Efficacy of Hydrotherapy on Arterial Blood Pressure in patients with peripheral artery disease: A systematic review and meta-analysis

Abstract

Abstract Background Hydrotherapy is an effective therapeutic modality in controlling pain and increasing blood flow, but its effect on Peripheral arterial diseases (PAD) is still unclear.Aim The aim of this systematic review was to investigate the effect of hydrotherapy on the arterial blood pressure in patients with PAD.Method A systematic review searches were conducted on the PubMed, Scopus, Physiotherapy Evidence Database (PEDro) and EBSCO databases from 2015 till 2022. Studies were eligible if randomized controlled trails (RCTs) investigating the effect of hydrotherapy on arterial blood pressure in patients with PAD. Qualitative data was extracted from six studies. Methodological quality was used to assess the risk of bias using the PEDro scale.Results A Meta-analysis was conducted on 6 RCTs (214 patients: 204 patients with PAD and 10 healthy subjects) to calculate the standardized mean difference (SMD) with 95% confidence interval (CI), and overall effect size (ES) of the ankle brachial index (ABI), Systolic blood pressure (SBP), Diastolic blood pressure (DBP), 6-min-walk test (6MWT) distance, resting heart rate (RHR). The Meta-analysis showed that hydrotherapy had non-significant effects on the SBP (SMD 0.01 [95% CI -0.26-0.27]), the DBP (SMD − 0.18 [95% CI -0.58-0.22]), the ABI (SMD 0.08 [95% CI -0.57-0.73], 6MWT (SMD 0.45 [95% CI -0.19-1.08]), RHR (SMD − 0.19 [95% CI -0.52-0.14]).Conclusion The results of this review could not conclude the non-significant effects of the hydrotherapy in improving the SBP, ABI, DBP, RHR, and the 6MWT distance in patients with PAD.