Award Date


Degree Type


Degree Name

Master of Science in Exercise Physiology


Kinesiology and Nutrition Sciences

First Committee Member

John Young, Chair

Second Committee Member

Richard Tandy

Third Committee Member

John Mercer

Graduate Faculty Representative

Satish Bhatnagar

Number of Pages



The success of the Total Knee Arthroplasty (TKA) depends upon its functional outcomes of increase in reduction in pain, and gait ambulation and performing functional activities of daily living. Compromised range of motion, pain and weakness can reduce their ability to perform activities of daily living. Aquatic Physical Therapy may offer an alternative intervention to traditional Physical Therapy Rehabilitation and many studies have shown improvements in range of motion, swelling, pain reduction, stiffness and quality of life after TKA. AquaStretch, a relatively new form of aquatic therapy, claims to restore the functional mobility which is lost restrictions caused due to inflammatory processes. The studies done in the past compared the effects of aquatic therapy to those of land based therapy and found the two techniques to be equally effective. Currently, there is not any literature available which looks into the benefits of combining the two therapies. The purpose of this study was to investigate the effectiveness of an integrated treatment approach (Aqua Stretch and conventional therapy) compared to land therapy alone in improving range of motion after TKA.

Range of motion (ROM) data from the study group (physiotherapy and Aqua Stretch) and control group (physiotherapy only) were collected and studied retrospectively. The ROM was compared using a 2 (groups) × 2 (pre, post) mixed model ANOVA method of statistical analysis (α=0.05).

Following the respective rehabilitation protocols, there was a significant improvement in ROM in both the groups (p>0.05). However, the improvement in ROM in study group was not different than that of control group (p>0.05).

In summary, the integrated techniques of aquatic and land based therapy was not more effective than the land based therapy in increasing the ROM at knee joint in knee replacement patients. However, other functional outcomes of knee replacement like pain, edema, strength and overall knee function are the avenues for future exploration of this technique.

INDEX WORDS: Total Knee Arthroplasty, range of motion, Aquatic therapy


Arthroplasty; Joints — Range of motion; Knee – Surgery – Patients – Rehabilitation; Physical therapy; Total knee replacement


Alternative and Complementary Medicine | Kinesiology | Motor Control | Physical Therapy | Rehabilitation and Therapy

File Format


Degree Grantor

University of Nevada, Las Vegas




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