{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:59:56Z","timestamp":1790593196630,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JIMD Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Enzyme Replacement Therapy (ERT) is the clinical standard for Mucopolysaccharidosis II (MPSII), yet its limited penetration into poorly vascularised tissues such as bone, cartilage and heart valves leaves participants with significant musculoskeletal morbidity. This small study evaluated the feasibility of hydrotherapy as an adjunct to ERT in addressing these therapeutic gaps and improving Health\u2010Related Quality of Life (HRQoL). Using a crossover design, the study assessed five male participants with MPSII. Key outcomes included HRQoL via the Short Form Health Survey (SF\u201036), functional mobility by the 6\u2010Minute Walk Test (6MWT) and pain interference through the Brief Pain Inventory (BPI). Data from the SF\u201036 and BPI showed improvements, including a mean improvement in Physical Functioning, Role Physical and Social Functioning and a mean reduction of 16.2 in pain interference. Analgesic relief over 24\u2009h was 45.8% in the hydrotherapy arm, compared to 18% in the observation arm. Psychological conditions including anxiety, depression and kinesiophobia were also analysed. Participants demonstrated a mean increase of 44.5\u2009m in the 6MWT, suggesting that the \u2018unloading\u2019 effect of water facilitated gait speed and endurance (compared to observation arm: mean difference 55.8\u2009m 95% CI \u221251.6 to 163.1). Participants achieved a mean strength increase of 6.1\u2009lb. during the hydrotherapy arm without adverse effects, corroborating the safety of aquatic resistance training in fragile populations. Our findings demonstrate the feasibility of hydrotherapy as an adjunct to ERT in participants with MPSII. By managing pain and improving HRQoL, hydrotherapy addresses physical and psychological burdens that ERT alone cannot achieve.<\/jats:p>","DOI":"10.1002\/jmd2.70114","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T01:35:53Z","timestamp":1786412153000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Hydrotherapy on Health\u2010Related Quality of Life, Pain and Mobility in Individuals With Mucopolysaccharidosis Type\n                    <scp>II<\/scp>\n                    (Hunter Syndrome): A Pilot Feasibility Study"],"prefix":"10.1002","volume":"67","author":[{"given":"Andrew","family":"Oldham","sequence":"first","affiliation":[{"name":"Adult Inherited Metabolic Diseases Salford Royal Organisation, Northern Care Alliance NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Stockton","sequence":"additional","affiliation":[{"name":"Metabolic Medicine Research Salford Royal Organisation, Northern Care Alliance NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Warburton","sequence":"additional","affiliation":[{"name":"Metabolic Medicine Research Salford Royal Organisation, Northern Care Alliance NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin","family":"Heal","sequence":"additional","affiliation":[{"name":"Centre for Biostatistics The University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Meehan","sequence":"additional","affiliation":[{"name":"Metabolic Medicine Research Salford Royal Organisation, Northern Care Alliance NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0148-6332","authenticated-orcid":false,"given":"Karolina M.","family":"Stepien","sequence":"additional","affiliation":[{"name":"Adult Inherited Metabolic Diseases Salford Royal Organisation, Northern Care Alliance NHS Foundation Trust  Salford UK"},{"name":"Division of Cardiovascular Sciences University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the MPS Society","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Orphanet \u201cMucopolysaccharidosis Type 2 \u201daccessed February 8 2026 https:\/\/www.orpha.net\/en\/disease\/detail\/580?name=mps%20II&mode=name."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-007-0635-4"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-6-72"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgmr.2023.101005"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3233\/PRM-2010-0112"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-025-04065-9"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13010075"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21041258"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2018.03.023"},{"key":"e_1_2_11_11_1","article-title":"Aquatic Exercise for the Treatment of Knee and Hip Osteoarthritis","volume":"3","author":"Bartels E. M.","year":"2016","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/1947-2714.132935"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2017.06.012"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20060006"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker396"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.07.005"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21082975"},{"key":"e_1_2_11_18_1","first-page":"A48","article-title":"The Role of Hydrotherapy in the Management of Children With Severe Osteogenesis Imperfecta","volume":"104","author":"Hupin E.","year":"2019","journal-title":"Archives of Disease in Childhood"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2024.02.005"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta21270"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/17581869.2026.2707412"}],"container-title":["JIMD Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmd2.70114","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmd2.70114","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmd2.70114","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:16:38Z","timestamp":1790590598000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmd2.70114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,10]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/jmd2.70114"],"URL":"https:\/\/doi.org\/10.1002\/jmd2.70114","archive":["Portico"],"relation":{},"ISSN":["2192-8312","2192-8312"],"issn-type":[{"value":"2192-8312","type":"print"},{"value":"2192-8312","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,10]]},"assertion":[{"value":"2026-04-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70114"}}