Comparing the Effectiveness of Aquatic and Land-Based Rehabilitation Exercises on Pain and Disability in Patients with Non-Specific Chronic Low Back Pain: A Systematic Review

Fatemeh Sori; Ali Yalfani; Mohamadreza Ahmadi

doi:10.18502/ssu.v33i5.19323

Fatemeh Sori Department of Exercise Rehabilitation, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan, Iran
Ali Yalfani Department of Exercise Rehabilitation, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan, Iran
Mohamadreza Ahmadi Department of Exercise Rehabilitation, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan, Iran

DOI: https://doi.org/10.18502/ssu.v33i5.19323

Keywords: Low back pain, Hydrotherapy, Rehabilitation, Pain, Disability.

Abstract

Introduction: Aquatic and land-based rehabilitation exercises are among the exercise interventions prescribed for the treatment of low back pain. However, it remains unclear which intervention can be more effective in managing and treating low back pain. The purpose of the present study was to evaluate the effectiveness of aquatic versus land-based rehabilitation exercises on pain and disability in individuals suffering from non-specific chronic low back pain.

Methods: Articles were searched from the scientific databases Web of Science, PubMed, Scopus, Cochrane Library, Since Direct, and Google Scholar. The search process utilized the keywords low back pain, rehabilitation, exercise, hydrotherapy, land-based exercise, water-based exercise, pain, disability. The collected articles were screened according to the inclusion and exclusion criteria, and the quality of the chosen studies was measured using the Downs and Black index. Finally, the studies were classified based on quality into three categories: low, moderate, and high.

Results: The results of exercises in water and on land showed no statistically significant differences in reducing pain and disability; however, water exercises were more effective. Regarding methodological quality, among of the 6 articles selected for systematic review, 4 were of moderate quality, while 2 were of high quality.

Conclusion: Hydrotherapy is more effective in reducing pain and disability in patients with chronic non-specific low back pain because of its buoyancy and hydrostatic pressure properties. Consequently, physicians should take into account aquatic exercise during the early stages of rehabilitation to facilitate physical activity and reduce the patient's disability.