2. Pathology
Low Back Pain
An estimation of 80% of adults will suffer at least one
incidence of LBP in their lives (Fonseca et al, 2009) .
Why Aquatic PT benefits patients with low back pain:
decreases the load on the spine
decreases pain
increases blood flow and circulation
warm temperature helps to loosen muscles and help to
increase ROM.
Patient must have no open wounds and/or incisions that
have not healed fully.
Patient should be comfortable in the water
3. Benefits of Aquatic PT cont..
According to an article, Water Therapy Exercise
Program, there are three other primary benefits of
Aquatic PT. They are:
“Buoyancy: when water counteracts with gravity to help
support the weight of the patient.
Viscosity: water provides resistance by means of gentle
friction
Hydrostatic pressure: there are powerful effects produced by
hydrostatic pressure that improve heart and lung function.
This pressure effect also aids in improving muscle blood flow”
(Cole, MD & Becker, MD, MS, 2013)
4. Beginner
Warm-up
3 laps across pool forwards
3 laps across pool backwards
3 laps across pool side step
Exercises
HS/Quad stretch using noodle as an aid
Shoulder flexion/extension, while standing with core tight
Shoulder abduction/adduction, while standing with core
tight
Mini squat with core tight
Spinal traction while floating with noodle
5. Intermediate
Warm-up
3 laps across pool forwards
3 laps across pool backwards
3 laps across pool side step
3 laps across pool marching
Exercises
HS/Quad stretch using noodle as an aid
Balance while sitting on noodle going front to back
Balance while sitting on noodle, performing alternating knee
flexion/extension
Balance while sitting on noodle, performing alternating shoulder
flexion/extension
Standing hip flexion/extension, abduction/adduction
Spinal traction with noodle
6. Advanced
Warm-up
3 laps across pool forwards
3 laps across pool backwards
3 laps across pool side step
3 laps across pool marching
3 laps across pool military
Exercises
HS/Quad stretch using noodle as an aid
Balance while sitting on noodle going left to right
Balance while sitting on noodle, performing alternating knee
flexion/extension
Balance while sitting on noodle, performing alternating shoulder
flexion/extension
Standing hip flexion/extension, abduction/adduction
Spinal traction with noodle
7. Outcomes
Most patients in aquatic PT were in the beginner phase of
rehabilitation
1 patient did not relax as well in the pool as the others
Patients stated they had relief the day of aquatic PT and
the day after
Patients felt as if they could do more exercises in water
than on land
Drawbacks
Only saw the low back pain patients in aquatic PT a few times
(1-2x max)
Slightly slower to progress due to only 1 day a week of aquatic
PT
8. References
Cole, MD, A. J., & Becker, MD, MS, B. E. (2013). Water
therapy exercise program. Retrieved from
http://www.spine-
health.com/wellness/exercise/water-therapy-exercise-
program
Fonseca, J. L., Magini, M., & Freitas, T. H. (2009).
Labortory gait analysis in patients with low back pain
before and after a pilates intervention. Journal of Sport
Rehabilitation, (18), 269-282.
9. Research
“Eight weeks of aquatic therapy program decrease
levels of back pain and disability, increase quality of
life, and improve health-related fitness in adults with
chronic low back pain without effects in body
composition. A dose–response effect was observed in
some parameters, with greater benefits when
exercising 3 days per week compared with 2 days.”
Baena-Beato, P. A., Arroyo-Morales, M., Delgado-
Fernández, M., Gatto-Cardia, M. C. and Artero, E. G.
(2013), Effects of Different Frequencies (2–3 Days/Week) of
Aquatic Therapy Program in Adults with Chronic Low Back
Pain. A Non-Randomized Comparison Trial. Pain
Medicine, 14: 145–158. doi: 10.1111/pme.12002
