Hydrotherapy more beneficial for MS patients than conventional physiotherapy

Hydrotherapy improved balance and eased the fatigue of multiple sclerosis (MS) patients more than land-based physical therapy after just eight weeks of training, according to the results of a recent clinical trial published in Multiple Sclerosis and Related Disorders.

A team of researchers from the University of Thessaly in Lamia, Greece, including corresponding author Konstantinos Chandolias, Ph.D., assessed 26 adults with relapsing-remitting MS randomized to receive either hydrotherapy or standard physiotherapy for eight weeks.

MS is a chronic autoimmune disorder characterized by inflammation that damages the myelin sheath, which is the protective coating around nerve fibers. When damage occurs, electrical signals are unable to be transmitted efficiently, which leads to neurological impairment. This impairment manifests in many ways, including muscle weakness, fatigue and mood changes.

“Enhanced balance and core stability from aquatic training can translate to safer ambulation and greater independence in daily activities for people with MS,” Chandolias and his colleagues write in the study. “Improvements in fatigue are not only statistically significant but also translate into better daily function and energy for patients.”

Progress was measured using the Modified Fatigue Impact Scale (MFIS) and the Berg Balance Scale (BBS).

The MFIS score is calculated using a patient’s answers to 21 questions about physical, cognitive and psychosocial impacts of MS, with a higher overall score indicating greater fatigue.

The BBS measures patients’ ability to maintain balance in various activities, including when transitioning from sitting to standing, while standing with their back unsupported and while reaching forward. A higher score indicates better balance.

At trials’ end, the aquatic therapy group BBS score increased by 2.7 points, from 52.6 to 55.3, and the MFIS score decreased by 9 points (from 40.1 to 31.1).

The control group BBS score decreased by 3.6 points (from 53.65 to 50.01) and the MFIS score increased by 5.5 points (from 39.2 to 44.8).

Both types of sessions were led by trained specialists.

The hydrotherapy sessions were 35 minutes long and given twice a week, and the conventional physical therapy sessions were given in 45-minute sessions twice a week.

There are approximately 1 million people in the United States with MS. The average estimated annual burden of MS is $85.4 billion. Individually, the average cost is approximately $88,487 a year, which is $65,612 more each year than medical costs for individuals who do not have MS. This is primarily driven by prescription cost and indirect productivity loss caused by symptoms.

Aquatic therapy works by increasing buoyancy, which can lessen pain and promote freedom of movement. It also promotes strength and coordination because of the extra resistance of water. Water temperature can also improve circulation and stress relief.

“Our findings reinforce that aquatic therapy is a valuable and effective component of MS rehabilitation, leveraging the supportive, low-impact and therapeutic properties of water to enable patients to exercise more efficiently and confidently,” Chandolias and his colleagues write in the study. “As accessibility to therapeutic pools and trained personnel increases, aquatic therapy should be embraced as a key rehabilitative strategy for MS, with ongoing research and clinical innovation guiding its best use in the years ahead.”