AquaLogix vs. Standard Aquatic Equipment In Cardinal and Multiplanar (PNF) Patterns with Patients Who Have Non-Descript Low Back Pain

Size: px

Start display at page:

Download "AquaLogix vs. Standard Aquatic Equipment In Cardinal and Multiplanar (PNF) Patterns with Patients Who Have Non-Descript Low Back Pain"

Opal Stevens
6 years ago
Views:

Amodeo, Nick Bresso, John Calati, Aaron Duca

1 AquaLogix vs. tandard Aquatic Equipment In Cardinal and Multiplanar (PNF) Patterns with Patients Who Have Non-Descript Low Back Pain tudents: Jordan Amodeo, Nick Bresso, John Calati, Aaron Duca Mentor: Jon Nettie, PT Wayne tate University Eugene Applebaum College of Pharmacy and Health ciences

2 Introduction Epidemiological studies show that about 80% of the population will suffer from some sort of back pain in their lives, and that low back pain is one of the most frequent complaints among patients It has been estimated that low back pain costs the economy more than 20 million dollars through medical costs and lost work days

3 Introduction Conservative interventions can include: pinal manipulative therapy Exercise Advice and education Transcutaneous electrical nerve stimulation Aquatic therapy

Introduction Benefits of Aquatic Therapy Objects in water weigh substantially less so there is less intervertebral disc pressure, allowing for an earlier start to treatment and a more aggressive

4 Introduction Benefits of Aquatic Therapy Objects in water weigh substantially less so there is less intervertebral disc pressure, allowing for an earlier start to treatment and a more aggressive program. Buoyancy: force that acts in the opposite direction of earth s gravity Hydrostatic pressure: pressure that the water exerts on the immersed object Water temperature desensitizes the patient from pain

5 AquaLogix Fitness ystems A multi-patented, diverse array of aquatic exercise equipment that can be utilized to treat a wide variety of patient conditions Principle of omni-directional drag resistance The AquaLogix system consists of two devices: bells and fins

6 AquaLogix Bells The bells are a drag resistance device that encloses the hand of the user in a perforated and finned cage Provides resistance through all directions of movement 3 different resistance levels available: Low cardio bells Medium cross trainers High sculptors

7 AquaLogix Bells Low Resistance Medium Resistance High Resistance

8 AquaLogix Fins The fins are designed similar to an ankle cuff weight. However, instead of weight plates or sand being placed inside the cuff weight, there are four different fins attached to the outside. A Velcro strap is used to secure the device round the patient s lower leg On each of the four fins there is a transverse fin on the vertical fin Two different levels of resistance available: low and high

9 AquaLogix Fins

10 Research on AquaLogix Technology There is currently no research available regarding the use of AquaLogix Fitness ystems to treat patients of any condition or disorder The only research performed using the AquaLogix technology was by Prins et al. in 2006 The study examined the use of kinematic motion analysis in the evaluation of selected exercises used in the treatment of patients for whom aquatic physical therapy has proved beneficial The patients used the AquaLogix bells and fins during the analysis of the resistive force of water and how limb velocities vary as a function of the different cross-sectional areas of each level of AquaLogix bells

11 Call For Research Aquatic foam dumbbells and ankle weights are typically used for aquatic rehabilitation programs in the treatment of patients with low back pain Affordable, practical, and widely accepted throughout the physical therapy world AquaLogix has been gaining notoriety among the fitness world in recent years Must be brought to the attention of physical therapists implementing aquatic rehabilitation programs Accurate and reliable research must be performed to determine the effectiveness of the AquaLogix technology compared to standard aquatic dumbbells

12 Purpose This investigation sought to determine the efficacy of an aquatic therapy protocol using AquaLogix technology in order to improve function and reduce symptoms in patients with non-descript low back pain

13 Hypothesis It is hypothesized that an aquatic rehabilitation protocol involving AquaLogix technology will provide increased function and a reduction of symptoms related to low back pain when compared to an aquatic rehabilitation protocol without AquaLogix technology.

14 Methods ample recruitment: A randomized controlled trial utilizing convenience and snowball sampling 12 chronic low back, male and female patients. 6 subjects in each group years of age referred by their physician to the DMC RIM OP PT Brasza Clinic. Voluntary consent forms. Ideally, participants will be tested for 50 minutes in 8 treatment sessions over a period of 4 weeks. Twice a week

15 Inclusion Criteria Age years Chronic low back pain greater than 2 months

16 Exclusion Criteria Inability to participate due to fear of the water. Any uncontrolled cardiac problems. Incontinent. Any uncontrolled diabetes. Receiving any other treatment for their low back pain.

17 Testing Protocol There will be two experimental groups, participants will participate in a series of exercise routines. Participants will be randomly designated to participate in the AquaLogix group (Group 1) or tandard Foam Dumbbell group (Group 2) on the first session. The subjects selected for Group 1 or 2 will stay in their designated groups through the entire study. The same aquatic exercises protocol will be used by both groups.

18 Outcome Measures Oswestry Disability Index (ODI): The Oswestry Disability Index (ODI) will be used to assess functional outcomes of each subject at the beginning and end of this study. Numeric Pain Rating cale (NPR): The Numeric Pain Rating cale (NPR) will be used by each participant to rate his/her pain levels before and after each physical therapy aquatic class.

19 Design and Procedures The ODI will be completed prior to the first and following the last intervention. The subject s self report of pain using the NPR will be completed at the beginning and end of each of the physical therapy aquatic classes. Blood pressure was obtained at the beginning of each session to ensure a safe range for aquatic exercise.

20 Intervention Warm up: Walk (width of the pool) for 3 minutes with aquatic equipment on ankles. General squats: 3 sets of 10 ubmersing body to shoulder height in the water. May rest hands on side rail for balance.

Intervention UE work: 3 sets of 10 for each. Alternating shoulder flexion Bilateral shoulder abduction Internal/External rotation: arms at the side (both sides at the same time.

21 Intervention UE work: 3 sets of 10 for each. Alternating shoulder flexion Bilateral shoulder abduction Internal/External rotation: arms at the side (both sides at the same time.) Horizontal abduction/adduction (both sides at the same time.) houlder flexion: Bilaterally PNF D1: Bilaterally (both sides at the same time.) PNF D2: Bilaterally (both sides at the same time.) Punches: Grasp equipment, thumbs up, elbows bent then fully extend the arm as if punching

22 Intervention LE work: 3 sets of 10 for each Hip extension: Bilaterally One side at a time. Hip abduction: Bilaterally One side at a time. Hamstring curl: Bilaterally One side at a time. Cool down: Walk (width of the pool) for 3 minutes with aquatic equipment on ankles.

23 Power Analysis The power analysis for the number of subjects our study will need in each group consists of a t test with a difference between two independent means of the two groups. With an effect size of 0.60 and an alpha of 0.05 at 80% power, we will need approximately 45 subjects per group (N=90).

24 Results

25 Results Independent amples Test comparing Oswestry Disability Index scores: There was no significant difference between the two groups for scores on the Oswestry Disability Index Established p-value < 0.05 ignificance level of is not statistically significant

26 Results

27 Results There was no significant difference between the two groups for NPR scores Greater general trend toward reduction in pain symptoms for AquaLogix group compared to Dumbbell group ODI vs. NPR

28 Discussion/Conclusion Implications of this study may be useful for understanding the benefits of aquatic therapy in reducing LBP. There were strong relationships with the ODI between AquaLogix group in a therapy pool and a decline in LBP. These preliminary results also suggest that clinicians may want to consider using AquaLogix equipment to effectively treat patients with LBP.

29 Discussion/Conclusion These data indicate that both the AquaLogix group & the Dumbbell group are valid interventions for LBP. These preliminary results suggest that AquaLogix equipment can be an effective treatment method for LBP in clinics with access to a therapy pool. AquaLogix Omni-Directional Drag Resistance total body fitness system incorporates water s natural property of resistance movement while providing the ability to conduct an improved natural movement pattern (all 3 planes) in the water versus the Dumbbell equipment.

30 Limitations of the study Finding subjects that fall within the research criteria that can participate/commit to a study over the course of 8 weeks. Getting subjects to consistently commit up to twice per week. Difficult to monitor subjects physical activity outside the study parameters. mall sample size Additional study: is appropriate to explore the relationship between land based exercise and AquaLogix in LBP.

31 Acknowledgements Thank you to the professors involved, the employees and physical therapists of RIM, and the DMC for assistance and dedication to the completion of this research project.

32 References Koes BW, Bouter LM, Beckerman H, van der Heijden GJ, Knipschild PG. Physiotherapy exercises and back pain: a blinded review. Brit Med J. 1991;302(6792): Pengel HM, Maher CG, Refschauge KM. ystematic review of conservative interventions for subacute low back pain. Clin Rehabil. 2002;16(8): Macedo LG, Latimer J, Maher CG, et al. Effect of motor control exercises versus graded activity in patients with chronic nonspecific low back pain: a randomized controlled trial. Phys Ther. 2012;92(3): Hayden JA, van Tulder MW, Tomlinson G. ystematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med. 2005;142(9): Konlian C. Aquatic therapy: making a wave in the treatment of low back injuries. Orthop Nurs. 1999;18(1):11-8. Becker BE. Aquatic therapy: scientific foundations and clinical rehabilitation applications. Phys Med Rehabil Cli. 2009;1(9): Waller B, Lambeck J, Daly D. Therapeutic aquatic exercise in the treatment of low back pain: a systematic review. Clin Rehabil. 2009;23(1):3-14. Dundar U, olak O, Yigit I, Evcik D, Kavuncu V. Clinical effectiveness of aquatic exercise to treat chronic low back pain: a randomized controlled trial. pine. 2009;34(14): tout T. AquaLogix Fitness. AquaLogix Available at Accessed March 29, 2012.

33 References Benson T. National Aeronautics and pace Administration. What is drag? 10 eptember Availabe at 12/airplane/drag1.html. Accessed April 1, Kopansky C. Canadian Aquafitnesss Leaders Allianace Inc. Aqua Bells and Fins. 27 eptember Available at Accessed April 1, tout T. TLM Enterprises. AquaLogix Available at Accessed April 2, Prins JH, Kimura I, Turner M, Weisbach M, Lehoullier L. The application of kinematic motion analysis in the evaluation of therapeutic exercises used in aquatic rehabilitation. Arch Phys Med Rehabil. 2006;87. Fairbank JC, Pynsent PB. The Oswestry Disability Index. pine. 2000;25(22): Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. pine. 2000;25(24): Finch E, Brooks D, tratford P, Mayo N. Physical rehabilitation outcome measures: a guide to enhanced clinical decision making. J NeuroEng Rehabil. 2005;2(2):1-4. Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14: Young IA, Cleland JA, Michener LA, Brown C. Reliability, construct validity, and responsiveness of the neck disability index, patient-specific functional scale, and numeric pain rating scale in patients with cervical radiculopathy. Am J Phys Med Rehabil. 2010;89(10): Jensen MP, Miller L, Fisher LD. Assessment of pain during medical procedures: a comparison of three scales. Clin J Pain. 1998;14(4):343-9.

34 Questions?

REMEMBER GOOD POSTURE DURING ALL YOUR EXERCISES, AVOID SLOUCHING AS YOUR CURRENT PROGRAM BECOMES EASY SLOWLY INCREASE:

REMEMBER GOOD POSTURE DURING ALL YOUR EXERCISES, AVOID SLOUCHING Apr 06, 2017 AS YOUR CURRENT PROGRAM BECOMES EASY SLOWLY INCREASE: # OF LAPS YOU ARE WALKING # OF REPITITIONS # OF SECONDS YOU HOLD A STRETCH