Water Versus Land Based Perturbation Exercises in Elderly Participants With Back Pain

Gulf Medical University

Status: Completed

Conditions: Back Pain; Back Pain Lower Back Chronic; Back Pain With Radiation; Back Pain Without Radiation

Treatments: Behavioral: Exercises

Study type: Interventional

Funder types: Other

Identifiers

NCT05585294

INT/COHS/UG/012-2019

COHS_UG_Research_6122017 (Other Identifier)

Details and patient eligibility

About

The aim of this study was to compare the effectiveness of land based versus water based perturbation exercises on the pain, disability, fear of falling, and fear avoidance beliefs in elderly participants. Overweight/obese subgroup was compared with healthy weight with chronic low back pain participants to investigate any effect on BMI on both interventions. The results of the study revealed that both exercise groups i.e., land and water based exercise had a significant reduction in pain level, fear of falling, fear avoidance belief related to work, disability and improved SLR.

Full description

Twenty-four grouped into 12 per group participated water based and land based exercise protocol. Both groups were given McKenzie Method of exercises in 1st week based on the treatment-based classification (TBC) approach or personalized to the need of participants as per TBC.

Perturbation-based postural exercises were given to participants, which were performed on land or water for 6 weeks.

The perturbation based exercises were categorized into four levels, where level 1:static postural control, 2:dynamic postural control 3:Extremity loaded postural control and 4: cognitive task associated postural control. The perturbation were provided at shoulder and hip level, by intervention providers progressive enough to initiate anticipatory or compensatory postural adjustments.

Both groups were educated on pain assurance and spinal ergonomics feedback. The Outcomes were measured using a Visual analog scale, Oswestry disability index, Fear avoidance belief questionnaire, Straight leg raise, Modified fall efficacy scale, and Borg scale. The pain level were assessed for personalized progression from level 1 to level 4 progression of perturbation exercises.

Both the exercise groups of land and water showed improvement in measured clinical outcomes in terms of reduction in pain level, fear of falling, fear avoidance belief related to work, SLR, and disability. Water-based group showed additional benefits and significant improvement in fear avoidance belief related to physical activity and exercised with low rate of perceived exertion.

Enrollment: 24 patients

Sex: All

Ages: 55 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Pain history of minimum 12 weeks duration in below labels
• Participants with the diagnostic labels of spondylosis
• Non-specific chronic low back pain
• Back pain radiating to leg or sciatica
• Subacute back pain

Exclusion criteria

• Unstable blood pressure
• Cardiac failure
• Incontinence
• Uncontrolled epilepsy
• Open wounds
• Acute infections
• Neurological disorders
• Orthopedic conditions affecting exercise participation in pool and land
• Cardio-respiratory conditions affecting exercise participation in pool and land.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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24 participants in 2 patient groups

Water based perturbation exercise group

Experimental group

Description:

In both groups, the participants screened for Treatment-based classification of back pain and based on TBC interventions were provided. From second week, water based perturbation exercise were initiated personalized to the level of participants. Treatment-based classification of back pain intervention was gradually tapered in orderly fashion during 6 weeks, concurrently introduced land based perturbation exercise gradually phased from level 1 to level 4.

Treatment:

Behavioral: Exercises

Land based perturbation exercise group

Active Comparator group

Description:

All procedures were followed similar to Water based perturbation exercise group except perturbation based exercises were provided in land.

Treatment:

Behavioral: Exercises