Efficacy of Hydrotherapy on Arterial Blood Pressure, Systolic and Diastolic Blood Pressure, 6-Minute Walk Test, and Resting Heart Rate in Patients with Peripheral Artery Disease: A Systematic Review and Meta-Analysis

This systematic review aimed to investigate the effects of hydrotherapy on arterial blood pressure in patients with peripheral arterial disease (PAD). A systematic review was conducted using PubMed, Scopus, Physiotherapy Evidence Database (PEDro), and EBSCO databases from 2015 to 2023. The methodological quality was assessed using the PEDro scale to evaluate the risk of bias. A meta-analysis was conducted on six randomized control trials (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 (6 MWT) distance, and resting heart rate (RHR). The meta-analysis showed that hydrotherapy had non-significant effects on SBP (SMD 0.01 [95% CI -0.26-0.27]), DBP (SMD -0.18 [95% CI, -0.58-0.22]), ABI (SMD 0.08 [95% CI, -0.57-0.73]), 6 MWT (SMD 0.45 [95% CI, -0.19-1.08]), and RHR (SMD -0.19 [95% CI, -0.52-0.14]). The results of this review demonstrated non-significant effects of hydrotherapy in improving SBP, ABI, DBP, RHR, and 6 MWT distance in PA patients.