Cuesta (2009) evidence-based physiotherapy with deep water running on non-specific low back pain versus evidence-based physiotherapy only: a randomized controlled trial

Background

Systematic reviews have concluded that of the Manual Therapy (MT) in start, exercise therapy (EX), behavioural therapy and education (ED) is a best options in treatment on Chronic non-specific low back pain (CLPB) (COST B 13 Guidelines EBM-Europe, 2006)
Evidence-Based Physiotherapy (EBP) = MT (nonnalisation)+EX+ED
Aerobic exercise has recently been included in the treatment of (CLBP). (Chatzitheodorou et al. 2007)
Aquatic aerobic exercise is particularly popular and is presented in various forms one of which is deep water running (DWR). (Geytenbeek, 2002)
The mechanical indication for DWR is based on the reduced compression of the lumbar spine, (Dowzer et al. 1998)
The physiological indication is that pain is reduced due to the activation of the hypothalamus – pituitary – adrenal (HPA) axis, which gradually increases the plasma cortisol concentration levels during exercise above 60% of maximum oxygen consumption (Branderberger, 1985).
DWR is a feasible aerobic exercise with persons with certain grade of disability (Assis, 2006)
The effectiveness of DWR as an alternative to other aerobic workouts has also been demonstrated in diverse age groups (Broman et al. 2006).
Additionally, it is clinically effective in various musculoskeletal disorders, such as hip and knee osteoarthritis (Hinman et al. 2007) and fibromyalgia (Assis et al. 2006).
Deep water running has been shown to prolong the beneficial effect on functional ability in persons with CLPB following a program of land based physical exercise (Quinn et al. 1994).