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


  • 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).

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