A Randomised Controlled Study of the Outcome of Hydrotherapy for Subjects with Low Back or Back and Leg Pain

Abstract

Background and purpose: Exercise is frequently selected by physiotherapists to treat patients with low back pain (LBP) or with back and leg pain. Anecdotally a particular form of exercise, group hydrotherapy, is widely accepted as a beneficial and cost-effective method of management. This study was designed to investigate the claimed benefits of group hydrotherapy for subjects with chronic low back pain (CLBP) and back and leg pain. Subjects: A total of 109 adults with LBP or back and leg pain of more than three months duration were randomly assigned to either a hydrotherapy (experimental) or control (delayed hydrotherapy) group; 95 subjects completed the study. Methods: Before and after the four-week‘intervention period’ the following measures were recorded for all subjects in both groups: the ranges of active lumbar flexion and extension and of passive straight leg raise; the levels of lower limb strength, reflex responses, light touch sensation, functional disability using the Oswestry Low Back Pain Disability Questionnaire, and pain using the McGill Pain Questionnaire. All measurements were made and recorded by an experienced physiotherapist unaware of the group assignment of subjects. Results: Analysis with chi-square showed a statistically significant greater number of subjects in the experimental group improved in their function and fewer deteriorated. Subjects whose condition improved on the other measures were typically in the experimental group, while those whose condition deteriorated were typically in the control group. Conclusion and discussion: The findings offer qualified support to anecdotal evidence that group hydrotherapy can benefit subjects with CLBP or back and leg pain. Exercise is frequently selected by physiotherapists to treat patients with low back pain (LBP) or with back and leg pain. Anecdotally a particular form of exercise, group hydrotherapy, is widely accepted as a beneficial and cost-effective method of management. This study was designed to investigate the claimed benefits of group hydrotherapy for subjects with chronic low back pain (CLBP) and back and leg pain. A total of 109 adults with LBP or back and leg pain of more than three months duration were randomly assigned to either a hydrotherapy (experimental) or control (delayed hydrotherapy) group; 95 subjects completed the study. Before and after the four-week‘intervention period’ the following measures were recorded for all subjects in both groups: the ranges of active lumbar flexion and extension and of passive straight leg raise; the levels of lower limb strength, reflex responses, light touch sensation, functional disability using the Oswestry Low Back Pain Disability Questionnaire, and pain using the McGill Pain Questionnaire. All measurements were made and recorded by an experienced physiotherapist unaware of the group assignment of subjects. Analysis with chi-square showed a statistically significant greater number of subjects in the experimental group improved in their function and fewer deteriorated. Subjects whose condition improved on the other measures were typically in the experimental group, while those whose condition deteriorated were typically in the control group. The findings offer qualified support to anecdotal evidence that group hydrotherapy can benefit subjects with CLBP or back and leg pain.