Introduction: Multiple sclerosis is an autoimmune, progressive and incurable disease of the central nervous system, most commonly occurring between the ages of 20 and 40. Multiple sclerosis is caused by an inability to synthesise myelin. Integrated rehabilitation can reduce the effects and symptoms of the disease, thereby improving the patient's quality of life. Successful therapies include hydrotherapy. Purpose: The purpose of this thesis was to review the literature and determine the effectiveness of hydrotherapy on balance in people with multiple sclerosis Methods: Research articles were searched in the electronic databases PEDro, PubMed and CINAHL. According to the inclusion criteria, we included studies in English that investigated the effects of hydrotherapy on balance in people with multiple sclerosis were investigated in different samples of subjects. Results: Based on the inclusion and exclusion criteria, six studies published between 2011 and 2021 were included in the literature review. The number of subjects in the studies ranged from 11 to 57 and the treatment periods of the subjects ranged from 5 to 12 weeks. The four studies included an experimental group and a control group. One study included three groups. In this study, the effects of pilates and hydrotherapy were compared and contrasted with the results of the control group. In the pilot study, due to the absence of a control group, only the results of the measurements before and after the aquatic exercise programme were compared. In all the studies analysed, there was a statistically significant improvement in postural control and balance in the groups where individuals exercised in water (p < 0.05). The subjects gained lower limb muscle capacity (p < 0.05) due to the increase in resistance and the reduction in fear of falling during the water exercise (p < 0.05). This also improved walking time (p < 0.05), which has a significant impact on the independent and quality performance of daily activities. Discussion and conclusion: The research reviews show a positive effect of hydrotherapy on balance, postural control, lower limb strength and the quality of performance of activities of daily living in patients with multiple sclerosis. In the future, high quality randomised controlled trials with a larger number of subjects participating over a longer period of time are needed. Additional research with more homogenous treatment period and duration of pool exercise, and to determine long-term effects, would help to provide clearer findings on the effectiveness of aquatic exercise added to standard physiotherapy for people with multiple sclerosis.
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