A single-blind, randomized controlled trial conducted in A Coruña, Spain, has provided evidence that aquatic therapy (AT) outperforms land-based therapy (LBT) in managing pain and improving sleep quality in women with fibromyalgia. The study involved 40 women, randomly assigned to AT or LBT groups, who participated in 60-minute physiotherapeutic sessions three times per week for 12 weeks.
Primary outcomes focused on pain intensity, while secondary measures included pressure pain threshold, quality of life, sleep quality, fatigue, and physical ability. At the 18-week follow-up, the AT group showed significant improvements in both pain intensity and sleep quality compared to the land-based therapy group. The AT group reported a substantial reduction in pain (2.7, IQR 1.5-4.9) compared to the LBT group (5.5, IQR 3.3-7.6), with a statistically significant difference (p=0.023) and a large effect size (Cohen’s d=0.8). In addition, the AT group demonstrated a significant improvement in sleep quality (12.0, IQR 7.3-15.3) compared to the LBT group (15.0, IQR 13.0-17.0), with a p-value of 0.030 and an effect size of 0.8.
The findings of the study emphasize the potential of AT as a highly beneficial treatment for fibromyalgia, particularly when compared to land-based exercise therapies. While both interventions offered positive outcomes, AT showed superior results in key areas such as pain management and sleep quality, making it a promising option for long-term symptom relief.
Complementing these findings, previous research by Andrade et al. showed that aquatic physical therapy led to improvements in oxygen uptake at the ventilatory anaerobic threshold and peak cardiopulmonary exercise testing, alongside symptom relief. However, detraining effects were observed after 16 weeks, as benefits diminished to baseline levels, underscoring the importance of sustained therapy for maintaining gains.
AT sessions, typically lasting 60 minutes and conducted 2–3 times per week in a warm water pool (28–32°C), are designed by trained physiotherapists to enhance strength, mobility, and relaxation. The unique properties of water, including buoyancy, viscosity, and hydrostatic pressure, make it particularly effective for fibromyalgia patients. Buoyancy decreases joint load, enabling easier movement, viscosity provides gentle resistance to strengthen muscles, and hydrostatic pressure improves circulation and reduces swelling, creating an ideal environment for low-impact therapeutic exercises.
The current research reinforces AT as a safe, effective, and accessible intervention for fibromyalgia patients, particularly those who face challenges with land-based exercise. The study not only emphasizes its efficacy in reducing pain and enhancing sleep quality but also suggests its role in restoring physical capacity and improving quality of life.
The study paves the way for integrating AT into standard care protocols for fibromyalgia and other chronic pain conditions. Future research should explore its long-term effects and potential benefits as a complementary treatment, ensuring sustained symptom relief and improved outcomes for patients. Regular AT may serve as a cornerstone in the holistic management of fibromyalgia, promoting better physical and emotional well-being.
Reference
- Rivas Neira S, Pasqual Marques A, Fernández Cervantes R, Seoane Pillado MT, Vivas Costa J. Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial. Physiotherapy. 2024 Jun;123:91–101.
- Andrade CP, Zamunér AR, Forti M, Tamburús NY, Silva E. Effects of aquatic training and detraining on women with fibromyalgia: controlled randomized clinical trial. Eur J Phys Rehabil Med. 2019 Feb;55(1):79–88.