title: A randomized and controlled trial of hydrotherapy in rheumatoid arthritis.
abstract: OBJECTIVE
  The aim of this study was to evaluate the therapeutic effects of hydrotherapy which combines elements of warm water immersion and exercise. It was predicted that hydrotherapy would result in a greater therapeutic benefit than either of these components separately.
  
  
  METHODS
  One hundred thirty-nine patients with chronic rheumatoid arthritis were randomly assigned to hydrotherapy, seated immersion, land exercise, or progressive relaxation. Patients attended 30-minute sessions twice weekly for 4 weeks. Physical and psychological measures were completed before and after intervention, and at a 3-month followup.
  
  
  RESULTS
  All patients improved physically and emotionally, as assessed by the Arthritis Impact Measurement Scales 2 questionnaire. Belief that pain was controlled by chance happenings decreased, signifying improvement. In addition, hydrotherapy patients showed significantly greater improvement in joint tenderness and in knee range of movement (women only). At followup, hydrotherapy patients maintained the improvement in emotional and psychological state.
  
  
  CONCLUSIONS
  Although all patients experienced some benefit, hydrotherapy produced the greatest improvements. This study, therefore, provides some justification for the continued use of hydrotherapy.
authors.forename: J
authors.initials: J
authors.lastname: Hall
authors.forename: S M
authors.initials: SM
authors.lastname: Skevington
authors.forename: P J
authors.initials: PJ
authors.lastname: Maddison
authors.forename: K
authors.initials: K
authors.lastname: Chapman
mesh_terms: D001172:Arthritis, Rheumatoid / Q000534:rehabilitation*; D005081:Exercise Therapy; D005260:Female; D006304:Health Status; D006801:Humans; D006875:Hydrotherapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D016896:Treatment Outcome