Use of Hydrotherapy for the Management of Ankylosing Spondylitis (AS)

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Original Editors - Harrison Chipchase

Top Contributors - Wilson Gay, Angeliki Chorti, Harrison Chipchase, Lucy Olivia Thomas, Khloud Shreif, Nico Pennant, Kim Jackson and Cindy John-Chu  

Clinical Relevance

Case study

Mr Smith Case study:

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Benefits of Hydrotherapy

Benefits of hydrotherapy:

stiffness, pain, risk of developing a stooped posture and fatigue are all issues associated with AS.  

Hydrotherapy can be beneficial as:

• The warmth and the buoyancy make stretches more effective
• It’s less painful
• It’s easier to stay upright because the effect of gravity is less
• It requires less physical effort
• Afterwards you usually have a really good night’s sleep

• Water can act as resistance to help strengthen muscles  
• Can provide shock absorption  

(National axial spondylitis association)  

Patient experience studies:  

(Martin et al., 2018)

250 members of the national axial spondylitis association (NASS) completed an online survey on the patients’ experience of hydrotherapy. From thematic analysis of the questionnaires, five themes emerged.

1.Emotional well being : Patients described greater control over their condition when exercising in water

2. Exercise behaviour : patients often performed a wider variety of exercises including challenging exercises that they would not usually attempt on land

3. Group effect : patients described a sense of motivational support when exercising with others in a group  

4. Professional support : Patients cited the benefit of hydrotherapy sessions led by a physiotherapist who shared their expertise and discussed problems.

5 - Pool Environment: Patients described gains from non-impact exercise      and weightlessness in the water. The warmer pool temperature was stated as a reason for the benefits obtained.

Hydrotherapy was shown to be most beneficial for improving pain relief, mood, quality of life stiffness and flare management, but less beneficial for improving sleep quality and fatigue.  

Randomised control trial:  

(Dundar et al., 2014)

A total of 69 patients (58 male and 11 female) completed the study. Patients were randomly allocated to a land exercise or aquatic exercise group. The study found that both groups showed significant improvements in their symptoms. However, improvement in VAS score, bodily pain, general health and social functioning were greater in the aquatic exercise group.  

Hydrotherapy Exercise and Prescription

Outcome measures

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