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Wounds & Water

Villalta EM et al.2012 Early aquatic physical therapy improves function and does notincrease risk of wound-related adverse events for adults after orthopeadic surgery: a systematic review and meta-analysis 


To determine the risk of adverse events such as wound infection when participating in early aquatic physical therapy. Eight studies (average Pedro score 5.3/10).

N = 287 participants, adults (average age 65) less than 3 months postoperative orthopedic surgery (post-op TKR, THR, ACL Reconstruction, Rotator Cuff Repair). Aquatic therapy at Post-Op-Day 4, Post-Op-Day10, Post-Op-Day14.


Interventions: 3 trials were 1:1 aquatic therapy, 5 trials were group sessions. Variance of 2 or 3 times per week from 6 to 12 weeks duration. In waist to chest deep water; 4 studies had additional land therapy; addressed function, strength, ROM.


Results: Favoured aquatic therapy for ADL gains, reduction of oedema; significant ROM gains in post-op shoulder study.

No adverse effects with immersion as early as POD4 TKR.

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