Aquatic Therapy Effects on Spinal Kinematics and Muscle Activation Patterns in Chronic Low Back Pain

Introduction: Chronic low back pain is commonly associated with reduced spinal mobility, impaired activation of core stabilizing muscles, and functional limitations. Aquatic therapy, due to the unique physical properties of water, offers a low‑load and controlled environment that may facilitate movement correction and muscular strengthening. This study aimed to investigate the effects of a six‑week aquatic therapy program on spinal kinematics and core muscle activation in individuals with chronic low back pain. Methods: This semi‑experimental study employed a pretest–posttest design with a control group. Thirty participants with chronic low back pain were randomly assigned to an aquatic therapy group or a land‑based exercise group. Spinal range of motion was assessed using a three‑dimensional motion analysis system, and core muscle activation was recorded using surface electromyography. The aquatic intervention was conducted over ۱۲ sessions across six weeks. Results: The aquatic therapy group demonstrated significant improvements in spinal range of motion, including flexion (p < ۰.۰۰۱), extension (p = ۰.۰۰۲), lateral flexion (p = ۰.۰۰۴), and rotation (p = ۰.۰۰۱), compared with the control group. Core muscle activation also increased significantly following the intervention, particularly in the multifidus (p < ۰.۰۰۱), erector spinae (p = ۰.۰۰۳), rectus abdominis (p = ۰.۰۰۹), and external oblique (p = ۰.۰۰۴). Positive associations were observed between increased muscle activation and improved spinal mobility (p < ۰.۰۱). Conclusion: Aquatic therapy effectively enhances spinal kinematics and core muscle activation in individuals with chronic low back pain. By reducing mechanical load and increasing proprioceptive input, aquatic exercise provides a safe and beneficial rehabilitation modality for improving functional outcomes in this population.

کلیدواژه ها:

Chronic low back pain ، Aquatic therapy ، Spinal kinematics ، Electromyography ، Core muscles