Effects of two different pool exercises on physical disability, pain, daily life activity and depression with people knee osteoarthritis

ABSTRACTIt is essential to determine what kind of a change pain and physical disability onknee osteoarthritis is subject to through an exercise treatment in poolconcurrently with physical therapy, and to determine which type of pool exerciseis more efficient in therapeutic terms. The purpose of this study is to ascertainwhether pool exercise makes extra contribution to treatment, and if it does,which type of exercise is more effective on physical disability, pain, daily lifeactivity and depression, through a comparison both between two different poolexercise trainings and with cases for which hydrotherapy is not prescribed. 89patients in total participated to our study, who had been diagnosed as kneeosteoarthritis. The cases included in the study were separated into threegroups. 60 individuals were selected for the pool exercise groups, and, throughrandom sampling technique, they were divided into two equal groups eachincluding 30 individuals. The third group consisted of 29 individuals who wereout patients, not receiving water exercise treatment. Two different types ofexercise was applied in a pool for the cases in the study group. As a waterexercise therapy; the first study group was given an exercise training only forlower extremity, consisting of two phases and containing warm-up, stretchingand strengthening periods in each phase. The second study group was givenexercises for upper extremity along with trunk exercise training, in addition tothe lower extremity exercises applied on the first group. During the study, painseverity in our cases were evaluated through a visual analogue scale. Physicaldisability and daily life activity were evaluated by a (Western Ontario andMcMaster Universities Osteoarthritis Index) WOMAC index. A Hospital Anxietyand Depression scale was used for evaluation of emotional status in our cases.Upon a pain severity evaluation according to VAS on the both study groups andthe control group, and a comparison between the groups, statistically positiveresults were achieved in all groups after the therapy. When the gradual changein pain severity scores among the groups were observed according to VASbefore and after therapy, the rate of change in the first study group was foundhigher compared to the other groups (p<0,001). When the gradual change invii(Western Ontario and McMaster Universities Osteoarthritis Index) WOMAC painseverity, stiffness and physical function scores among the groups wereobserved before and after therapy, the rate of change in the second study groupwas found higher compared to the other groups (p<0,001). When HospitalAnxiety and Depression scale HAD depression scores among the groups wereexamined before and after the therapy. Nevertheless, it was found out thatdepression status of the cases in the first study group were better whencompared to the other groups. Upon the evaluation of 6-minute walking test inall groups, the walking distance after therapy was subject to an increase(p<0.001). In conclusion, it was found out that pool therapy was effective inknee OA treatment. It was also observed that the first study group was in bettercondition in terms of pain severity results of the cases. It was found out thatdaily life activity and physical disability results in the second study group wererather improved in comparison with the first study group. It was seen that thepool exercise therapy consisting of upper & lower extremity and trunk exerciseswere more effective in improvement of functions. Depression severity levels ofthe individuals were lessened and their exercise capacities were improved bypool exercise therapy which was applied for three weeks.Keywords: Osteoarthritis, pool exercies, pain, daily life activity, physicaldisabilityviii