Hydrotherapy in Physiotherapy - a critical review of literature.

Introduction
To evaluate the benefits of hydrotherapy in patients with musculoskeletal dysfunctions.

Material and methods
Four data bases were searched (Cochrane Central Register of Controlled Trials / Cochrane Library, MEDLINE, PEDro, Web of Science) for the last 20 years articles, published between January 2000 and February 2020. Selection criteria were: randomized control trials (RCT) in patients with musculoskeletal dysfunctions and systematic reviews of hydrotherapy treatment.

Results
For the final analysis only 5 randomized control trials were included. Patients in the studies had following medical conditions: low back pain, fibromyalgia, knee and hip osteoarthritis. Systematic review of hydrotherapy treatment was not found. All studies had a high risk of bias. The quality level of scientific evidence for the parameters like pain, quality of life, functional status, trigger points and joint mobility was low.

Conclusions
Since the analyzed studies present poor quality and there is lack of systematic review of existing articles, there is no possibility to confirm efficacy of hydrotherapy procedure in patients with pain or musculoskeletal dysfunctions. There is necessity to perform systematic review for hydrotherapy treatment clinical trials and also more high quality clinical trials with this procedure.