Institute of Complementary Medicine, University of Bern, Switzerland.
Institute of Sport Science, University of Hildesheim, Germany.
PLoS One. 2020 Mar 13;15(3):e0229705. doi: 10.1371/journal.pone.0229705. eCollection 2020.
WATSU (portmanteau word: water and shiatsu) is a form of passive hydrotherapy in chest-deep thermoneutral water (35°C = 95°F = 308.15 K). It combines elements of myofascial stretching, joint mobilization, massage, and shiatsu and is reported to be used to address physical and mental issues. The objective of this systematic review (PROSPERO Registration No. CRD42016029347) and the meta-analyses was to assess the applications, indications, and the effects of WATSU to form a basis for further studies.
A search for "WATSU OR watershiatsu OR (water AND shiatsu)" was conducted without any restrictions in 32 databases. Peer reviewed original articles addressing WATSU as a stand-alone hydrotherapy were assessed for risk of bias. Quantitative data of effects on pain, physical function, and mental issues were processed in random model meta-analyses with subgroup analyses by study design. Effect sizes were expressed as Hedges's g (± 95% confidence intervals).
Of 1,906 unique citations, 27 articles regardless of study design were assessed for risk of bias. WATSU has been applied to individuals of all ages. Indications covered acute (e.g. pregnancy related low back pain) and chronic conditions (e.g. cerebral palsy) with beneficial effects of WATSU regarding e.g. relaxation or sleep quality. Meta-analyses suggest beneficial effect sizes of WATSU on pain (overall Hedges's g = -0.71, 95% CI = -0.91 to -0.51), physical function (overall Hedges's g = -0.76, 95% CI = -1.08 to -0.44), and mental issues (overall Hedges's g = -0.68, 95% CI = -1.02 to -0.35).
Various applications, indications and beneficial effects of WATSU were identified. The grade of this evidence is estimated to be low to moderate at the best. To strengthen the findings of this study, high-quality RCTs are needed.
WATSU（水疗和指压疗法的混成词）是一种在齐胸深的温热中性水中（35°C = 95°F = 308.15K）进行的被动水疗形式。它结合了肌筋膜拉伸、关节活动、按摩和指压疗法的元素，据报道可用于解决身体和精神问题。本系统评价（PROSPERO 注册号：CRD42016029347）和荟萃分析的目的是评估 WATSU 的应用、适应证和效果，为进一步研究奠定基础。
在 32 个数据库中进行了无限制的“WATSU 或 watershiatsu 或（水和指压疗法）”搜索。评估了针对 WATSU 作为独立水疗的同行评审原始文章的偏倚风险。对疼痛、身体功能和精神问题的影响进行了定量数据分析，采用随机模型荟萃分析，按研究设计进行亚组分析。效应大小表示为 Hedges 的 g（±95%置信区间）。
从 1906 个独特的引文，27 篇文章无论研究设计如何，都被评估了偏倚风险。WATSU 已应用于各个年龄段的个体。适应证包括急性（例如妊娠相关腰痛）和慢性疾病（例如脑瘫），WATSU 对放松或睡眠质量等有有益的影响。荟萃分析表明，WATSU 在疼痛方面的效果大小具有统计学意义（总体 Hedges 的 g = -0.71，95%CI = -0.91 至 -0.51），身体功能（总体 Hedges 的 g = -0.76，95%CI = -1.08 至 -0.44）和精神问题（总体 Hedges 的 g = -0.68，95%CI = -1.02 至 -0.35）。
确定了 WATSU 的各种应用、适应证和有益效果。最佳情况下，该证据的等级估计为低到中等。为了加强本研究的发现，需要高质量的 RCT。
