Background: Physiotherapists commonly use hydrotherapy as a treatment approach for various types of conditions. As hydrotherapy utilizes the hydrodynamic properties of water to promote relaxation and decrease pain perception, previous research has suggested that hydrotherapy may help to decrease the health burden of musculoskeletal conditions. The aim of this review was to critically examine literature investigating (a) the benefits of hydrotherapy on reducing pain and disability associated with chronic musculoskeletal conditions, and (b) report on literature findings regarding the perceived benefit of hydrotherapy on the wellbeing of adults with chronic musculoskeletal conditions. Methods: Select electronic databases were searched to identify relevant articles. Studies meeting the inclusion criteria were critically analyzed using the Downs and Black protocol with agreement between raters assessed via Kappa analysis. Results: Nine original articles addressing the benefits of hydrotherapy on adult populations with chronic musculoskeletal conditions were analysed. The mean critical appraisal score was 73% (Kappa = 0.87) with the evidence suggesting that hydrotherapy had a positive effect on pain, quality of life, condition related disability and functional exercise capacity. It was also noted that following hydrotherapy, the perceived benefit of wellbeing was superior to land-based exercise protocols in cases where water temperature was within a thermoneutral range (33.5°C to 35.5°C). Conclusion: Hydrotherapy helps to reduce the health burden of musculoskeletal conditions. Improvements in the perception of wellbeing are likely to occur following hydrotherapy that is conducted in water within the thermoneutral range.
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