A systematic Review looking at the effectiveness of Hydrotherapy (Aqua Therapy, AT)) verus land based exercise or control exercise group supported short and midterm functional benefits of AT over land based exercise of minimal clinically important difference (MCID). There is limited evidence to suggest AT is more effective than land or no intervention on functional measures of walking, stair climbing and ROM. The author acknowledges firm conclusions are difficult to make the current literature due to a lack of high quality studies.
The evidence in this review indicates aquatic rehabilitation interventions should start within 2-weeks post-surgery and last for at least 3-5 weeks, with 3-5 sessions per week, to have greatest likelihood of a clinically meaningful outcome. What is more, rehabilitation on the pool should focus on the intensity of the exercise as opposed to the type of exercise.
Wilkins, Benjamin (2017) The Effectiveness of Aquatic Therapy Following Total Hip or Total Knee Arthroplasty: A Systematic Literature Review. The Journal of the Hydrotherapy Association of Chartered Physiotherapists 29(2): 15-21