Global research trends in aquatic exercise therapy for musculoskeletal disorders: a bibliometric analysis

Aquatic exercise therapy has gained recognition as a valuable non-pharmacological intervention for managing musculoskeletal disorders. Despite the growing body of evidence supporting its efficacy, research on aquatic exercise therapy remains fragmented, with limited understanding of key trends, influential studies, and evolving themes within the field. This study aims to conduct a comprehensive bibliometric analysis to identify publication trends, key authors, and the evolution of research themes in aquatic exercise therapy for musculoskeletal disorders.

A total of 117 articles were selected based on predefined search terms and inclusion criteria, resulting in 3,985 citations, with an average of 35.9 citations per article and an H-index of 37.

Publications surged between 2013 and 2024, accounting for 88.3% of total output. Peaks occurred in 2019 (n = 14) and 2022 (n = 368 citations). Key contributors include Mariana Arias Avila and Basia Belza, with journals such as BMC Musculoskeletal Disorders and Arthritis & Rheumatism-Arthritis Care & Research playing pivotal roles. Research trends shifted from disease-specific studies to broader quality-of-life outcomes, with keywords such as "rheumatoid arthritis", "balneotherapy", and "quality of life" emerging as focal points.

The findings underscore the growing importance of aquatic exercise therapy in clinical rehabilitation and suggest that future research should focus on long-term outcomes, underrepresented populations, and the integration of aquatic exercise therapy with emerging rehabilitation technologies.