Background: One of the most common non-pharmacological interventions for rheumatoid arthritis is hydrotherapy and land-based exercises. The goal of the study was to determine the effectiveness of hydrotherapy versus land-based exercise outcomes to improve the quality of life among chronic rheumatoid arthritis. Methods: A Triple-Blinded, Randomized Controlled, Parallel-Group, Multiple Arm Trial was conducted between 29/09/2019 to 30/09/2021. Single centre, the study was done at the Department of Physical Medicine & Rehabilitation, KGMU (India). Eligible 90 patients (45 males and 45 females aged 17 to 75 years old suffering from chronic rheumatoid arthritis) and randomisation through the Sequentially Numbering Sealed Opaque Envelope method (SNSOE). The intervention (RJHLERA) administered was hydrotherapy exercise (Week30-minutes session for 6 weeks and exercises in a hydrotherapy bathtub submerging body, water temperature (30-35 degrees Celsius) and land-based exercises (Weekly 30-minute session for 6 weeks and exercises in land and 11 minutes planned set of an active exercise (as a placebo) on land exercises for the clear control group. Assess the Quality of life using by RJQOL-22 Scale. Findings: For the quality of life, the pre-test results showed all the subjects had either poor or neither poor nor good levels of RJQOL-22 selected in each group. At post-test, the hydrotherapy exercise group showed the maximum response with 67.9% very good and, 21.4% good. The group land-based exercises group showed the next to maximum response with 19.2% good while the group the clear control group showed the least/poor response with nil cases in the good/very good category. Interpretation: The study recommends hydrotherapy and land-based exercise as safe, inexpensive interventions. Amongst hydrotherapy exercise and land-based exercises, Hydrotherapy showed the maximum (much better) to improve the quality of life in chronic rheumatoid arthritis patients
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