A Cochrane review [Abstract] 1 included 4 RCTs with a total of 94 subjects after stroke. The studies used aquatic physical exercises, hydrotherapy and water-based exercise programs, the training periods lasted from 2 to 3 months. There was a significant improvement in activity of daily living (MD 13.20 points on the functional capacity subscale of the Brazilian-Portuguese version of the SF-36; 95% CI 8.36 to 18.04; 1 trial, n=31) and on muscle strength (MD 1.01 Nm/kg; 95% CI 0.19 to 1.83; 1 trial, n=13). There was no significant improvement in ability to walk (MD 0.14 m/s; 95% CI -0.32 to 0.606; 1 trial, n=13), postural balance (MD 3.05 points; 95% CI -3.41 to 9.52; 2 trials, n=38) or fitness (MD 3.6 (VO2max; 95% CI -0.53 to 7.73; 1 trial, n=13) after water-based exercises treatment compared to the control group. Adverse effects were not reported.
Comment: The quality of the evidence is downgraded by study quality (unclear allocation concealment, short follow-up time), inconsistency (heterogeneity in patients, interventions and outcomes), indirectness (differences in studied patients) and imprecise results (few patients with wide confidence intervals).
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