Physician-authored summaries and commentary on the most important medical research, provided by the NEJM Group, a division of the Massachusetts Medical Society.
© Massachusetts Medical SocietyJuly 2022
Water-based exercise was superior to traditional physical therapy in several measures of pain and function.
In the continuing search for ways to manage chronic low back pain (LBP), Chinese investigators conducted a single blinded randomised trial of supervised aquatic exercise versus traditional physical therapy in 113 adults (age range, 18 to 65 years; mean age, 31 years) with moderate to severe LBP (mean duration, 13 months). Participants were randomised to supervised aquatic or traditional physical therapy in twice weekly sessions for 12 weeks.
At one year follow up, mean scores on a 24 point disability scale improved by about four points more among patients in the aquaticexercise group than among those in the traditional exercise group – a clinically meaningful difference. On a 10 point pain scale, patients in the aquatic exercise group improved by nearly two points more than did patients in the traditional exercise group. Significant improvements in secondary measures of function and sleep also favoured aquatic exercise patients.
Comment: These patients were younger, on average, than those with chronic LBP seen by many US primary care clinicians, and access to supervised aquatic exercise could be a problem for many patients. The authors note that the study included back pain patients ‘with or without lower limb pain.’ About 20% of patients had radiating pain, but whether this refers specifically to radicular leg pain (e.g. sciatica) and whether such patients responded differently than those with nonspecific lumbosacral strain is unclear. However, these results offer one additional avenue for managing this common and often recalcitrant problem.
THOMAS L. SCHWENK, MD
Professor Emeritus, Family and Community Medicine, University of Nevada School of Medicine, Reno, USA.
Peng MS, et al. Efficacy of therapeutic aquatic exercise vs physical therapy modalities for patients with chronic low back pain: a randomized clinical trial. Neurology 2022; 5: e2142069.
This summary is taken from the following Journal Watch title: Women's Health.