Combined and Aquatic Exercise in Chronic Low Back Pain
Effects of Combined-exercise and Aquatic-exercise on Pain, Disability and Functional Capacity in Patients With Chronic Low Back Pain
The goal of this randomized clinical trial is to evaluate the effects of a combined aquatic- and land-based exercise program, as well as an aquatic-exercise program, compared with a control group receiving home-based exercise, on pain, disability, and functional capacity in adults with CLBP. Secondary objectives include examining the effects on fear of movement, anxiety and depression, quadriceps and hand-grip strength, and lumbar mobility. The main question it aims to answer is: "Which type of exercise program is most effective at improving pain, disability, functional capacity, fear of movement, anxiety and depression, quadriceps and hand-grip strength, and lumbar mobility in adults with chronic low back pain?".
Participants will perform an aquatic-based exercise program (aquatic group), a combined aquatic and land-based exercise program (aquatic and land group), or a land-based exercise program (home group).
Researchers will compare groups to find any differences in pain, disability, functional capacity, kinesiophobia, anxiety and depression, quadriceps and hand-grip strength, and lumbar mobility.
Tutkimuksen yleiskatsaus
Tila
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskeluyhteys
- Nimi: Joana Borges, MSc
- Puhelinnumero: +351964928447
- Sähköposti: joanaccborges24@hotmail.com
Opiskelupaikat
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Castelo Branco District
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Covilha, Castelo Branco District, Portugali, 6201-001
- University of Beira Interior
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Ottaa yhteyttä:
- Joana Borges, MSc
- Puhelinnumero: +351964928447
- Sähköposti: joanaccborges24@hotmail.com
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Päätutkija:
- Joana Borges, MSc
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Päätutkija:
- Henrique Neiva, PhD
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Päätutkija:
- Diogo Monteiro, PhD
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Alatutkija:
- Fernanda M. Silva, PhD
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Alatutkija:
- Tiago Pastilha, MSc
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Päätutkija:
- Pedro Duarte-Mendes, PhD
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Kuvaus
Inclusion Criteria:
- all genders;
- aged over 18 years;
- Chronic Low Back Pain lasting three months or longer and with an intensity of 3 or higher on the Visual Analogue Scale at rest.
Exclusion Criteria:
- Individuals who refuse to participate or do not provide informed consent;
- Pain radiating to the lower limb;
- Recent pregnancy or childbirth (less than 8 weeks ago);
- Ongoing physical therapy treatments;
- Severe rheumatological, neurological, neoplastic, cardiovascular diseases or other conditions that could prevent full participation in the intervention;
- History of spinal surgery;
- Inflammatory, infectious, or malignant spinal diseases;
- Psychiatric disorders that may affect adherence and symptom assessment.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Kaksinkertainen
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
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Kokeellinen: Aquatic and Land Group
This arm will include 24 exercise sessions (three non-consecutive sessions per week), conducted over an 8-week period.
16 sessions of the aquatic-exercise program and 8 sessions of the land-based exercise program.
|
This intervention will consist of an aquatic-exercise program, performed in shallow water (120-150 cm deep) at a temperature of 32-34 °C, and supervised by a physiotherapist with over two years of experience in aquatic-based exercise and Ai Chi method. The aquatic-exercise sessions, will consist of a 5-minute warm-up phase, a 30-40-minute training phase, and a 10-15-minute relaxation/cool-down phase, adapted from Ai Chi exercise positions. The Ai Chi method consists of 19 katas (movements) that incorporate deep breathing, coordinated upper and lower limb actions, trunk control, and slow, continuous motion. In this study, only 10 of these 19 katas will be included in the aquatic-exercise protocol.
This program will include specific land-based exercises, supervised by a physiotherapist with more than two years of experience in therapeutic exercise.
The land-based exercise program, will be divided into three components: core stability exercises (15-20 minutes), trunk and lower limb stretching exercises (10-15 minutes), and relaxation/coordination exercises adapted from the Ai Chi method (10-15 minutes).
|
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Kokeellinen: Aquatic Group
This arm will comprise 24 sessions of the aquatic-exercise program (three non-consecutive sessions per week), conducted over an 8-week period.
|
This intervention will consist of an aquatic-exercise program, performed in shallow water (120-150 cm deep) at a temperature of 32-34 °C, and supervised by a physiotherapist with over two years of experience in aquatic-based exercise and Ai Chi method. The aquatic-exercise sessions, will consist of a 5-minute warm-up phase, a 30-40-minute training phase, and a 10-15-minute relaxation/cool-down phase, adapted from Ai Chi exercise positions. The Ai Chi method consists of 19 katas (movements) that incorporate deep breathing, coordinated upper and lower limb actions, trunk control, and slow, continuous motion. In this study, only 10 of these 19 katas will be included in the aquatic-exercise protocol. |
|
Active Comparator: Home Group
This arm will include 24 sessions of the home-based exercise program (three non-consecutive sessions per week) over an 8-week period.
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This exercise program will consist of a home-based exercise program.
Each session will last 20-30 minutes and will be performed individually at home without professional supervision.
The home-based exercise program will include core stability exercises that progress from the supine to the quadruped position.
It will mirror the land-based exercise program and is adapted from a previous unsupervised home-based protocol.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Visual Analogue Scale
Aikaikkuna: One measurement will be assessed at baseline and one at each follow-up (8 and 12 weeks).
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Pain intensity will be assessed with the Visual Analogue Scale (Minimum: 0; Maximum 10).
Higher values correspond to worse outcome.
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One measurement will be assessed at baseline and one at each follow-up (8 and 12 weeks).
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Oswestry Disability Index - version 2.0
Aikaikkuna: One measurement will be assessed at baseline and one at each follow-up (8 and 12 weeks).
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Disability due to low back pain will be assessed with the Oswestry Disability Index (Minimum: 0; Maximum 100).
Higher values correspond to worse outcome.
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One measurement will be assessed at baseline and one at each follow-up (8 and 12 weeks).
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Short Physical Performance Battery
Aikaikkuna: One measurement will be assessed at baseline and one at each follow-up (8 and 12 weeks).
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Lower-limb functional capacity (balance, gait speed, chair stands) will be assessed with the Short Physical Performance Battery, a simple tool that includes the four-meter gait speed test, the five-repetition sit-to-stand test and a balance test, and gives a total score based on the performance in each of those tests.
Each component is scored (0-4), yielding a composite score (0-12), with higher scores indicating better performance.
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One measurement will be assessed at baseline and one at each follow-up (8 and 12 weeks).
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Tampa Scale of Kinesiophobia-13
Aikaikkuna: One measurement will be assessed at baseline and one at each follow-up (8 and 12 weeks).
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Fear of movement will be assessed with the Tampa Scale of Kinesiophobia-13 (Minimum: 13; Maximum 52).
Higher values correspond to worse outcome.
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One measurement will be assessed at baseline and one at each follow-up (8 and 12 weeks).
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Hospital Anxiety and Depression Scale
Aikaikkuna: One measurement will be assessed at baseline and one at each follow-up (8 and 12 weeks).
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Anxiety and depression will be assessed with the Hospital Anxiety and Depression Scale (Minimum: 0; Maximum 21).
Higher values correspond to worse outcome.
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One measurement will be assessed at baseline and one at each follow-up (8 and 12 weeks).
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Fixed Handheld Dynamometry for Assessing Quadriceps Strength
Aikaikkuna: Three measurements will be assessed at baseline and three at each follow-up (8 and 12 weeks).
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Quadriceps muscle (both sides) maximum voluntary isometric contraction will be assessed with Fixed Handheld Dynamometry with participants seated and the knee positioned at approximately 90° of flexion.
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Three measurements will be assessed at baseline and three at each follow-up (8 and 12 weeks).
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Hand-Grip Dynamometry
Aikaikkuna: Three measurements will be assessed at baseline and three at each follow-up (8 and 12 weeks).
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Maximum isometric strength of the hand and forearm muscles (both sides) will be assessed with Hand-Grip Dynamometry with participants seated with the elbow flexed at 90° and the forearm in a neutral position.
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Three measurements will be assessed at baseline and three at each follow-up (8 and 12 weeks).
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Modified-Modified Schober Test
Aikaikkuna: Three measurements will be assessed at baseline and three at each follow-up (8 and 12 weeks).
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Lumbar spine range of motion will be assessed with the Modified-Modified Schober Test.
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Three measurements will be assessed at baseline and three at each follow-up (8 and 12 weeks).
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Yhteistyökumppanit ja tutkijat
Sponsori
Tutkijat
- Opintojohtaja: Diogo Monteiro, PhD, Instituto Politécnico de Leiria
- Opintojohtaja: Pedro Duarte-Mendes, PhD, Instituto Politécnico de Castelo Branco
- Opintojohtaja: Henrique Neiva, PhD, University of Beira Interior
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Arvioitu)
Ensisijainen valmistuminen (Arvioitu)
Opintojen valmistuminen (Arvioitu)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
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