Aquatic Health Benefits Bulletin

NSPF provides a monthly Aquatic Health Benefits Bulletin (AHBB), each focusing on a different topic area: athletes and non-impaired, cardiopulmonary & systemic, neurological & cognitive musculoskeletal, pediatric, and women's health. The monthly posts include 300-500 vignettes written in laymen's terms and the corresponding scientific references. The bibliography is organized by a certain topic area with links to publications that are available online. The AHBB is a great resource for the pool and spa industry influencers who want to help build demand for pools, spas, and aquatic facilities by promoting the benefits of water immersion and activity. It is also a perfect way for aquatic leaders to help promote healthier living and reduce drownings.


June 2018: Aquatics & Juvenile Arthritis



Content courtesy of the National Swimming Pool Foundation

Aquatic therapy has long been under investigation as a potential treatment for use with the arthritic patient. For generations, the only research being done in the aquatics field was for the osteoarthris and rheumatoid arthritis populations. Immersion in warm water has been a panacea for the ages. There is nothing like it. With immersion comes weightlessness – and this loss of weight can actually be manipulated to allow for partial joint compression. The viscosity of the water creates an environment where resistance can be created at the blink of an eye. Movement creates resistance and cessation of movement removes all resistance. In the water, it is possible to move in all 3 planes of motion without setting up elaborate workout regimes and the workouts created by water are predominantly concentric (meaning less delayed onset muscle soreness) and safe to perform. Juvenile idiopathic arthritis presents a host of potential complaints for which immersed exercise is the answer. There is little stress on joints, like there is with weight based resistance. The potential for falls or negative consequences of loss of balance episodes are almost nil, allowing stair climbing, gait training and proprioceptive drills. Truly, there is not another medium akin to immersion for this patient population.  


Baydogan, S. N., Tarakci, E., & Kasapcopur, O. (2015). Effect of Strengthening Versus Balance-Proprioceptive Exercises on Lower Extremity Function in Patients with Juvenile Idiopathic Arthritis. American Journal of Physical Medicine & Rehabilitation, 94(6), 417–428.

Bhattacharyya, M., Bradley, H., & Gerber, B. E. (2010). Hydrosurgery: Alternative Treatment Technique for Management of Chronic Osteomyelitis and Septic Arthritis of Hallucial Joint of a Juvenile Foot. The International Journal of Lower Extremity Wounds, 9(4), 155–159.

Cavallo, S., Brosseau, L., Toupin-April, K., Wells, G. A., Smith, C. A., Pugh, A. G., … Bigford, S. (2017). Ottawa Panel Evidence-Based Clinical Practice Guidelines for Structured Physical Activity in the Management of Juvenile Idiopathic Arthritis. Archives of Physical Medicine and Rehabilitation, 98(5), 1018–1041.

Doǧru Apti, M., Kasapçopur, Ö., Mengi, M., Öztürk, G., & Metin, G. (2014). Regular aerobic training combined with range of motion exercises in juvenile idiopathic arthritis. BioMed Research International, 2014, 16–21.

Elnaggar, R. R. K., & Elshafey, M. A. M. (2016). Effects of Combined Resistive Underwater Exercises and Interferential Current Therapy in Patients with Juvenile Idiopathic Arthritis: A Randomized Controlled Trial. American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists, 95(2), 96–102.

Fellas, A., Hawke, F., Santos, D., & Coda, A. (2017). Prevalence, presentation and treatment of lower limb pathologies in juvenile idiopathic arthritis: A narrative review. Journal of Paediatrics and Child Health, 53(9), 836–840.

Fragala-Pinkham, M. A., Dumas, H. M., Barlow, C. A., & Pasternak, A. (2009). An Aquatic Physical Therapy Program at a Pediatric Rehabilitation Hospital: A Case Series. Pediatric Physical Therapy, 21(1), 68–78.

Kuntze, G., Nesbitt, C., Whittaker, J. L., Nettel-Aguirre, A., Toomey, C., Esau, S., … Emery, C. A. (2018). Exercise Therapy in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis. Archives of Physical Medicine and Rehabilitation, 99(1), 178–193.e1.

Long, A. R., & Rouster-Stevens, K. A. (2010). The role of exercise therapy in the management of juvenile idiopathic arthritis. Current Opinion in Rheumatology, 22(2), 213–217.

Takken, T., Van Der Net, J., Kuis, W., & Helders, P. J. M. (2003). Aquatic fitness training for children with juvenile idiopathic arthritis. Rheumatology, 42(11), 1408–1414.