect of electroconvulsive therapy ( ECT ) on depression and other symptoms of fibromyalgia was studied in a prospect i ve 3‐month trial in 13 patients with fibromyalgia and concomitant depression . All the patients met the DSM‐IV diagnostic criteria for Major Depressive Disorder and fulfilled the American College of Rheumatology diagnostic criteria for fibromyalgia . The Montgomery and Åsberg Depression Rating Scale ( MADRS ) and the clinical global impression scale ( CGI ) were used to assess the severity of depression and the clinical change of the patients . The fibromyalgia impact question naire ( FIQ ) was used to evaluate the severity of the fibromyalgia symptoms . The intensity of pain was evaluated using a 6‐point scale ( 0=no pain , 5=very severe pain ) , and tender point palpation . All assessment s were performed at baseline and at follow‐up visits , which took place one week , one month and three months after ECT . There was a significant improvement in depression  after ECT  according to MADRS . Using CGI , six patients were much or very much improved , while four patients were minimally improved and three patients had no change . There was significant improvement in four out of ten FIQ item scores , “ feel good ” , “ fatigue ” , “ anxiety ” and “ depression ” . No significant change was found in the FIQ item scores “ physical function ” , “ pain ” , “ stiffness ” and “ morning tiredness ” or number of tender points and self‐reported pain . We conclude that ECT is a safe and effective treatment for depression in fibromyalgia patients , but has no effect on the pain or other physical symptoms of these patients OBJECTIVE To evaluate the effects of aquatic exercise therapy on gait variability and disability compared with usual care for people with Parkinson disease ( PD ) . DESIGN Single-blind r and omized controlled trial . SETTING Community-based hydrotherapy pool . PARTICIPANTS Individuals with PD ( Hoehn-Yahr stages I-III ) ( N=21 ) . INTERVENTIONS Participants were r and omly assigned to either an aquatic exercise therapy group ( 45min , twice a week for 6wk ) or a group that received usual care . MAIN OUTCOME MEASURES The primary outcome measure was gait variability as measured using a motion capture system . Secondary outcomes were quality of life measured on the Parkinson 's Disease Question naire-39 and freezing of gait and motor disability quantified by the Unified Parkinson 's Disease Rating Scale . Feasibility was evaluated by measuring safety , adverse events , and participant satisfaction . RESULTS People in the aquatic therapy group and usual care group showed similar small improvements in gait variability . The aquatic therapy group showed greater improvements in disability than the usual care group ( P<.01 ) . No differences between groups or over time were identified for freezing of gait or quality of life . Aquatic therapy sessions were safe and enjoyable with no adverse events . CONCLUSIONS Aquatic therapy appears feasible and safe for some people in the early stages of PD Background Aquatic exercise is recommended by the Osteoarthritis Research Society ( OARSI ) , by the American College of Rheumatology ( ACR ) and by the European League Against Rheumatism ( EULAR ) as a nonpharmacological method of controlling the knee osteoarthritis ( KOA ) symptoms . Moreover , given that weight loss results in a reduction of the load that is exerted upon the knee during daily activities , obesity is also considered to be a modifiable risk factor for the development and or exacerbation of KOA . The implementation of an exercise based weight loss program may , however , itself be limited by the symptoms of KOA . The aquatic program against osteoarthritis ( termed “ PICO ” in Portuguese ) prioritizes the control of symptoms and the recovery of functionality , with an attendant increase in the patient ’s physical activity level and , consequently , metabolic rate . Our laboratory is assessing the effectiveness of 3 months of PICO on the symptoms of KOA , on physical function , on quality of life and on gait . In addition , PICO shall examine the effects of said exercise intervention on inflammatory biomarkers , psychological health , life style and body composition . Methods / Design The trial is a prospect i ve , single-blinded , r and omized controlled trial , and involves 50 overweight and obese adults ( BMI = 28–43.5 kg/m2 ; age 40–65 yrs ) with radiographic KOA . The participants are r and omly allocated into either an educational attention ( control ) group or an aquatic ( exercise program ) group .  This paper describes the experimental protocol that is used in the PICO project . Discussion The PICO program shall provide insight into the effectiveness of an aquatic exercise program in the control of KOA symptoms and in the improvement of the quality of life . As such , they are likely to prove a useful reference to health professionals who intend to implement any kind of therapeutic intervention based around aquatic exercise . Trial registration NCT01832545
Due to the low method ological rigor , the results were insufficient to demonstrate statistical and clinical differences in most of the outcomes
Objective : To assess the effectiveness of aquatic physical therapy in the treatment of fibromyalgia .