Benefits and Research in Aquatic Physiotherapy

There is extensive research supporting the use of aquatic exercise in many types of conditions. In most of these clinical trials, particularly for hip and knee arthritis or joint replacement but also in back pain, shoulder pain and following joint sprains and after surgery, the water exercise programs are designed and supervised by a physiotherapist. These aquatic physiotherapy programs are based on a number of key benefits related to exercising in water.

Evidence based practice in aquatic physiotherapy relates to:

  • Reduced body weight load through the lower back and leg joints and muscles allows functional activities earlier in your rehabilitation program for your hip or knee such as walking and squats.
  • Load depends on the depth of immersion. Standing in water up to your waist is about 50% of your body weight and standing in water up to your chest is about 30% of your body weight
  • Load with walking also depends on how fast you are walking in the water.
  • Buoyancy and freedom of movement in water may help flexibility and pain. Pain may also be improved with less compressive load on joints.
  • Hydrostatic pressure is pressure from the water on your legs when you are standing in water. This gentle but strong compression from the water.
  • May help joint and leg swelling and circulation
  • Increases circulation of blood back to the heart which may have some additional benefits with cardiovascular fitness
  • Drag or turbulence created when you move in water can be a great source of resistance and strengthening.


Evidence based practice in aquatic physiotherapy relates to:

  • Integrating the conclusions of high quality research
  • Clinical experience of the therapist
  • Individual assessment and preferences of the person involved in a treatment or exercise program

At Aquatic Physio Exercise Australia we are committed to incorporating the highest level evidence into our advice and programs. We commit to

  • being actively involved in research through PhD studies and research projects
  • reviewing published aquatic exercise research on a quarterly basis
  • using the quality evidence in effectiveness and biomechanics available


Becker B (2009) Aquatic therapy: scientific foundations and clinical rehabilitation applications.PMR.Sep;1(9):859-72
Hall J, Bisson D and O’Hare P (1990) The Physiology of Immersion. Physiotherapy, 1990; 76(9):517-521
Hall J, Swinkels A, Briddon J, Mc Abe CS. (2008) Does Aquatic Exercise Relieve Pain in Adults With Neurologic or
Musculoskeletal Disease? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Archives of
Physical Medicine and Rehabilitation, 89 (5):873-883
Harrison R and Bulstrode S (1987): Percentage weight-bearing during partial immersion. Physiotherapy Prac 3:60-3
Harrison R, Hillman M, Bulstrode S (1992): Loading of the lower limb when walking partially immersed: Implications for clinical practice. Physiotherapy 78: 164-6