Disability Predictors in Chronic Low Back Pain After Aquatic Exercise

Abstract

The physical and psychological factors associated with reduction of disability after aquatic exercise are not well understood. Sixty participants (30 men and 30 women; age, 50.60 [9.69] yrs; body mass index, 27.21 [5.20] kg/m²) with chronic low back pain were prospectively recruited. The 8-wk aquatic therapy program was carried out in an indoor pool sized 25 × 6 m, with 140-cm water depth and 30°C (1°C) of water temperature, where patients exercised for 2-5 days a week. Each aquatic exercise session lasted 55-60 mins (10 mins of warm-up, 20-25 mins of aerobic exercise, 15-20 mins of resistance exercise, and 10 mins of cooldown). Demographic information, disability (Oswestry Disability Index), back pain (visual analog scale), quality-of-life (Short Form 36), abdominal muscular endurance (curl-up), handgrip strength, trunk flexion and hamstring length (sit and reach), resting heart rate, and body mass index were outcomes variables. Significant correlations between change in disability and visual analog scale (at rest, flexion, and extension), curl-up and handgrip (r ranged between -0.353 and 0.582, all Ps < 0.01) were found. Changes in pain and abdominal muscular endurance were significant predictors of change in disability after therapy.

Comparison of 2 Multimodal Interventions With and Without Whole Body Vibration Therapy Plus Traction on Pain and Disability in Patients With Nonspecific Chronic Low Back Pain

“…The FOTO group's mean NRS was 7.8 and the IBI group's NRS was 7.5, classifying all group participants with severe pain. 33 The majority of exercise intervention studies for NSCLBP that we reviewed reported mean baseline NRS scores ranging between 3.1 and 6.4 [40][41][42][43][44][45] with a pain classification of mild to moderate, 33 or 1-2 classifications below participants in our study. A change of -2 points has been found to be associated with clinically important outcomes such as reduction in pain medication intake or returning to work or both.…”

“…Additionally, our participants' baselines ODI scores were 41.9 and 46.8 for the FOTO and IBI groups, respectively, classifying our participants regardless of group as having severe disability, 38,39 whereas the majority of exercise intervention studies for NSCLBP that we reviewed reported mean baseline ODI scores of 19.44-39, [40][41][42][43][44][45][47][48][49][50][51] classifying these participants as having minimal to moderate disability. 38,39 The NRS pain and ODI disability scores are among the outcome measures most commonly used by physical therapists.…”

Does Postural Awareness Contribute to Exercise-Induced Improvements in Neck Pain Intensity? A Secondary Analysis of a Randomized Controlled Trial Evaluating Tai Chi and Neck Exercises

“…Among the variables that other exercise studies have evaluated for predicting response are participant age, sex, and disability, and the type or dosage of interventions. [4][5][6] Improvements in body awareness might also be highly relevant to chronic neck and back pain, because studies have repeatedly pointed at the link between those pain conditions and disturbed body image, especially in chronic back [7][8][9] and neck pain. 10,11 A variety of body image measures have been used in research before including measures of proprioception and kinesthetic sense, [12][13][14][15][16] of interoceptive awareness, 17,18 and of postural awareness.…”

Efeitos da fisioterapia aquática no tratamento da dor lombar crônica inespecífica: uma revisão integrativa

“…De acordo com Baena-Beato et al 11 , a relação entre incapacidade e dor é bidirecional e um processo complexo, pois a incapacidade é um sintoma de dor que resulta em perda de função. Em seu estudo, ficou concluído que alterações na intensidade da dor e na musculatura abdominal foram preditores significativos de mudança na incapacidade em pacientes com dor lombar crônica; os pacientes com dor lombar crônica que se sentem mais incapacitados são aqueles menos ativos fisicamente.…”