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Efficacy of aquatic therapy in people with spinal cord injury: a systematic review and meta-analysis


Study design

Systematic review and meta-analysis. Spinal cord injury (SCI) is a pathological condition that provokes the loss of one or more body functions due to an injury to the spinal cord as a result of trauma or disease. Hydrotherapy plays a key role in the rehabilitation of neurological patients due to the properties of water environments.


The goal of this study was to evaluate the efficacy of hydrotherapy in patients who suffer from SCIs.


We searched 5 different databases: CINAHL, PubMed, Scopus, Web of Science, and PEDro for studies to include. Only randomized controlled trials (RCTs) published in English were considered. To evaluate the risk of bias, Jadad and PEDro scales were used.


Eleven Randomized Controlled Trials were included, and 3 articles remained to be analyzed. According to the evaluation through Cochrane Risk of Bias tool, one study had a high level of quality. The remaining 2 studies achieved a score indicative of a low level of quality. A total of 71 individuals with SCI were included in the studies; age and level of injury varied in each study. The outcome measures used in the studies were: Functional Independence Measure (FIM), Ashworth scale, CardioTouch 3000 s in sitting position and Quark CPET.


The aquatic environment provides a rehabilitation tool able to facilitate movement, physical and cardiovascular exercise, resistance training, and body relaxation.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.


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Author information

Authors and Affiliations



LP and IR were responsible for designing the review protocol, writing the protocol and report, conducting the search, screening potentially eligible studies, extracting and analyzing data, interpreting results, updating reference lists, and creating tables. GG and AB were responsible for designing the review protocol and screening potentially eligible studies. They contributed to writing the report, extracting and analyzing data, interpreting results and creating tables. AC contributed to data extraction and provided feedback on the report.

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Correspondence to Giovanni Galeoto.

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Palladino, L., Ruotolo, I., Berardi, A. et al. Efficacy of aquatic therapy in people with spinal cord injury: a systematic review and meta-analysis. Spinal Cord (2023).

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