SynthesisBMC musculoskeletal disorders2026
The dose-response relationship of aquatic exercise for musculoskeletal pain relief: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMusculoskeletal pain constitutes a pervasive global health burden and represents a primary driver of disability worldwide. While aquatic exercise (AQE) is a promising intervention, its clinical application remains limited by the lack of quantitative dose guidance and standardized exercise prescription parameters. Therefore, this systematic review and meta-analysis aimed to evaluate the independent analgesic effect of AQE compared with passive controls and to explore the dose-response relationship between exercise dose and pain relief.
methodsFour major databases were searched from inception to January 2026 for randomized controlled trials (RCTs) comparing AQE with passive controls in adults with musculoskeletal pain. Standardized mean differences (SMDs) were calculated using random-effects models. A model-based network meta-analysis using Metabolic Equivalents of Task (METs) was conducted to model the dose-response relationship.
resultsTwenty-nine RCTs involving 2,210 participants were included. AQE yielded a moderate, statistically significant reduction in pain compared to passive controls (SMD = -0.55; 95% CI: -0.69 to -0.42; p < 0.001), with benefits persisting during the follow-up period (SMD = -0.51; 95% CI: -0.80 to -0.23; P < 0.001). Subgroup analyses indicated that middle-aged patients (45-59 years) and those with chronic disease durations (> 10 years) demonstrated larger pooled effect sizes. Among intervention modalities, pool-based multicomponent exercise yielded the largest effect size, followed by resistance and aerobic training. Regarding protocols, a frequency of 3 sessions/week, session duration > 60 min, and intervention periods ≥ 13 weeks were associated with more pronounced improvements. Crucially, dose-response analysis revealed an inverted U-shaped relationship, suggesting an effective therapeutic window of 450-1700 METs-min/week, with the peak analgesic effect observed at approximately 1200 METs-min/week.
conclusionsAQE appears to provide meaningful pain relief for musculoskeletal disorders, with benefits that may persist during follow-up. By identifying a peak therapeutic effect at approximately 1200 METs-min/week, this study aims to advance AQE from a qualitative recommendation toward quantitative, evidence-based guidance. These findings provide rigorous evidence base for understanding the physiological adaptations to aquatic therapy, informing tailored clinical management and optimized rehabilitation strategies.
trial registrationThe review protocol was registered in PROSPERO (CRD420261303731).
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.