Review Article

The benefits of hydrotherapy to patients with spinal cord injuries

Terry J. Ellapen, Henriëtte V. Hammill, Mariëtte Swanepoel, Gert L. Strydom
African Journal of Disability | Vol 7 | a450 | DOI: https://doi.org/10.4102/ajod.v7i0.450 | © 2018 Terry J. Ellapen, Henriëtte V. Hammill, Mariëtte Swanepoel, Gert L. Strydom | This work is licensed under CC Attribution 4.0
Submitted: 10 November 2017 | Published: 16 May 2018

About the author(s)

Terry J. Ellapen, School of Biokinetics Recreation and Sport, Physical Activity Sport and Recreation (PhASRec), North-West University, South Africa
Henriëtte V. Hammill, School of Biokinetics Recreation and Sport, Physical Activity Sport and Recreation (PhASRec), North-West University, South Africa
Mariëtte Swanepoel, School of Biokinetics Recreation and Sport, Physical Activity Sport and Recreation (PhASRec), North-West University, South Africa
Gert L. Strydom, School of Biokinetics Recreation and Sport, Physical Activity Sport and Recreation (PhASRec), North-West University, South Africa

Abstract

Background: Many patients with spinal cord injury (PWSCI) lead sedentary lifestyles, experiencing poor quality of life and medical challenges. PWSCI don’t like to participate in land-based-exercises because it’s tedious to perform the same exercises, decreasing their rehabilitative compliance and negatively impacting their well-being. An alternative exercise environment and exercises may alleviate boredom, enhancing compliance.

Objectives: Discuss the benefits of hydrotherapy to PWSCI concerning underwater gait-kinematics, thermoregulatory and cardiovascular responses and spasticity.

Methodology: A literature surveillance was conducted between 1998 and 2017, through the Crossref meta-database and Google Scholar, according to the PRISMA procedures. Key search words were water-therapy, aquatic-therapy, hydrotherapy, spinal cord injury, rehabilitation, human, kinematics, underwater gait, cardiorespiratory, thermoregulation and spasticity. The quality of each paper was evaluated using a modified Downs and Black Appraisal Scale. The participants were records pertaining to PWSCI and hydrotherapy. The outcomes of interest were: hydrotherapy interventions, the impact of hydrotherapy on gait-kinematics, thermoregulation during water submersion and cardiorespiratory function of PWSCI. Omitted records included: non-English publications from before 1998 or unrelated to hydrotherapy and PWSCI. The record screening admissibility was performed as follows: the title screen, the abstract screen and the full text screen.

Results: Literature search identified 1080 records. Upon application of the exclusion criteria, 92 titles, 29 abstracts and 17 full text records were eligible. Only 15 records were selected to be included in this clinical commentary. Evidence shows a paucity of randomised control trials (RCT) conducted in this field.

Conclusion: Hydrotherapy improves PWSCI underwater gait-kinematics, cardiorespiratory and thermoregulatory responses and reduces spasticity.


Keywords

Hydrotherapy; spinal cord injury; rehabilitation

Metrics

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Crossref Citations

1. Spasticity Management After Spinal Cord Injury
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doi: 10.1007/s40141-020-00280-6

2. Minimal Clinically Important Differences for Measures of Pain, Lung Function, Fatigue, and Functionality in Spinal Cord Injury
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Physical Therapy  vol: 101  issue: 2  year: 2021  
doi: 10.1093/ptj/pzaa210

3. The impact of community-based, non-pharmaceutical interventions on anxiety and depression in fibromyalgia: A systematic review and network meta-analysis
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Journal of Psychiatric Research  vol: 182  first page: 50  year: 2025  
doi: 10.1016/j.jpsychires.2025.01.014

4. Water-Based Interventions for People With Neurological Disability, Autism, and Intellectual Disability: A Scoping Review
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Adapted Physical Activity Quarterly  vol: 38  issue: 3  first page: 474  year: 2021  
doi: 10.1123/apaq.2020-0036

5. Suyun Tedavi Amaçlı Kullanımı: Balneoterapi ve Hidroterapi
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Bütünleyici ve Anadolu Tıbbı Dergisi  vol: 4  issue: 2  first page: 62  year: 2023  
doi: 10.53445/batd.1245432

6. Activity based restorative therapy considerations for children: medical and therapeutic perspectives for the pediatric population
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Frontiers in Rehabilitation Sciences  vol: 4  year: 2023  
doi: 10.3389/fresc.2023.1186212

7. The Impact of Aquatic Programme Activities on the Quality of Life for People with Disabilities in the Western Cape, South Africa
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The Open Public Health Journal  vol: 18  issue: 1  year: 2025  
doi: 10.2174/0118749445336312240930090044

8. The state of aquatic therapy use for clients with spinal cord injury or disorder: Knowledge and current practice
Andresa R. Marinho-Buzelli, Cindy Gauthier, Katherine Chan, Alison M. Bonnyman, Avril Mansfield, Kristin E. Musselman
The Journal of Spinal Cord Medicine  vol: 45  issue: 1  first page: 82  year: 2022  
doi: 10.1080/10790268.2021.1896274

9. The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials
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International Journal of Surgery  vol: 110  issue: 3  first page: 1711  year: 2024  
doi: 10.1097/JS9.0000000000000962

10. Quantification of Lower Limb Kinematics During Swimming in Individuals with Spinal Cord Injury
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Sensors  vol: 25  issue: 13  first page: 3950  year: 2025  
doi: 10.3390/s25133950

11. Wearable technologies for monitoring aquatic exercises: A systematic review
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Clinical Rehabilitation  vol: 37  issue: 6  first page: 791  year: 2023  
doi: 10.1177/02692155221141039

12. Evidence of Improvement of Lower Limb Functioning Using Hydrotherapy on Spinal Cord Injury Patients
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Biomedicines  vol: 11  issue: 2  first page: 302  year: 2023  
doi: 10.3390/biomedicines11020302

13. Metabolic and cardiopulmonary impact of aquatic exercise and nutritional guidance for four individuals with chronic motor incomplete spinal cord injury: a case series
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Physiotherapy Theory and Practice  vol: 39  issue: 7  first page: 1553  year: 2023  
doi: 10.1080/09593985.2022.2042632

14. Inertial-Sensor-Controlled Functional Electrical Stimulation for Swimming in Paraplegics: Enabling a Novel Hybrid Exercise Modality
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IEEE Control Systems  vol: 40  issue: 6  first page: 117  year: 2020  
doi: 10.1109/MCS.2020.3019152

15. Systemic Inflammatory Changes in Spinal Cord Injured Patients after Adding Aquatic Therapy to Standard Physiotherapy Treatment
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doi: 10.3390/ijms25147961

16. Changes in Respiratory Muscle Pressure of Healthy Individuals with Different Levels of Immersion in Water: Observational Study
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doi: 10.30621/jbachs.1273896

17. Global Prevalence of Deep Vein Thrombosis in Patients with Spinal Cord Injury: A Systematic Review and Meta-Analysis
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Neurotrauma Reports  vol: 6  issue: 1  first page: 491  year: 2025  
doi: 10.1089/neur.2024.0144

18. Efficacy of aquatic therapy in people with spinal cord injury: a systematic review and meta-analysis
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Spinal Cord  vol: 61  issue: 6  first page: 317  year: 2023  
doi: 10.1038/s41393-023-00892-4

19. Effect of an Aquatic Balance-Training Program in Patients with Chronic Stroke: A Single-Group Experimental Pilot Study
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doi: 10.3390/medicina56120656

20. Stem Cell Conditioned Medium Treatment for Canine Spinal Cord Injury: Pilot Feasibility Study
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21. Research Progress on the Therapeutic Effect Evaluation and Mechanism of Action of Aquatic Exercise Intervention for Knee Osteoarthritis
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doi: 10.12677/aps.2025.134058

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doi: 10.18231/j.ijogr.2020.055

23. Review study on hydrotherapy and AQUA therapy in spine disorders
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Timisoara Physical Education and Rehabilitation Journal  vol: 15  issue: 29  first page: 31  year: 2022  
doi: 10.2478/tperj-2022-0011