This study aimed (i) to complement existing research by focusingon aquatic physical therapy was potentially beneficial to patients with AS; (ii)tosystematically analyze all evidence available in the literature about effectiveness of the aquatic physical therapy intervention on pain and disease activity in AS patients. A systematic search was performed in major electronic databasesto identify studies reporting aquatic physical therapy intervention on pain and disease activity of AS patients. Three independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. Qualitative descriptions were conducted, and quantitative analysis was performed with RevMan software (version 5.3).The results were expressed in terms of mean difference(MD) and the corresponding 95% confidence interval.A total of five studies comprising 1,393 participants were included in the study. Meta-analyses showed that aquatic physical therapy interventions significantly reduced the pain scores(SMD=-0.44, 95 % CI:-0.84,-0.04, p=0.03) and BASDAI scores (MD=-0.40, 95% CI:-0.73,-0.06, p=0.02) because of follow up time among these studies; therefore, a subgroup analysis should be conducted for comparison. Aquatic physical therapy can statistically significantly reduce pain and disease activity in patients with AS compared with controls.
Keywords: Ankylosing spondylitis; aquatic physical therapy; disease activity; meta-analysis; pain.