Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C


Objective: The objective of this selective EBM review is to determine whether or not hydrotherapy improves health-related quality of life (HR-QoL) in adult men and women with multiple sclerosis (MS).

Study Design: Review of three randomized controlled trials (RCTs) published between 2012-current, all in the English language.

Data Sources: Three randomized controlled trials (RCTs), all of which evaluate the effectiveness of hydrotherapy compared to a control group that was asked either not to change their exercise habits or to participate in land-based activities. All studies were found using PubMed and Embase.

Outcomes Measured: Each of the three articles analyzed the effects of hydrotherapy on improving health-related quality of life. The Short form-36 (SF-36), Multiple Sclerosis Quality of Life-54 (MSQOL-54), and Multiple Sclerosis Impact Scale-29 (MSIS-29) were the questionnaires used to measure HR-QoL.

Results: The studies by Castro-Sanchez et al.7 and Kargarfard et al.5 found that hydrotherapy significantly improved HR-QoL in adult MS patients compared to the control group. The study by Bansi et al.8 was inconclusive because HR-QoL improved both in the experimental and control group, with no significant difference between the two.

Conclusions: Hydrotherapy was shown to improve HR-QoL in all three studies. However, in one study, HR-QoL improved independent of the therapy used, with no significant difference between the hydrotherapy and land-based exercise groups.8 Therefore, evidence is inconclusive.