The effects of a Community Aquatic Exercise Programme For Chinese People with Knee Osteoarthritis

Background: Knee osteoarthritis(OA )is one of the most prevalence musculoskeletal problem causing disabilities in the elderly population. Community Rehabilitation Network (CRN) of The Hong Kong Society for Rehabilitation has been providing community aquatic exercise programme for the people with OA knee pain. Purpose: The purpose of the current study is to explore the effects of a structural community-based hydrotherapy classes on pain, balance, exercise capacity, daily functional outcomes and quality of life. Methods: 40 subjects who suffered from knee pain were recruited into land based control group (n=20) and pool based intervention group (n=20). It was a quasi-controlled trial with pre-post intervention assessments. The intervention group underwent a 5-week 50minutes each physiotherapist led community aquatic exercise programme (CAEP) with twice a week exercise training while the control group were self- administered and were given OA knee management pamphlet and joint caring advice by physiotherapist. Subjects were assessed immediately before and after 5-weekprogram. The primary outcome was pain(Numeric Pain Rating Scale), while the secondary outcomes were self-reported questionnaire on lower limb arthritis (Western Ontario and McMaster Osteoarthritis Index),balance (Functional Reach Test),exercise capacity(6-MinutesWalkTest),and psychological status (SF-12). Results: The aquatic exercise group demonstrated significant improvement on pain, balance and mental component of SF-12 compared with the control group. While the control group reported significant improvement in the change of 6-Minute Walk Test compared with aquatic exercise group. Secondary outcomes such as the changes of physical component of SF-12, WOMAC sub-scores between two groups were found to have no significantly difference. Conclusion(s): A 5-week community aquatic exercise programme focusing on range of motion, proprioception, strengthening and balancing of lower limbs produced favourable outcome on pain and balance for the people with OA knee. The results provided evidence on the value of such kind of community aquatic program for local people with OA knee. Implications: The study is a collaborative study among university and an on-governmental organization. The present study is designed to test the effectiveness of physiotherapist led aquatic intervention program aiming to reduce or prevent the world wide knee osteoarthritis problem. If this is successful, it can be implemented in many outpatient physiotherapy departments in Hong Kong and other countries. Also, there is a potential to further extend the service to different nongovernmental organizations and may allow the patients to have such training at the community. Keywords: Aquatic physiotherapy; Knee osteoarthritis; Community exercise Funding acknowledgements: Not applicable. Ethics approval: Joint CUHK-NTEC Clinical Research Ethics Review Committee.