Swimming for low back pain

 
Swimmer clutching her lower back

Swimming for low back pain

 
Swimmer clutching her lower back

A recent Seeding Grant recipient is investigating the use of a swimming program to help people with chronic low back pain.

Deb Wareham APAM, a second-year PhD student at Macquarie University, New South Wales, is an early-career researcher with a focus on primary care and a particular interest in low back pain (LBP).

Since 2021, she has been working at MQ Health Physiotherapy outpatient clinic, which sees many people with LBP.

‘I was a research assistant for two NHMRC- funded trials, RESTORE and WalkBack, and it was my association with them
that inspired the creation of this current trial,’ says Deb.

‘The trial is the central component of my PhD and it’s been great focusing on something that could have a clear clinical impact for many people.’

The rationale for the study came about due to a common belief about the effectiveness of swimming for LBP.

Deb says, ‘For a long time there has been a preconception held by the general public that swimming is good for LBP.

'Many patients and their friends and family—even fellow clinicians— mention it.

'But surprisingly there is almost no research on the topic.’

‘The study is a randomised controlled trial.

'The treatment group receive a combination of an individualised swimming and education program, with access to a pool for eight weeks and four sessions with a physiotherapist.

'The control group receive education only.

'The three key messages of the education sessions are: the back is made for movement, flare-ups are common and the most important thing is to keep moving, and pain is an alarm for the body.’

The primary outcome will measure back-related function, using the 24-item Roland-Morris Disability Questionnaire for LBP.

‘The outcomes are collected at three weeks, eight weeks, 13 weeks, six months and 12 months,’ says Deb.

‘The 12-month follow-up was added purely because of the support of the PRF Seeding Grant and we’ll also be looking at factors such as pain intensity, patient-perceived improvement and fear avoidance—all classic LBP-related outcomes.’

The study’s other aim will be to work out the feasibility and acceptability of using a swimming and education program for LBP.

‘We will look at how much people adhere to the swimming program and assess their intention to continue with it after the trial.

'It’s important that the program simulates as much as possible what happens in the clinic, so all the sessions are delivered via telehealth, not in or next to a pool.

'I hope that this will allow us to create a program that other physios can deliver in a tangible and useful format,’ Deb says.

The PRF Seeding Grant has given Deb the chance to create a larger and more in-depth trial.

‘Thanks to the grant, we have access to swimming facilities and a research assistant and are able to add a follow-up at 12 months as well as recruit participants from across Australia, not just metropolitan Sydney,’ she says.

‘The PRF grant helps to ensure that we can get the highest quality data and we’re excited to see what the results are.’
 

 

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