Osteoarthritis (OA) is a degenerative form of arthritis affecting many older adults over the age of 50. It is the most common type of arthritis and its prevalence continues to increase along with an aging worldwide population. Commonly affecting the spine, hands, hips and knees, OA can result in significant pain and disability.

Various forms of exercise have been shown to improve OA symptoms and even delay the progression of the disease, especially muscle strengthening programs. However, until a recent study the benefits of water-based exercise was not known.

"The surprise in this study was that there was any functional gain in the hydro group," says lead author Maria Crotty, head of the Flinders University department of rehabilitation and aged care in Adelaide, Australia.

"We expected the patients would like hydro, but actually the gym group would get the gains. In fact, both exercise groups did pretty well, so it provides some support for hydro," she adds.

In a randomized controlled trial involving 105 participants, hydrotherapy (water-based resistance exercise) was directly compared to gym-based exercise (land-based resistance exercise) during 2001-2002.

The study has shown that both forms of exercise produce positive but different benefits, as the hydrotherapy group showed greatest improvement in walking distance and the gym group demonstrated greatest improvement in quadriceps strength.

Gym-Based Resistance Exercise Is Also Useful for Osteoarthritis

It can be concluded from these results that hydrotherapy programs are effective in improving physical function and possibly cardio-vascular fitness, especially when pain or disability prevent extended periods of weight bearing exercise (e.g. walking). However, for increasing strength around affected joints in order to improve joint stability and improve shock-absorbing capacity, gym-based resistance exercise is significantly more effective in achieving this.

Exercise often is recommended for people suffering from osteoarthritis, the most common form of arthritis and one in which the risk increases with increasing age and weight. While water exercise is EZ Riverly popular (and expensive), to date there has been little evidence in support of pool therapy, say the study authors.

"Hydrotherapy is very useful with overweight patients who find aerobic exercise difficult (often they have painful knees and/or hips)," Crotty writes. "Osteoarthritis is a growing problem in overweight populations, and the common advice is [to] walk, but many of this patient group are reluctant or unable to walk."

If you want to focus on strengthening muscles, however, it's probably more efficient to use the gym, she adds.

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