Muscle activity during aquatic and land exercises in people with and without low back pain

Stelios G. Psycharakis, Simon G.S. Coleman, Linda Linton, Konstantinos Kaliarntas, Stephanie Valentin

Research output: Contribution to journalArticle

Abstract

Background: Chronic low back pain (CLBP) is the most prevalent musculoskeletal disorder. Aquatic exercises are commonly used by physiotherapists for CLBP treatment and management but there are no data on trunk muscle activation during aquatic exercises in people with CLBP.

Objective: We quantified activation of trunk and gluteal muscles, exercise intensity, pain and perceived exertion in people with and without CLBP when performing water and land exercises.

Design: Cross-sectional.

Methods: Twenty participants with non-specific CLBP and 20 healthy participants performed 15 aquatic exercises and 15 similar land exercises. Mean and peak muscle activation were measured bilaterally from erector spinae, multifidus, gluteus maximus, gluteus medius, rectus abdominis, external oblique and internal oblique, using waterproof and wireless surface electromyography. Exercise intensity (heart rate), perceived exertion (Borg scale) and, for the CLBP group, pain (visual-to-analogue scale) were recorded.

Results: There were no significant between-group differences. Between-environment significant differences were found in heart rate (always higher on land), exertion (higher in the water for three exercises and on land for six exercises) and muscle activation (higher on land in 29% and in the water in 5% of comparisons). Pain levels were low, but pain was reported more than twice as frequently on land (7.7% Vs 3.7% of cases).

Limitations: People with high levels of disability and CLBP classification were not included.

Conclusions: People with mild-to-moderate CLBP had similar exercise responses to healthy controls. Aquatic exercise produced sufficient muscle activation, intensity and exertion, and should not be assumed to be less strenuous or less effective in activating trunk and pelvic muscles than exercise on land. These data can be used to inform design and prescription of rehabilitation programmes and interventions.
Original languageEnglish
Pages (from-to)297-310
Number of pages14
JournalPhysical Therapy
Volume99
Issue number3
Early online date23 Jan 2019
DOIs
Publication statusE-pub ahead of print - 23 Jan 2019

Fingerprint

Low Back Pain
Exercise
Muscles
Pain
Water
Heart Rate
Paraspinal Muscles
Rectus Abdominis
Physical Therapists
Electromyography
Pain Measurement
Pain Management
Prescriptions
Healthy Volunteers
Rehabilitation

Cite this

Psycharakis, Stelios G. ; Coleman, Simon G.S. ; Linton, Linda ; Kaliarntas, Konstantinos ; Valentin, Stephanie. / Muscle activity during aquatic and land exercises in people with and without low back pain. In: Physical Therapy. 2019 ; Vol. 99, No. 3. pp. 297-310.
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abstract = "Background: Chronic low back pain (CLBP) is the most prevalent musculoskeletal disorder. Aquatic exercises are commonly used by physiotherapists for CLBP treatment and management but there are no data on trunk muscle activation during aquatic exercises in people with CLBP. Objective: We quantified activation of trunk and gluteal muscles, exercise intensity, pain and perceived exertion in people with and without CLBP when performing water and land exercises.Design: Cross-sectional.Methods: Twenty participants with non-specific CLBP and 20 healthy participants performed 15 aquatic exercises and 15 similar land exercises. Mean and peak muscle activation were measured bilaterally from erector spinae, multifidus, gluteus maximus, gluteus medius, rectus abdominis, external oblique and internal oblique, using waterproof and wireless surface electromyography. Exercise intensity (heart rate), perceived exertion (Borg scale) and, for the CLBP group, pain (visual-to-analogue scale) were recorded. Results: There were no significant between-group differences. Between-environment significant differences were found in heart rate (always higher on land), exertion (higher in the water for three exercises and on land for six exercises) and muscle activation (higher on land in 29{\%} and in the water in 5{\%} of comparisons). Pain levels were low, but pain was reported more than twice as frequently on land (7.7{\%} Vs 3.7{\%} of cases).Limitations: People with high levels of disability and CLBP classification were not included.Conclusions: People with mild-to-moderate CLBP had similar exercise responses to healthy controls. Aquatic exercise produced sufficient muscle activation, intensity and exertion, and should not be assumed to be less strenuous or less effective in activating trunk and pelvic muscles than exercise on land. These data can be used to inform design and prescription of rehabilitation programmes and interventions.",
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Muscle activity during aquatic and land exercises in people with and without low back pain. / Psycharakis, Stelios G.; Coleman, Simon G.S.; Linton, Linda; Kaliarntas, Konstantinos; Valentin, Stephanie.

In: Physical Therapy, Vol. 99, No. 3, 23.01.2019, p. 297-310.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Muscle activity during aquatic and land exercises in people with and without low back pain

AU - Psycharakis, Stelios G.

AU - Coleman, Simon G.S.

AU - Linton, Linda

AU - Kaliarntas, Konstantinos

AU - Valentin, Stephanie

PY - 2019/1/23

Y1 - 2019/1/23

N2 - Background: Chronic low back pain (CLBP) is the most prevalent musculoskeletal disorder. Aquatic exercises are commonly used by physiotherapists for CLBP treatment and management but there are no data on trunk muscle activation during aquatic exercises in people with CLBP. Objective: We quantified activation of trunk and gluteal muscles, exercise intensity, pain and perceived exertion in people with and without CLBP when performing water and land exercises.Design: Cross-sectional.Methods: Twenty participants with non-specific CLBP and 20 healthy participants performed 15 aquatic exercises and 15 similar land exercises. Mean and peak muscle activation were measured bilaterally from erector spinae, multifidus, gluteus maximus, gluteus medius, rectus abdominis, external oblique and internal oblique, using waterproof and wireless surface electromyography. Exercise intensity (heart rate), perceived exertion (Borg scale) and, for the CLBP group, pain (visual-to-analogue scale) were recorded. Results: There were no significant between-group differences. Between-environment significant differences were found in heart rate (always higher on land), exertion (higher in the water for three exercises and on land for six exercises) and muscle activation (higher on land in 29% and in the water in 5% of comparisons). Pain levels were low, but pain was reported more than twice as frequently on land (7.7% Vs 3.7% of cases).Limitations: People with high levels of disability and CLBP classification were not included.Conclusions: People with mild-to-moderate CLBP had similar exercise responses to healthy controls. Aquatic exercise produced sufficient muscle activation, intensity and exertion, and should not be assumed to be less strenuous or less effective in activating trunk and pelvic muscles than exercise on land. These data can be used to inform design and prescription of rehabilitation programmes and interventions.

AB - Background: Chronic low back pain (CLBP) is the most prevalent musculoskeletal disorder. Aquatic exercises are commonly used by physiotherapists for CLBP treatment and management but there are no data on trunk muscle activation during aquatic exercises in people with CLBP. Objective: We quantified activation of trunk and gluteal muscles, exercise intensity, pain and perceived exertion in people with and without CLBP when performing water and land exercises.Design: Cross-sectional.Methods: Twenty participants with non-specific CLBP and 20 healthy participants performed 15 aquatic exercises and 15 similar land exercises. Mean and peak muscle activation were measured bilaterally from erector spinae, multifidus, gluteus maximus, gluteus medius, rectus abdominis, external oblique and internal oblique, using waterproof and wireless surface electromyography. Exercise intensity (heart rate), perceived exertion (Borg scale) and, for the CLBP group, pain (visual-to-analogue scale) were recorded. Results: There were no significant between-group differences. Between-environment significant differences were found in heart rate (always higher on land), exertion (higher in the water for three exercises and on land for six exercises) and muscle activation (higher on land in 29% and in the water in 5% of comparisons). Pain levels were low, but pain was reported more than twice as frequently on land (7.7% Vs 3.7% of cases).Limitations: People with high levels of disability and CLBP classification were not included.Conclusions: People with mild-to-moderate CLBP had similar exercise responses to healthy controls. Aquatic exercise produced sufficient muscle activation, intensity and exertion, and should not be assumed to be less strenuous or less effective in activating trunk and pelvic muscles than exercise on land. These data can be used to inform design and prescription of rehabilitation programmes and interventions.

U2 - 10.1093/ptj/pzy150

DO - 10.1093/ptj/pzy150

M3 - Article

VL - 99

SP - 297

EP - 310

JO - Physical Therapy

JF - Physical Therapy

SN - 0031-9023

IS - 3

ER -