Muscle Activity During Aquatic and Land Exercises in People With and Without Low Back Pain.
Stelios G Psycharakis, Simon G S Coleman, Linda Linton and 2 others
PMID 30690522WHAT IT FOUND
In 40 men, people with chronic low back pain activated trunk and gluteal muscles similarly to people without musculoskeletal disorders.
Water and land exercises were mostly similar for muscle activity, though heart rate was higher on land and pain was reported more often on land.
Key findings
01Muscle activation, perceived exertion, and heart rate were not different in most comparisons between the chronic low back pain group and the control group.
02Muscle activation was similar between water and land in about two-thirds of comparisons, higher on land in about 29%, and higher in water in about 5%.
03Pain was generally low, and the average pain score did not differ between environments, but pain was reported more often on land than in water.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 40 men were studied, and the chronic low back pain group had mild-to-moderate disability and low fear of movement, so the results may not apply to women or people with more severe or fearful presentations. The study measured muscle electrical activity, heart rate, perceived exertion, and pain during exercises. It does not show whether either environment improves low back pain over time. Exercises had standardized cadence and specific resistance, so changing speed, resistance, or exercise choice may alter muscle activation. EMG was normalized using submaximal isometric contractions, not maximum voluntary contractions, because maximum contractions were considered limited in people with low back pain; this affects how absolute activation levels can be compared. Between-group differences were sparse, including 1 of 840 muscle activation comparisons and 1 of 30 perceived exertion comparisons, so small differences should not be overinterpreted.
Declared interests
The study was funded by the Chief Scientist Office in Scotland, and the funding source had no role in the study design, conduct, or reporting. No other conflict of interest statement is provided.
The easy way to misread this
Do not conclude that aquatic exercise is a proven treatment for chronic low back pain or that it reduces pain more than land exercise. The paper reports muscle activity, heart rate, perceived exertion, and pain during exercises in 40 men, and pain scores were low in both environments.