Aquatic exercise interventions in the treatment of musculoskeletal upper extremity disorders: A scoping review

ObjectiveTo identify literature on aquatic exercise therapy used to manage upper extremity musculoskeletal disorders and identify key concepts, intervention components, and gaps in the evidence base.Data sourcesThe comprehensive search included MEDLINE (Ovid), CINAHL (EBSCOHost), Embase (Ovid), CENTRAL (Cochrane Central Register of Controlled Trials) databases and grey literature sources.Review methodsJBI Scoping review methodology guided this review through protocol development, searching, screening, data extraction and analysis. Study Selection included: Participants - Adults with upper extremity musculoskeletal disorders; Concept - Aquatic based exercise therapy; Context - any setting in any very highly developed nation.ResultsThe search identified 5045 sources with 68 studies included in the final synthesis. Findings outlined shoulder problems were the most reported upper extremity condition treated (n = 78) especially following rotator cuff repair (n = 17), followed by the hand and wrist (n = 9), and elbow (n = 6). Range of movement (n = 36) and resistance exercises (n = 17) were the most common interventions reported for aquatic therapy, however compliance with reporting guidance across included studies was poor. Sixteen health domains were identified with range of movement (n = 21) and pain (n = 20) the most common, and 62 outcome measures were reported related to the identified domains. Qualitative aspects of aquatic interventions were evaluated in two papers.ConclusionThere is a need for more primary experimental and qualitative studies related to the upper extremity and aquatic therapy. Improved reporting quality of aquatic therapy exercise intervention is required as is the need to establish specific core outcome sets and domains in this area.