Skip to main content Skip to main navigation menu Skip to site footer

Current clinical status of hydrotherapy; an evidence based retrospective six-years (2012-2017) systemic review

  • Sameera Mohammed Almassmoum ,
  • Eman Ahmed Balahmar ,
  • Shoroug Taye Almutairi ,
  • Goot Albuainain ,
  • Rizwan Ahmad ,
  • Atta Abbas Naqvi ,


Introduction: Hydrotherapy is an approach which uses water and its characteristics to maintain health, prevent and cure diseases. Hydrotherapy has been known throughout history in different regions. Recently it has been incorporated with conventional system of treatment also. The purpose of this literature is to view the current status of hydrotherapy in terms of clinical trials and research and to highlight the positive as well as negative aspects of hydrotherapy as compared to conventional system.

Methods: Various databases were extensively searched for articles consisting of clinical trials in humans using Google Scholar, PubMed, Web of science, and Sci Finder, etc. using the keyword such as hydrotherapy, clinical trials in hydrotherapy, randomized controlled clinical trials, clinical evidence in hydrotherapy, etc. This review article includes six retrospective years from 2012 to 2017.

Results: A total of nineteen clinical trials met the inclusion criteria. The hydrotherapy was used either alone or as an adjunct with a conventional system for treatment or reducing the symptoms severity as well as the quality of life in many conditions such as multiple sclerosis, fibromyalgia, postpartum pain, migraine, wound healing, musculoskeletal system, Parkinson’s disease, osteoarthritis, spastic paraparesis, hemophilia, etc.

Conclusions: People are using hydrotherapy as a treatment for various health conditions and its use in particular with the conventional system makes the outcome more effective and considerable in different diseases.


  1. Bahadorfar, M. (2014). A Study of Hydrotherapy and Its Health Benefits. International Journal of Research, 1(8), 294-305.
  2. Ganesh V Devkate et al. (2016). Hydrotherapy A New Trend in Disease Treatment.Ijsrm.Human, 5 (2), 117-135.
  3. Wardle, J. (2013 ). Hydrotherapy: a forgotten Australian therapeutic modality. Australian Journal of Herbal Medicine ,25(1), 12-17.
  4. Tsitsis, N., Polkas, G., Daoutis, A., Prokooiou, E., & Kourkouta, L. (2013). Hydrotherapy in Ancient Greece. Balkan Military Medical Review,16(4).
  5. Switzerland. Annals of burns and fire disasters, 27(4), 184. Moufarrij, S., Deghayli, L., Raffoul, W., Hirt-Burri, N., Michetti, M., de Buys Roessingh, A., ... & Applegate, L. A. (2014). How important is hydrotherapy? Effects of dynamic action of hot spring water as a rehabilitative treatment for burn patients in.
  6. van Tubergen, A., & van der Linden, S. (2002). A brief history of spa therapy. Annals of the Rheumatic Diseases, 61(3), 273-275.
  7. Gianfaldoni, S., Tchernev, G., Wollina, U., Roccia, M. G., Fioranelli, M., Gianfaldoni, R., & Lotti, T. (2017). History of the Baths and Thermal Medicine. Open Access Macedonian Journal of Medical Sciences, 5(4), 566.
  8. Sinclair, M. (2007). Modern hydrotherapy for the massage therapist. Baltimore, MD: Wolters Kluwer/Lippincott Williams & Wilkins.
  9. Moss, G. A. (2010). Water and health: a forgotten connection?. Perspectives in public health, 130(5), 227-232.
  10. Dull, H. (2004). Watsu: freeing the body in water. Trafford Publishing.
  12. Baker, P. W. (2011). Is there a role for contrast hydrotherapy?. Journal of Lymphoedema, 6(2).
  13. Hing, W. A., White, S. G., Bouaaphone, A., & Lee, P. (2008). Contrast therapy—A systematic review. Physical Therapy in Sport, 9(3), 148-161.
  14. Mathew, C. S., Babu, B., Shanji, C., Pothan, N., Kutoor, D. S., & Abraham, E. (2016). Hydrotherapy: A Review. International Journal Of Pharmaceutical and Chemical Sciences, 5, 196-197.
  15. Journal of the Royal College of General Practitioners, 66(644), e193. Al Himdani, S., Javed, M. U., Hughes, J., Falconer, O., Bidder, C., Hemington-Gorse, S., & Nguyen, D. (2016). Home remedy or hazard?: Management and costs of paediatric steam inhalation therapy burn injuries. The British Journal of General Practice : The.
  16. Nicol, N. H., & Boguniewicz, M. (2017). Wet wrap therapy in moderate to severe atopic dermatitis. Immunology and Allergy Clinics, 37(1), 123-139.
  17. Crinnion, W. J. (2011). Sauna as a valuable clinical tool for cardiovascular, autoimmune, toxicant-induced and other chronic health problems. Alternative Medicine Review, 16(3), 215-226.
  18. of the rheumatic diseases, 62(12), 1162-1167. Foley, A., Halbert, J., Hewitt, T., & Crotty, M. (2003). Does hydrotherapy improve strength and physical function in patients with osteoarthritis—a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme. Annals.
  19. Burke, D. T., Ho, C. H. K., Saucier, M. A., & Stewart, G. (1998). EFFECTS OF HYDROTHERAPY ON PRESSURE ULCER HEALING1. American journal of physical medicine & rehabilitation, 77(5), 394-398.
  20. Ernst, E., Saradeth, T., & Resch, K. L. (1992). Hydrotherapy for varicose veins: a randomized, controlled trial. Phlebology, 7(4), 154-157.
  21. Kurabayashi, H., Machida, I., & Kubota, K. (1998). Improvement in ejection fraction by hydrotherapy as rehabilitation in patients with chronic pulmonary emphysema. Physiotherapy Research International, 3(4), 284-291.
  22. Bumin, G., Uyanik, M., Yilmaz, I., Kayihan, H., and Topcu, M. (2003). Hydrotherapy for Rett syndrome. Journal of rehabilitation medicine, 35(1), 44-45.
  23. Evidence-based complementary and alternative medicine, 2012. Castro-Sánchez, A. M., Matarán-Peñarrocha, G. A., Lara-Palomo, I., Saavedra-Hernández, M., Arroyo-Morales, M., & Moreno-Lorenzo, C. (2012). Hydrotherapy for the treatment of pain in people with multiple sclerosis: a randomized controlled trial.
  24. Alikhajeh, Y., Hosseini, S. R. A., & Moghaddam, A. (2012). Effects of hydrotherapy in static and dynamic balance among elderly men. Procedia-Social and Behavioral Sciences, 46, 2220-2224.
  25. Verhagen, A. P., Cardoso, J. R., & Bierma-Zeinstra, S. M. (2012). Aquatic exercise & balneotherapy in musculoskeletal conditions. Best Practice & Research Clinical Rheumatology, 26(3), 335-343.
  26. Fathollahi, Z., Imanipour, V., Mousaei, M., & Mahdi, F. (2013). The effect of 10 weeks hydrotherapy on quality of life and coordination function in the women with multiple sclerosis. International Journal of Biosciences (IJB), 3(6), 153-156.
  27. Int J Sports Med, 34(7), 600-605. Segura-Jiménez, V., Carbonell-Baeza, A., Aparicio, V. A., Samos, B., Femia, P., Ruiz, J. R., & Delgado-Fernández, M. (2013). A warm water pool-based exercise program decreases immediate pain in female fibromyalgia patients: uncontrolled clinical trial.
  28. 83-88. Mazloum, V., Rahnama, N., & Khayambashi, K. (2014). Effects of therapeutic exercise and hydrotherapy on pain severity and knee range of motion in patients with hemophilia: a randomized controlled trial. International journal of preventive medicine, 5(1),.
  29. Zhang, Y., Roxburgh, R., Huang, L., Parsons, J., & Davies, T. C. (2014). The effect of hydrotherapy treatment on gait characteristics of hereditary spastic paraparesis patients. Gait & posture, 39(4), 1074-1079.
  30. 139-146. Pereira, E. C. S., Baião, M., de Carvalho, J. H., & Correia, V. (2014). Elderly’s Physical-Functional Fitness and Perceived Functional Capacity and Health after Participation in a Hydrotherapy Program. Journal of Spatial and Organizational Dynamics, 2(2),.
  31. Mohammed, A. H., Mahran, H. G., & Aboelazm, S. N. (2014). Does Hydrotherapy Improve Shoulder Abduction in Post-mastectomy Patients?. International Journal, 2(11), 484-490.
  32. Volpe, D., Giantin, M. G., Maestri, R., & Frazzitta, G. (2014). Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson’s disease: a randomized controlled pilot study. Clinical rehabilitation, 28(12), 1210-1217.
  33. Bhandari, M., Jeray, K. J., Petrisor, B. A., Devereaux, P. J., Heels-Ansdell, D., Schemitsch, E. H., ... & Liew, S. (2015). A Trial of Wound Irrigation in the Initial Management of Open Fracture Wounds. The New England journal of medicine, 373(27), 2629.
  34. Zhao, J., Zhang, J., Ji, X., Li, X., Qian, Q., & Xu, Q. (2015). Does intramedullary canal irrigation reduce fat emboli? A randomized clinical trial with transesophageal echocardiography. The Journal of arthroplasty, 30(3), 451-455.
  35. Sujan, M. U., Rao, M. R., Kisan, R., Abhishekh, H. A., Nalini, A., Raju, T. R., & Sathyaprabha, T. N. (2016). Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients. Journal of neurosciences in rural practice, 7(1), 109.
  36. Atkin, L., & Ousey, K. (2016). Wound bed preparation: A novel approach using HydroTherapy. British journal of community nursing, 21(Sup12), S23-S28.
  37. 218-225. Enblom, A., Wicher, M., & Nordell, T. (2016). Health-related quality of life and musculoskeletal function in patients with musculoskeletal disorders: after compared to before short-term group-based aqua-exercises. European journal of physiotherapy, 18(4),.
  38. Batten, M., Stevenson, E., Zimmermann, D., & Isaacs, C. (2017). Implementation of a hydrotherapy protocol to improve postpartum pain management. Journal of Midwifery & Women’s Health, 62(2), 210-214.
  39. Carroll, L. M., Volpe, D., Morris, M. E., Saunders, J., & Clifford, A. M. (2017). Aquatic exercise therapy for people with Parkinson disease: a randomized controlled trial. Archives of physical medicine and rehabilitation, 98(4), 631-638.
  40. Cardiovascular Nursing, 16(5), 381-389. Hägglund, E., Hagerman, I., Dencker, K., & Strömberg, A. (2017). Effects of yoga versus hydrotherapy training on health-related quality of life and exercise capacity in patients with heart failure: A randomized controlled study. European Journal of.
  41. Fleming, S. A., & Gutknecht, N. C. (2010). Naturopathy and the primary care practice. Primary Care: Clinics in Office Practice, 37(1), 119-136.
  42. Aspinall, S. T., & Graham, R. (1989). Two sources of contamination of a hydrotherapy pool by environmental organisms. Journal of Hospital Infection, 14(4), 285-292.
  43. Mena, K. D., & Gerba, C. P. (2009). Risk assessment of Pseudomonas aeruginosa in water. In Reviews of Environmental Contamination and Toxicology Vol 201 (pp. 71-115). Springer, Boston, MA.
  44. Penny, P. T. (1991). Hydrotherapy pools of the future—the avoidance of health problems. Journal of Hospital Infection, 18, 535-542.
  45. Kelvinson, R. C. (1995). Colonic hydrotherapy: a review of the available literature. Complementary Therapies in Medicine, 3(2), 88-92.
  46. Abrams, R. S., Nichter, L. S., Sloan, G. M., & Holdrege, S. (1988). Electrolyte changes caused by hydrotherapy in purpura fulminans. The Journal of burn care & rehabilitation, 9(5), 488-489.
  47. Chertow, G., & Brady, H. (1994). Hyponatraemia from tap-water enema. The Lancet, 344(8924), 748.
  48. Acosta, R. D., & Cash, B. D. (2009). Clinical effects of colonic cleansing for general health promotion: a systematic review. The American journal of gastroenterology, 104(11), 2830.
  49. Norlela, S., Izham, C., & Khalid, B. A. K. (2004). Colonic irrigation-induced hyponatremia. Malaysian Journal of Pathology, 26(2), 117-118.
  50. Aird, I. A., Luckas, M. J., Buckett, W. M., & Bousfield, P. (1997). Effects of intrapartum hydrotherapy on labour related parameters. Australian and New Zealand journal of obstetrics and gynaecology, 37(2), 137-142.
  51. Romano, L., & Halkett, E. V. C. (2018). Rehabilitation of the feline patient: acupuncture and hydrotherapy as part of a multidisciplinary team approach. The Veterinary Nurse, 9(1), 26-31.
  52. Khalaji, M., Kalantari, M., Shafiee, Z., & Hosseini, M. A. (2017). The Effect of Hydrotherapy on Health of Cerebral Palsy Patients: An Integrative Review. Iranian Rehabilitation Journal, 15(2), 173-180.
  53. COOKE, M., CHADWICK, P., HAYCOCKS, S., RIPPON, M., & SIMM, S. (2017). Enabling wound healing and preventing limb amputation: a cost--benefit case study of Hydro-Responsive Wound Dressings. Wounds UK, 13(4).
  54. Teng, M., Zhou, H. J., Lin, L., Lim, P. H., Yeo, D., Goh, S., ... & Lim, B. P. (2018). Cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders in Singapore. Journal of Public Health.
  55. , 47(5), 459-467. Van Tubergen, A., Boonen, A., Landewé, R., Mölken, R. V., Van Der Heijde, D., Hidding, A., & Van Der Linden, S. (2002). Cost effectiveness of combined spa–exercise therapy in ankylosing spondylitis: a randomized controlled trial. Arthritis Care & Research.
  56. Batten, M., Stevenson, E., Zimmermann, D., & Isaacs, C. (2017). Implementation of a hydrotherapy protocol to improve postpartum pain management. Journal of Midwifery & Women’s Health, 62(2), 210-214.
  57. Hinman, R. S., Nicolson, P. J. A., Dobson, F. L., & Bennell, K. L. (2015). Use of Nondrug, Nonoperative Interventions by Communityâ€Dwelling People With Hip and Knee Osteoarthritis. Arthritis care & research, 67(2), 305-309.
  58. 1444-1449. Archanah, T., Shashikiran, H. C., Shetty, P., & Chandrakanth, K. K. (2018). Effect of a hydrotherapy based alternate compress on osteoarthritis of the knee joint: a randomized controlled trial. International Journal of Research in Medical Sciences, 6(4),.
  59. Furnham A, Vincent C. Reasons for using CAM. In: Kelner M, Wellman B, Pescosolido B, Saks M, editors.Complementary and alternative medicine: Challenges and change. Amsterdam: Harwood Academic Publishers and 2000.
  60. Rizwan Ahmad. Current Clinical Status of Osteopathy: Study Based on Retrospective Evidences of Six Years, A Systemic Review. Annual Research & Review in Biology. 20(1): 1-20, 2017 and no.ARRB.37675, Article.
  61. Dwamena F, Holmes-Rovner M, Gaulden CM, Jorgenson S, Sadigh G, Sikorskii A, et al. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database Syst Rev. 2012 and 12:12:CD003267.
  62. Homeopathy, Rizwan Ahmad. Current Clinical Status of, An Evidence Based Retrospective Six Years Review. Annual Research & Review in Biology. 22(1): 1-15, 2018 and no.ARRB.37676., Article.

How to Cite

Almassmoum, S. M., Balahmar, E. A., Almutairi, S. T., Albuainain, G., Ahmad, R., & Naqvi, A. A. (2018). Current clinical status of hydrotherapy; an evidence based retrospective six-years (2012-2017) systemic review. Bali Medical Journal, 7(3).




Search Panel

Sameera Mohammed Almassmoum
Google Scholar
BMJ Journal

Eman Ahmed Balahmar
Google Scholar
BMJ Journal

Shoroug Taye Almutairi
Google Scholar
BMJ Journal

Goot Albuainain
Google Scholar
BMJ Journal

Rizwan Ahmad
Google Scholar
BMJ Journal

Atta Abbas Naqvi
Google Scholar
BMJ Journal