Effects of Passive Hydrotherapy WATSU (WaterShiatsu) in the Third Trimester of Pregnancy: Results of a Controlled Pilot Study

WATSU (Water-Shiatsu) increases body awareness and improves pain and mood: A randomised controlled study

BACKGROUND AND PURPOSE

WATSU (Water-Shiatsu) is a body-oriented therapy in warm-water pool with passive movements, massage and breathing techniques. The present study investigated the short-term effect of a single session of WATSU on body awareness.

MATERIALS AND METHODS

In a randomized-controlled study 60 volunteers (18-65 years) were assigned to a 20-min intervention of WATSU or to a 20-min lecture on WATSU. Immediately before and after the intervention they had to answer questionnaires. Primary endpoint of the investigation was the change of the total score of the non-verbal Awareness Body Chart (ABC). Secondary endpoints were the changes of the scores of the 14 single body parts of the ABC, of the Visual Analogue Pain Scale, of a German self-perception questionnaire (KEKS) and changes in mood scored with a German questionnaire on mood (Bf-SR). To compare groups, Mann-Whitney U tests were used.

RESULTS

The WATSU group had a significantly higher increase in the ABC total score in comparison to the lecture group (WATSU: 0.3 (IQR 0 - 0.8), lecture: 0.1 (IQR -0.2 - 0.2), p = 0.014). In the KEKS no group differences were seen. In WATSU a significantly stronger improvement of pain (Visual Analogue Pain Scale: WATSU: -15 (IQR -29 to -8), lecture: -4 (IQR -9 - 2), p < 0.001) and of mood (Bf-SR: WATSU: -6 (IQR -14 to -2), lecture: -1 (IQR -5 - 1), p = 0.003) could be observed.

CONCLUSION

This study showed that WATSU immediately increases body awareness and improves pain and mood.

The impact of WATSU as Physiotherapy Method on Fatigue for People Diagnosed with Multiple Sclerosis

Aim: To identify the impact of WATSU method on fatigue which has an impact on sleep and quality of life, pain and depression or its aggravation. Materials and Methods: The study involved the four participants. The following instruments were used: Multiple Sclerosis Quality of Life questionnaire; Pittsburgh Sleep Quality Index; Burns Depression Checklist; Fatigue Impact Scale. The study was carried out in medical center in Lithuania from 09-11-2019 till 18-01-2020 during 10 weeks. Each participant of the study received ten WATSU sessions. The research data was processed using SPSS Statistics 20. Qualitative Outcome Measures were conducted by content analysis, observation, semi-structured individual interview methods. Results: After 10 sessions, fatigue lessened in all people investigated. Initially, the average of fatigue was 70 points and decreased to 34 points after the investigation. The average sleep quality index was as high as 5 points, after ten weeks the average decreased to 3 points. Changes in assessment of major to mild depression: initially, the average was 36 points, which decreased to 14 points after ten weeks. Conclusions: The WATSU method was effective in reducing fatigue as a physiotherapy method. Along with changes in fatigue, the Pittsburgh Sleep Quality Index decreased, energy and motivation increased, quality of life improved, level of depression reduced, and the change was statistically significant. While assessing the quality of life, pain was found to be decreased – it became less frequent after ten weeks of sessions and less intense or even absent, its influence on daily activities decreased.

Foot Hydrotherapy: Non-pharmacology Treatment for Reducing Anxiety in Third Trimester Pregnancy

Objective: This research aims to examine the effect of foot hydrotherapy as one of non-pharmacological therapies for reducing anxiety of pregnancy. Method: The reported study employed Quasi Experimental method by using two Group pretest-posttest design with comparison group. It involved 57 respondents who were recruited using consecutive sampling technique. Hamilton Anxiety Rating Scale (HARS) questionnaire was used to measure the respondents’ anxiety. For bivariate analysis, the data were tested using paired samples t-test and Independent T-test Result. The results of data analysis indicated that before the treatment, the anxiety values in the two groups were almost the same (21±2.3 dan 22.07±1.99). After the treatment in the intervention group, the anxiety value decreased while in the control group, the anxiety score was increased on the third day after the pretest measurement Data analysis which was conducted with Independent Sample t-test revealed that foot hydrotherapy using warm water reduced the anxiety level of pregnant women in the third trimester (p = 0,000). Conclusion: Giving foot hydrotherapy is effective for reducing anxiety in pregnant women. Therefore, the non-pharmacological therapy can be socialized and applied given to the public (society), especially pregnant women

WATSU therapy for individuals with Parkinson's disease to improve quality of sleep and quality of life: A randomized controlled study

BACKGROUND

and Purpose: Sleep disorders are one of the most frequent non-motor symptoms of Parkinson's disease (PD). This study aimed to verify whether adding WATSU to land-based therapy leads to additional beneficial therapeutic effects regarding quality of sleep and quality of life (QOL) in individuals with PD.

MATERIALS & METHODS

A randomized control trial design was used. Participants completed nine-week interventions. The control group (CG) received land-based therapy, while the intervention group (IG) received the same land-based therapy and additionally WATSU. Sleep quality and QOL were measured at baseline and post-interventions by Pittsburgh Sleep Quality Index and Nottingham Health Profile, respectively.

RESULTS

Twenty-eight participants completed the study. In contrast to CG, the IG presented with significant improvements in both, quality of sleep and QOL (p < 0.001).

CONCLUSION

WATSU has the potential to be an attractive adjunct therapy for producing positive health impacts regarding sleep quality, which may translate to an overall improvement in QOL of individuals with PD.

Applications, indications, and effects of passive hydrotherapy WATSU (WaterShiatsu)-A systematic review and meta-analysis

Background

WATSU (portmanteau word: water and shiatsu) is a form of passive hydrotherapy in chest-deep thermoneutral water (35°C = 95°F = 308.15 K). It combines elements of myofascial stretching, joint mobilization, massage, and shiatsu and is reported to be used to address physical and mental issues. The objective of this systematic review (PROSPERO Registration No. CRD42016029347) and the meta-analyses was to assess the applications, indications, and the effects of WATSU to form a basis for further studies.

Methods

A search for “WATSU OR watershiatsu OR (water AND shiatsu)” was conducted without any restrictions in 32 databases. Peer reviewed original articles addressing WATSU as a stand-alone hydrotherapy were assessed for risk of bias. Quantitative data of effects on pain, physical function, and mental issues were processed in random model meta-analyses with subgroup analyses by study design. Effect sizes were expressed as Hedges's g (± 95% confidence intervals).

Results

Of 1,906 unique citations, 27 articles regardless of study design were assessed for risk of bias. WATSU has been applied to individuals of all ages. Indications covered acute (e.g. pregnancy related low back pain) and chronic conditions (e.g. cerebral palsy) with beneficial effects of WATSU regarding e.g. relaxation or sleep quality. Meta-analyses suggest beneficial effect sizes of WATSU on pain (overall Hedges’s g = -0.71, 95% CI = -0.91 to -0.51), physical function (overall Hedges’s g = -0.76, 95% CI = -1.08 to -0.44), and mental issues (overall Hedges’s g = -0.68, 95% CI = -1.02 to -0.35).

Conclusion

Various applications, indications and beneficial effects of WATSU were identified. The grade of this evidence is estimated to be low to moderate at the best. To strengthen the findings of this study, high-quality RCTs are needed.

The benefits of combining water and land-based therapy

As the general population ages and lives longer with chronic disease and related disability, an increasing number of individuals may be pre-cluded from participating and excelling in traditional land-based therapy or exercise alone, despite its known benefits. This article discusses the benefits of water as an exercise and therapeutic medium, as well as the value of combining both water and land modalities, which enhance the benefits of exercise synergistically. This combined water and land approach has the potential to help clients achieve greater therapeutic benefits and clinical outcomes. As an example, described in this article are the rationale and basic framework for one treatment paradigm supported by research literature, the Burdenko Method, which has utilized combined exercise in water and on land for over four decades. These perspectives will hopefully foster increased understanding and application of exercise principles and programs outside of traditional land-based approaches.

Marine Healing, but Not Additional Intake of Undaria pinnatifida, Benefits Physical and Emotional Exhaustion Symptoms of Menopause

Menopausal symptoms can persist or worsen even years after menopause and affect women's quality of life. We investigated whether menopausal symptoms were alleviated through a marine healing program and if sea mustard intake additionally benefits these symptoms. A total of 42 menopausal women self-selected to participate as the marine (n = 22) or city group (n = 20). The marine group participated in a 5-day marine healing program consisting of a balanced diet, exercise, and mind-body practices using ocean resources. The city group continued one's daily routine without any intervention. Within the marine group, participants were randomly assigned to consume sea mustard (Undaria pinnatifida) (15.4 g dry weight/day; n = 11) or control (n = 11). Changes in menopausal symptoms were measured using the Menopause Rating Scale (MRS) before, immediately after, and 2 weeks after the end of the marine healing program. The city group completed the MRS at baseline and on day 20. Within subject differences of menopausal symptoms between baseline and immediately after the marine healing program were assessed using paired t-test. Intervention effects were assessed by mixed analysis of variance. Somatic, psychological, and urogenital symptoms were immediately alleviated after the marine healing program. No effect of sea mustard was detected in the marine group. After 2 weeks, the effect of marine healing persisted in physical and mental exhaustion only. A 5-day integrated marine healing program, but not additional sea mustard intake, temporarily alleviated menopausal symptoms. The reduction in physical and mental exhaustion after marine healing can be maintained for 2 weeks.

Trial Registration

Clinical Research Information Service Identifier: KCT0004025.

The investigation of effects of static immersion and calming in water on pregnant women's stress participating in preparation classes for childbirth

INTRODUCTION

Stress in pregnancy can have a negative effect on mother and fetus and at last on childhood. The use of stress reduction techniques in pregnant women has an effective role in the reduction of the mother and child's mental problems. This study aimed at determining the effect of static immersion and relaxing the pregnant women in water on stress, participating in preparation classes for childbirth in Isfahan, Iran, 2017.

METHODS

The present study was a semi-experimental and had pre- and post-test one on 55 pregnant women aged 20-30 weeks (20 test group and 35 control group) participating in the preparation classes for delivery by available sampling method selected in 2017 and their stress level was assessed by depression, anxiety, and stress scale questionnaire. Then, they were divided into test and control groups. In the control group, no intervention was performed, and in the test group, static immersion and calming in water was done in Isfahan University's 9-Dey Pool. To analyze the data, paired t-test, Chi-square t-test, and independent t-test were used.

RESULTS

In this study, stress in the test group decreased after the intervention, so that the mean stress score decreased from 20.20 to 16.67 (P < 0.05). Of course, the stress level declined in the control group, but in the control group, it decreased significantly.

CONCLUSION

Based on the findings of the present study, static immersion and calming in water are considered as reducing women's stress intervention in improving pregnancy period and are therefore recommended to be included in the sanitary system.

The effects of a relaxation program featuring aquatic therapy and autogenic training among people with cervical dystonia (a pilot study)

Classic physical interventions for cervical dystonia (CD) have focused on treating motor components or, on motor components and relaxation programs. However, no CD treatment study has focused on a relaxation program alone. We developed a pilot study to assess whether a therapy completely based on a relaxation program could improve the physical and mental symptomatologies of patients with CD. Fifteen persons were included in the experimental group, which received individual sessions of aquatic (Watsu) therapy (WT) and autogenic training (AT). In addition, 12 persons were included in passive control group. We administered different questionnaires related to quality of life (SF-36), pain (Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and Visual Analog Scale (VAS)) and mood (Beck Depression Inventory (BDI-II) and State-Trait Anxiety Inventory (STAI)). A significant interaction was observed between treatment and time with regard to the SF-36, VAS, and TWSTRS within the experimental group (p < 0.01). The BDI-II showed depression decrease as a simple effect (p < 0.05), and the STAI did not change. No effects were found with regard to the control group. In this exploratory study, we found that a therapy based on whole body relaxation improved the symptoms of patients with CD. This knowledge enables a disease-management strategy that uses a holistic perspective and moves beyond the dystonic focus.

Passive Hydrotherapy WATSU® for Rehabilitation of an Accident Survivor: A Prospective Case Report

BACKGROUND

WaterShiatsu (WATSU) is a passive form of hydrotherapy in warm water (35 °C) that aims at relaxation, pain relief, and a sense of security. This case report focuses on a patient's experience of integrating WATSU into her rehabilitative care.

CASE REPORT

A 52-year-old woman survived a severe motorcycle accident in which she sustained several fractures on the right side of her body, including ribs, the pelvis, and the femur. After discharge from stationary care, she independently scheduled 8 weekly WATSU sessions with an experienced WATSU therapist also trained in physiotherapy and psychosomatics. Quantitative and qualitative data obtained from the patient's diary and the therapist's notes is presented.

RESULTS

The patient associated WATSU with physical and emotional release, reconciliation with her body, and trunk mobilization (followed by ameliorated breath). She ascribed WATSU lasting effects on her body image and reported continuous improvement by the Patient-Specific Functional Scale. The therapist employed WATSU to equalize awareness throughout the body and for careful mobilization. Due to complications (elevated inflammation markers), only 6 of 8 scheduled sessions were administered.

CONCLUSIONS

WATSU was experienced as helpful in approaching a condition that the patient felt insufficiently covered by conventional physiotherapy alone. In early rehabilitation, additional medical/physiotherapeutic skills of contributing complementary therapists are advocated.

The Effects of Fibromyalgia Syndrome on Physical Function and Psychological Status of Pregnant Females

Objectives

This study aims to investigate the frequency and most common symptoms of fibromyalgia syndrome (FS) among pregnant females and determine the impacts of FS on physical functioning and psychological status.

Patients and methods

A total of 360 pregnant females (mean age 26.5 years, range 19 to 42 years) were included. The subjects were divided into two groups in terms of having (FS group; n=136; mean age 27 years; range 19 to 41 years) or not having FS (control group; n=224; mean age 26.5 years; range 20 to 42 years). The impact of FS on physical functions was evaluated using Fibromyalgia Impact Questionnaire. Psychological statuses of the subjects were evaluated using State-Trait Anxiety Inventory, Wijma Delivery Expectancy/Experience Questionnaire, and Beck Depression Inventory.

Results

Low back pain was the most common complaint while fatigue was the most common symptom in FS group. FS group had higher levels of pain and physical disability (p<0.001) and also higher values of anxiety, fear of childbirth, and depression (p<0.001, for all values) compared to control group. Symptom severity and physical function scores were significantly correlated with increased levels of pain, depression, anxiety, and fear of childbirth (p<0.001, for all values).

Conclusion

Fibromyalgia syndrome is common among pregnant females. The existence of FS in pregnancy is a severe factor contributing to maternal stress, anxiety, and depression. Therapeutic measures for fibromyalgia syndrome should be well-established to support healthy pregnancy and good child health outcome.

Systematic Review of Hydrotherapy Research: Does a Warm Bath in Labor Promote Normal Physiologic Childbirth?

Health sciences research was systematically reviewed to assess randomized controlled trials of standard care versus immersion hydrotherapy in labor before conventional childbirth. Seven studies of 2615 women were included. Six trials examined hydrotherapy in midwifery care and found an effect of pain relief; of these, 2 examined analgesia and found reduced use among women who bathed in labor. One study each found that hydrotherapy reduced maternal anxiety and fetal malpresentation, increased maternal satisfaction with movement and privacy, and resulted in cervical dilation progress equivalent to standard labor augmentation practices. Studies examined more than 30 fetal and neonatal outcomes, and no benefit or harm of hydrotherapy was identified. Two trials had anomalous findings of increased newborn resuscitation or nursery admission after hydrotherapy, which were not supported by additional results in the same or other studies. Review findings demonstrate that intrapartum immersion hydrotherapy is a helpful and benign practice. Hydrotherapy facilitates physiologic childbirth and may increase satisfaction with care. Maternity care providers are recommended to include hydrotherapy among routine labor pain management options and consider immersion to promote progress of normal or protracted labor, particularly among women with preferences to avoid obstetric medications and procedures.

A comparative study of the effects of trunk exercise program in aquatic and land-based therapy on gait in hemiplegic stroke patients

[Purpose] The purpose of this study was to compare the effects of aquatic and land-based trunk exercise program on gait in stroke patients. [Subjects and Methods] The subjects were 28 hemiplegic stroke patients (20 males, 8 females). The subjects performed a trunk exercise program for a total of four weeks. [Results] Walking speed and cycle, stance phase and stride length of the affected side, and the symmetry index of the stance phase significantly improved after the aquatic and land-based trunk exercise program. [Conclusion] These results suggest that the aquatic and land-based trunk exercise program may help improve gait performance ability after stroke.

The effects of aquatic trunk exercise on gait and muscle activity in stroke patients: a randomized controlled pilot study

[Purpose] The purpose of this study was to investigate the relationship between muscle activity and gait function following aquatic trunk exercise in hemiplegic stroke patients. [Subjects and Methods] This study’s participants included thirteen hemiplegic patients (ten males and three females). The aquatic therapy consisted of administering concentrative aquatic therapy for four weeks in a therapeutic pool. Gait parameters were measured using a gait analysis system adjusted to each subject’s comfortable walking speed. Electromyographic signals were measured for the rectus abdominis, external abdominal oblique, transversus abdominis/internal-abdominal oblique, and erector spine of each patients. [Results] The pre- and post-training performances of the transversus abdominis/internal-abdominal oblique were compared statistically. There was no statistical difference between the patients’ pre- and post-training values of maximal voluntary isometric contraction of the rectus abdominis, but the external abdominal oblique values tended to improve. Furthermore, gait factors improved significantly in terms of walking speeds, walking cycles, affected-side stance phases, affected-stride lengths, and stance-phase symmetry indices, respectively. [Conclusion] These results suggest that the trunk exercise during aquatic therapy may in part contribute to clinically relevant improvements in muscle activities and gait parameters.