Summary of findings 4. Summary of findings ‐ Hydrotherapy compared with no exercise.
| Hydrotherapy compared with no exercise for haemophilia | ||||||
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Patient or population: participants with haemophilia Settings: outpatients Intervention: hydrotherapy Comparison: no exercise | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| No exercise | Hydrotherapy | |||||
| Adverse events | Outcome not reported | NA | ||||
| Quality of life | Outcome not reported | NA | ||||
| Pain | Outcome not reported | NA | ||||
| Functional status | Outcome not reported | NA | ||||
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Range of motion: flexion and extension Follow up: 8 weeks |
See comment | See comment | NA | 20 (1 study) |
⊕⊝⊝⊝ very low1,2,3 | Data were presented via an analysis of covariance (post intervention scores adjusted for differences in pre intervention scores), so data could not be entered into the analysis. There was a statistically significant improvement in range of motion of the hydrotherapy group over the no exercise group. |
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Strength: knee flexor and extensor strength Follow up: 8 weeks |
See comment | See comment | NA | 20 (1 study) |
⊕⊝⊝⊝ very low1,2,3 | Data were presented via an analysis of covariance (post intervention scores adjusted for differences in pre intervention scores), so data could not be entered into analysis. There was a statistically significant improvement in both knee flexor and extensor strength of the hydrotherapy group over the no exercise group. |
| *The basis for the assumed risk is provided in the comments. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; NA: not applicable. | ||||||
| GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | ||||||
1. Downgraded once due to potential risk of bias: limited details of study design provided making assessment of study quality difficult and suspected selective reporting bias and post‐intervention scores are not presented.
2. Downgraded once due to imprecision: evidence available from only a single study recruiting a small sample of participants.
3. Downgraded once due to applicability: the single study contributing evidence recruits only participants with moderate haemophilia; results are not applicable to participants with mild or severe haemophilia.