An Aquatic to Land-based Therapy Transition Approach for Persons with Lower Extremity OA: A Case Report

Background: The benefits of physical therapy in the management of lower body osteoarthritis is widely discussed in the literature. However, recommendations in the usage of aquatic therapy, land-based therapy, and transitioning from aquatic therapy to land-based therapy in managing osteoarthritis is limited. Case Description: The patient was a 60-year-old male with primary complaints of low back pain, right hip pain, and right knee pain resulting from confirmed osteoarthritis in these regions. Interventions included utilizing the principles of aquatic therapy and adapting his plan of care to complete land-based therapy following his episode of aquatic therapy. Outcomes: The patient was treated for a total of 17 visits in aquatic therapy with an improvement in the patient’s Physical Functional Status Primary Measure score within the Focus On Therapeutic Outcomes measure from 35 to 36 for the lumbar spine and from 24 to 28 for the knee, a decrease in pain from 10/10 to 5/10, and an improvement in 5 Times Sit to Stand time from 28 seconds to 21 seconds. Discussion: The purpose of this case report is to describe the initial use of aquatic therapy in a patient with lower body osteoarthritis prior to continuing his therapy on land. The meaningful, yet limited improvement in reported pain and function in 11 weeks of aquatic therapy may suggest that aquatic therapy for individuals with lower extremity osteoarthritis is beneficial in the initial plan of care, but may also suggest that a transition from aquatic therapy to land-based therapy may be indicated to further enhance function.