Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.63231/2595-0118.202676-en
Brazilian Journal of Pain
Original Article

Perceptions of chronic low back pain and sleep quality among participants in aquatic physical therapy: qualitative study

Percepção sobre dor lombar crônica e qualidade de sono em indivíduos participantes de fisioterapia aquática: estudo qualitativo

Fernanda Aquino Costa; Jessica Dias Cardoso; Milena Paola Schuck; Valmor Ramos; Iramar Baptistella do Nascimento

Downloads: 0
Views: 9

Abstract

BACKGROUND AND OBJECTIVES: Chronic pain (CP), such as chronic nonspecific low back pain, represents a global challenge, affecting about 20% to 30% of the world's population. The objective of this study was to investigate the perception of individuals with chronic low back pain (CLBP) regarding the impacts of aquatic therapy (AT) on their pain and sleep quality (SQ).

METHODS: This is a qualitative, descriptive study, from a larger, experimental study, conducted with individuals with CLBP, aged between 18 and 65 years of both genders. The study was conducted at a public university in Santa Catarina. A Visual Analog Scale (VAS) and open interviews about the AT sessions were used as data collection instruments. Content analysis was used to interpret the data.

RESULTS: Thirteen participants (8 females and 5 male) with a mean age of 47.4 years participated in the study. The data emerged in the following categories: (1) Pain threshold in the lumbar spine when performing AT with the VAS; (2) Immediate perceptions after AT, regarding how participants felt when participating in the study; (3) Impressions of SQ, regarding sleeping well at night. The perceptions of pain and pain relief when participating in the study were reported, as well as the importance of adopting active behavior when performing aquatic exercises, the factor of belonging to the group and the comprehension of sleep in health.

CONCLUSION: In the perception of the individuals participating in the study, AT helped to improve pain and SQ.

Keywords

Aquatic therapy; Low back pain; Sleep

Resumo

JUSTIFICATIVA E OBJETIVOS: A dor musculoesquelética crônica (DC), como a dor lombar crônica inespecífica, representa um desafio global acometendo cerca de 20% a 30% da população mundial. O objetivo deste estudo foi investigar a percepção de indivíduos com dor lombar crônica (DLC) com relação aos impactos da fisioterapia aquática (FA) em sua dor e na qualidade do sono (QdS).

MÉTODOS: Trata-se de um estudo qualitativo, descritivo, proveniente de um estudo maior experimental, realizado com indivíduos com DLC, com idade entre 18 e 65 anos, de ambos os sexos. O estudo foi realizado em uma universidade pública de Santa Catarina. Como instrumento de coleta de dados foram utilizadas uma Escala Analógica Visual (EAV) e entrevistas abertas sobre as sessões de FA. Para interpretação dos dados, utilizou-se a análise de conteúdo.

RESULTADOS: Participaram do estudo 13 participantes (8 do sexo feminino e 5 do masculino), com média de idade de 47,4 anos. Os dados surgiram em categorias: (1) Limiar de dor na coluna lombar ao realizar a FA com a EAV; (2) Percepções imediatas após a FA, no que se refere a como os participantes se sentiram ao estarem no estudo; (3) Impressões da QdS, no que se refere a dormir bem à noite. As percepções de dor e o alívio dela ao participar do estudo foram relatados pelos participantes, assim como a importância de adotar um comportamento ativo ao efetuar exercícios aquáticos, do fator de pertencimento ao grupo e do entendimento do sono na saúde.

CONCLUSÃO: Na percepção dos indivíduos participantes do estudo, a FA auxiliou na melhora da dor e na QdS.

Palavras-chave

Dor lombar; Fisioterapia aquática; Sono

References

1 Psycharakis SG, Coleman S, Linton L, Kaliarntas K, Onslow R. Muscle activity during aquatic and land exercises in people with and without low back pain. Phys Ther. 2019;99(3):297-310. https://doi.org/10.1093/ptj/pzy150. PMid:30690522.

2 Taglietti M, Facco LM, Trelha CS, Melo FC, da Silva DW, Sawczuk G, Ruivo TM, de Souza TB, Sforza C, Cardoso JR. Eficácia dos exercícios aquáticos em comparação com a educação do paciente sobre o estado de saúde em indivíduos com osteoartrite de joelho: um ensaio clínico randomizado. Clin Rehabil. 2018;32(6): PMid:29417831.

3 Mirmoezzi M, Iradoust K, H’mida C, Taheri M, Trabelsi K, Ammar A, Paryab N, Nikolaidis PT, Knechtle B, Chtourou H. Efficacy of hydrotherapy treatment for the management of chronic low back pain. Ir J Med Sci. 2021;190(4):1413-21. https://doi.org/10.1007/s11845-020-02447-5. PMid:33409843.

4 Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, Keefe FJ, Mogil JS, Ringkamp M, Sluka KA, Song XJ, Stevens B, Sullivan MD, Tutelman PR, Ushida T, Vader K. The Revised IASP definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-82. https://doi.org/10.1097/j.pain.0000000000001939. PMid:32694387.

5 Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, Cohen M, Evers S, Finnerup NB, First MB, Giamberardino MA, Kaasa S, Korwisi B, Kosek E, Lavand’homme P, Nicholas M, Perrot S, Scholz J, Schug S, Smith BH, Svensson P, Vlaeyen JWS, Wang SJ. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019;160(1):19-27. https://doi.org/10.1097/j.pain.0000000000001384. PMid:30586067.

6 Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;9(9):CD009790. PMid:34580864.

7 Rezai V, Mahdavi-Nejad R, Zolaktaf V. Comparing the effects of different types of aquatic walking on endurance and electrical activities of spine extensor muscles in men with nonspecific chronic back pain. Int J Prev Med. 2020;11(1):168. https://doi.org/10.4103/ijpvm.IJPVM_403_19. PMid:33312477.

8 Paudel K, Shrestha M, Simkhada P, Poudel P, Sharma M. Sleep quality and its correlates among undergraduate medical students in Nepal: a cross-sectional study. PLOS Glob Public Health. 2022;2(2):e0000012. https://doi.org/10.1371/journal.pgph.0000012. PMid:36962248.

9 Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(6):843-4. PMid:26039963.

10 Xie Y, Liu S, Chen XJ, Yu HH, Yang Y, Wang W. Effects of exercise on sleep quality and insomnia in adults: a systematic review and meta-analysis of randomized controlled trials. Front Psychiatry. 2021;12:664499. https://doi.org/10.3389/fpsyt.2021.664499. PMid:34163383.

11 Lucena NF, Livramento AR. Physiotherapeutic action through hydrotherapy for low pain in pregnant woman. Braz J Implantol Health Sci. 2023;5:2256-68. https://doi.org/10.36557/2674-8169.2023v5n5p2256-2268.

12 Changming X, Zhiwei F, Juanw S, Baowu X-Q. Differences and correlations of anxiety, sleep quality, and pressure-pain threshold between patients with chronic low back pain and asymptomatic people. Pain Res Manag. 2022;7:8648584. PMid:35619991.

13 Denzin NK, Lincoln YS, editors. The SAGE handbook of qualitative research. 5th ed. Los Angeles: SAGE; 2018.

14 Creswell JW. Investigação qualitativa e projeto de pesquisa: escolhendo entre cinco abordagens. Porto Alegre: Penso Editora; 2014.

15 Patias ND, Von Hohendorff J. Critérios de qualidade para artigos de pesquisa qualitativa. Psicol Estud. 2019;24:e43536. https://doi.org/10.4025/psicolestud.v24i0.43536.

16 Yin RK. Estudo de caso: planejamento e métodos. Porto Alegre: Bookman Editora; 2015.

17 Matsudo S, Araújo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, Braggion G. Questionário Internacional de Atividade Física (Ipaq): estudo de validade e reprodutibilidade no Brasil. Rev Bras Ativ Fis Saude. 2012;6(2):5-18. http://doi.org/10.12820/rbafs.v.6n2p5-18.

18 Gift AG. Visual analogue scales: measurement of subjective phenomena. Nurs Res. 1989;38(5):286-8. https://doi.org/10.1097/00006199-198909000-00006. PMid:2678015.

19 Minayo MCS, Costa AP. Fundamentos teóricos das técnicas de investigação qualitativa. Rev Lusof Educ. 2018;(40):11-25.

20 Dundar U, Solak O, Yigit I, Evcik D, Kavuncu V. Clinical effectiveness of aquatic exercise to treat chronic low back pain: a randomized controlled trial. Spine. 2009;34(14):1436-40. https://doi.org/10.1097/BRS.0b013e3181a79618. PMid:19525833.

21 Young HA, Cousins A, Johnston S, Fletcher JM, Benton D. Autonomic adaptations mediate the effect of hydration on brain functioning and mood: evidence from two randomized controlled trials. Sci Rep. 2019;9(1):16412. https://doi.org/10.1038/s41598-019-52775-5. PMid:31712590.

22 Salas Salvadó J, Maraver Eizaguirre F, Rodríguez-Mañas L, Saenz de Pipaón M, Vitoria Miñana I, Moreno Aznar L. Importancia del consumo de agua en la salud y la prevención de la enfermedad: situación actual [The importance of water consumption in health and disease prevention: the current situation]. Nutr Hosp. 2020;37(5):1072-86. PMid:32960634.

23 Pooriput W, Allard JVDB, Nipaporn A, Prawit J. Effects of an active break and postural shift intervention on preventing neck and lowback pain among high-risk office workers: a 3-arm cluster-randomized controlled trial. Scand J Work Environ Health. 2021;47(4):306-17. https://doi.org/10.5271/sjweh.3949. PMid:33906239.

24 Bardin L. Análise de conteúdo. Lisboa: Edições 70; 2016.

25 Murad MH, Asi N, Alsawas M, Alahdab F. New evidence pyramid. Evid Based Med. 2016;21(4):125-7. https://doi.org/10.1136/ebmed-2016-110401. PMid:27339128.

26 Peng M, Wang R, Wang Y, Chen CC, Wang J, Liu XC, Song G, Guo JB, Chen PJ, Wang XQ. Efficacy of therapeutic aquatic exercise vs physical therapy modalities for patients with chronic low back pain: a randomized clinical trial. JAMA Netw Open. 2022;5(1):e2142069. https://doi.org/10.1001/jamanetworkopen.2021.42069. PMid:34994794.

27 Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, Keefe FJ, Mogil JS, Ringkamp M, Sluka KA, Song XJ, Stevens B, Sullivan MD, Tutelman PR, Ushida T, Vader K. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-82. https://doi.org/10.1097/j.pain.0000000000001939. PMid:32694387.

28 Dogge M, Custers R, Gayet S, Hoijtink H, Aarts H. Perception of action-outcomes is shaped by life-long and contextual expectations. Sci Rep. 2019;9(1):5225. https://doi.org/10.1038/s41598-019-41090-8. PMid:30914745.

29 Silva IS, Dario AB, Koerich MH. Effects of aquatic therapy in patients with chronic low back pain. Fisioter Bras. 2012;13:353-8.

30 De Souza CAL, Viana JE. Benefícios da hidroterapia na redução da dor e na melhora da função física em indivíduos com lombalgia: uma revisão de literatura. Rev Ibero-Am Humanid Cienc Educ. 2021;7(10):2173-85. https://doi.org/10.51891/rease.v7i10.2774.

31 Siqueira FA, Rebesco BD, Amaral AF, Maganhini CB, Dall Agnol SM, Furmann M, Mascarenhas LPG. Efeitos de um programa de Fisioterapia Aquática no equilíbrio e capacidade funcional de idosos. Saude Pesqui. 2017;10(2):331-8. https://doi.org/10.17765/1983-1870.2017v10n2p331-338.

32 Lee B, Kim G, Jo Y, Lee B, Shin YI, Hong C. Aquatic exercise at thermoneutral water temperature enhances antitumor immune responses. Immune Netw. 2019;19(2):e10. https://doi.org/10.4110/in.2019.19.e10. PMid:31089437.

33 Becker BE. Aquatic therapy: scientific foundations and clinical rehabilitation applications. PM R. 2009;1(9):859-72. https://doi.org/10.1016/j.pmrj.2009.05.017. PMid:19769921.
 


Submitted date:
11/17/2025

Accepted date:
04/01/2026

6a428b10a9539521d468447c brjp Articles
Links & Downloads

BrJP

Share this page
Page Sections