en فیزیوتراپی Physical Therapy مرور سیستماتیک/ آنالیز متا Systematic Review <div style="text-align: justify;"><strong>Purpose</strong>: This study aimed to assess the effect of hydrotherapy on range of motion (ROM) and pain in patients with hemophilia.<br> <strong>Methods</strong>: This study followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) 2020 guidelines. A thorough literature search was conducted in October 2024 across several databases, including PubMed, ProQuest, ScienceDirect, and Cochrane. The Cochrane risk of bias (RoB) 2 tool and the risk of bias in non-randomized studies &ndash; of interventions (ROBINS-I V2) were applied for study quality assessment, while Review Manager 5.4 was utilized for meta-analysis.&nbsp;<br> <strong>Results</strong>: In total, three studies were analyzed, and the methodological appraisal showed that two had low risk and one had moderate risk of bias. Significant improvements in knee extension ROM (SMD=1.17, 95% confidence interval [CI], 0.15%, 2.185%, P=0.02) and decreases in pain (SMD=-1.46, 95% CI, -2%, -0.91%), P&le;0.0001) were observed in the hydrotherapy group versus controls. However, knee flexion ROM improvement was not statistically significant (SMD=2.17, 95% CI, -0.42%, 4.77%], P=0.10).&nbsp;<br> <strong>Conclusion</strong>: Hydrotherapy may improve knee ROM and pain in hemophilia, particularly in knee extension. However, variability across studies limits the certainty of these findings. Further large-scale randomized controlled trials with standardized intervention protocols are required to clarify long-term outcomes and encourage widespread clinical application.</div> Hydrotherapy, Hemophilia, Rehabilitation, Range of motion (ROM), Pain 369 380 http://ptj.uswr.ac.ir/browse.php?a_code=A-10-758-1&slc_lang=en&sid=1 Kevin A. Chandra Kevin19axel@gmail.com 0009-0007-1812-4000 Yes Mgr. Gabriel Manek Atambua, General Regional Hospital, Belu, Indonesia. Astrid P. Amanda astridpriscilla91@gmail.com 0000-0001-5629-5715 No Bunda Citra Harapan Hospital, Bekasi, Indonesia. Jenifer Nathania jen.nath37@gmail.com 0009-0008-6300-3387 No St. Carolus Borromeus Hospital, Kupang, Indonesia. Maximillian Aritonang maxarf9t@gmail.com 0009-0009-0590-5435 No Cideres General Regional Hospital, Majalengka, Indonesia.