Chronic Low Back PainAQUA-LBPNCT07196826
Effect of Passive Versus Active Aquatic Therapy Compared With Conventional Physiotherapy for Chronic Low Back Pain
A study testing Active Aquatic Therapy, Passive Aquatic Therapy and Conventional Physiotherapy in people with Chronic Low Back Pain, run by Gulf Medical University at 1 site in United Arab Emirates.
Trial summary
This study is designed to help people with chronic low back pain, which is pain in the lower back that persists for more than three months and can affect daily life, including sitting, standing, walking, lifting, and other routine activities. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Chronic Low Back Pain
- What is being tested?
- Active Aquatic Therapy, Passive Aquatic Therapy and Conventional Physiotherapy
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 12 participants
- Where
- 1 siteUnited Arab Emirates
- Study dates
- 20 Feb 2026to 10 Aug 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adults aged 18 to 65 years.
- Diagnosed with nonspecific chronic low back pain (duration >3 months).
- Capable of attending sessions and providing written informed consent. -
Who cannot join
- Acute low back pain or red flags (fractures, malignancy, infection).
- Recent spinal surgery (<6 months).
- Neurological disorders affecting balance or gait.
- Cardiopulmonary conditions contraindicating immersion.
- Pregnancy.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United Arab Emirates1 site
Gulf medical University
Ajman, Al Jurf
Arulsingh, DR, +971505708763, dr.watson@gmu.ac.ae
About this study
Official title: Effect of Passive Versus Active Aquatic Therapy Over Conventional Physiotherapy in Patients With Chronic Low Back Pain - A Randomized Crossover Trial
This study is designed to help people with chronic low back pain, which is pain in the lower back that persists for more than three months and can affect daily life, including sitting, standing, walking, lifting, and other routine activities. Chronic low back pain can also impact work, mood, and overall quality of life, making it important to find effective rehabilitation methods that reduce pain and improve function.
The study compares the effects of three different rehabilitation approaches:
Read more
- Active aquatic therapy - participants perform exercises in water where they actively move their back, core, and legs. The water helps support the body and reduces stress on the spine, allowing safer and easier movement. This approach aims to improve strength, flexibility, core stability, and overall function.
- Passive aquatic therapy - participants receive assisted movements in water guided by a trained physiotherapist. This gentle method helps increase spinal mobility, reduces stiffness, promotes relaxation, and can relieve pain without placing stress on the lower back.
- Conventional physiotherapy - participants perform standard exercises on land, including stretching, strengthening, and core stabilization exercises. All sessions are supervised by licensed physiotherapists to ensure exercises are done safely and effectively.
Participants will be randomly assigned to one of the three groups. Each intervention lasts 4 weeks, with multiple sessions each week. All sessions are supervised to provide proper guidance, ensure safety, and adapt exercises to each participant's needs.
Before starting therapy, participants' pain levels, core strength, flexibility, spinal mobility, and ability to perform daily activities will be measured using simple and understandable assessments. These measures will be repeated at the end of the 4-week intervention to evaluate improvements and compare the effectiveness of each rehabilitation approach.
The study is safe and non-invasive. No surgery, injections, or medications are involved. Participants' personal information is kept confidential, and all collected data will be used solely for research purposes.
By participating in this study, patients may benefit from structured, supervised rehabilitation that could help reduce pain, improve mobility and strength, enhance balance and core stability, and increase confidence in performing daily activities. Patients' feedback during sessions will also help researchers understand their experiences and preferences, which can improve future treatment recommendations.
The results of this study will help patients, families, physiotherapists, and healthcare providers understand which type of rehabilitation is most effective for chronic low back pain. This information can guide treatment decisions, improve individualized care plans, and support patients in returning to normal activities with less discomfort and greater independence.
Overall, the study aims to provide clear, practical information about rehabilitation options for chronic low back pain, improve functional outcomes, and enhance quality of life. Participants' contributions will help generate evidence that may benefit others with similar conditions in the future, while also receiving safe and professional care throughout the study.
- Conditions
- Chronic Low Back Pain
- Being tested
- Active Aquatic Therapy, Passive Aquatic Therapy, Conventional Physiotherapy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Active Aquatic TherapyProcedure or surgery
Active Aquatic Therapy involves structured, therapist-guided exercises in a heated hydrotherapy pool (32-34°C). Water buoyancy and resistance reduce spinal load, facilitate movement, and enhance muscle activation. Sessions last 45-60 minutes, 3 times per week for 4 weeks, supervised by licensed physiotherapists. Each session includes warm-up (water marching, arm swings, trunk rotations), main exercises (lumbar spine function, core strengthening, balance, hip abduction, back extensions, aqua walking, arm/leg strengthening), and cool-down (floating, deep breathing, passive stretches). Intensity is monitored using the Borg RPE scale (60-80% max HR). This intervention uniquely uses active engagement in water to reduce pain and improve strength, flexibility, and function, distinguishing it from passive aquatic therapy and land-based physiotherapy.
Passive Aquatic TherapyProcedure or surgery
Passive Aquatic Therapy (Watsu) is a therapist-guided, passive aquatic technique performed in a warm hydrotherapy pool (35°C). The patient floats while the therapist gently moves their body in rhythmic, synchronized patterns, providing massage, stretching, joint mobilization, and acupressure. Sessions last 45-60 minutes, 3 times per week for 4 weeks, and include preparation/floating, cradling with passive movements, passive stretching and mobilization, acupressure, and final relaxation. Neck and knee supports are used for comfort. This intervention uniquely emphasizes passive relaxation and gentle mobilization, making it suitable for patients with severe movement limitations, distinguishing it from active aquatic therapy and conventional land-based physiotherapy.
Conventional PhysiotherapyProcedure or surgery
Conventional Physiotherapy is a land-based intervention for chronic low back pain, delivered in an outpatient physiotherapy clinic. Sessions last 45 minutes, 3 times per week for 4 weeks, and include hot pack application (10-12 min) to reduce stiffness, electrotherapy (TENS/Interferential, 15 min) for pain modulation, and supervised therapeutic exercises (15-20 min) focusing on lumbar mobility, core stability, and spinal strengthening. Exercises include William's flexion, prone press-ups, cat-cow mobilization, hamstring stretches, pelvic tilts, and abdominal bracing. This intervention emphasizes pain reduction, postural control, and strengthening deep abdominal and paraspinal muscles, distinguishing it from passive and active aquatic therapies, and serves as the standard comparator in this crossover study.
| Study group | Role | What they receive |
|---|---|---|
| Active Aquatic Therapy | Experimental | Participants perform exercises in water, actively moving their back, core, and legs. The buoyancy of water reduces stress on the spine and joints, making movements easier and safer. This therapy focuses on improving strength, flexibility, core stability, balance, and overall function. Each session is guided by a licensed physiotherapist who ensures proper technique and monitors participants for safety. This approach aims to reduce chronic low back pain, improve mobility, and enhance daily activity performance and quality of life. Receives: Procedure: Active Aquatic Therapy |
| Passive Aquatic Therapy | Experimental | Participants receive assisted movements in water guided by a trained physiotherapist. The therapist moves the participant's back, core, and legs gently, allowing for improved spinal mobility, reduced stiffness, and relaxation without stressing the lower back. Water resistance and support help increase flexibility and reduce pain. Each session is supervised to ensure safety, correct technique, and comfort. This method aims to relieve chronic low back pain, improve function, and enhance participants' ability to perform daily activities safely and comfortably. Receives: Procedure: Passive Aquatic Therapy |
| Conventional Physiotherapy | Active comparator | Participants perform standard land-based exercises including stretching, strengthening, and core stabilization exercises under the supervision of a licensed physiotherapist. The therapy focuses on improving spinal mobility, core strength, posture, and functional ability, aiming to reduce pain and improve daily activities. Each session is tailored to the participant's abilities and monitored for safety and correct technique. This conventional physiotherapy serves as the standard comparator to evaluate the effectiveness of aquatic therapies in managing chronic low back pain and enhancing quality of life. Receives: Procedure: Conventional Physiotherapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain Intensity
Pain intensity will be assessed using the Visual Analog Scale (VAS, 0-10 cm), where participants indicate their current level of low back pain from "no pain" to "worst imaginable pain." The VAS is a validated and reliable tool with high internal consistency and test-retest reliability.
Purpose: To measure change in pain intensity associated with chronic low back pain.
Measured: Measured at baseline (before any intervention) and after each 4-week intervention phase.
Secondary outcomes (2)
Functional Disability Oswestry Disability Index (ODI)
The ODI assesses limitations in daily activities due to low back pain, including sitting, standing, walking, and lifting. The instrument demonstrates excellent internal consistency (Cronbach's α = 0.82-0.90) and high reliability (ICC = 0.90-0.96).
Purpose: To measure change in functional disability related to low back pain.
Measured: Measured at baseline and after each 4-week intervention phase.
Lumbar Range of Motion (ROM)
Lumbar ROM will be measured using a double inclinometer according to AMA guidelines. Flexion and extension measurements are used to assess spinal mobility and functional flexibility. This method demonstrates high reliability for lumbar movement assessment.
Purpose: To measure change in lumbar flexibility and range of motion.
Measured: Measured at baseline and after each 4-week intervention phase.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Sep 2025
- Study start20 Feb 2026 (estimated)
- Primary completion10 Mar 2026 (estimated)
- Study completion10 Aug 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Chronic Low Back PainStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 12 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Gulf Medical University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07196826
- Sponsor's protocol ID
- IRB-COHS-STD-122-APR-2024
- Acronym
- AQUA-LBP
- Status last verified
- Dec 2025
- First submitted
- 20 Sep 2025
- Last updated
- 18 Dec 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 18 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Passive Versus Active Aquatic Therapy Over Conventional Physiotherapy in Patients With Chronic Low Back Pain - A Randomized Crossover Trial
- ClinicalTrials.gov ID
- NCT07196826
- Acronym / sponsor ID
- AQUA-LBP / IRB-COHS-STD-122-APR-2024
- Conditions
- Chronic Low Back Pain
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 12 participants (estimated)
- Lead sponsor
- Gulf Medical UniversityUniversity, hospital or other
- Study start
- 20 Feb 2026 (estimated)
- Primary completion
- 10 Mar 2026 (estimated)
- Study completion
- 10 Aug 2026 (estimated)
- First posted
- 29 Sep 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study is designed to help people with chronic low back pain, which is pain in the lower back that persists for more than three months and can affect daily life, including sitting, standing, walking, lifting, and other routine activities. Chronic low back pain can also impact work, mood, and overall quality of life, making it important to find effective rehabilitation methods that reduce pain and improve function.
The study compares the effects of three different rehabilitation approaches:
- Active aquatic therapy - participants perform exercises in water where they actively move their back, core, and legs. The water helps support the body and reduces stress on the spine, allowing safer and easier movement. This approach aims to improve strength, flexibility, core stability, and overall function.
- Passive aquatic therapy - participants receive assisted movements in water guided by a trained physiotherapist. This gentle method helps increase spinal mobility, reduces stiffness, promotes relaxation, and can relieve pain without placing stress on the lower back.
- Conventional physiotherapy - participants perform standard exercises on land, including stretching, strengthening, and core stabilization exercises. All sessions are supervised by licensed physiotherapists to ensure exercises are done safely and effectively.
Participants will be randomly assigned to one of the three groups. Each intervention lasts 4 weeks, with multiple sessions each week. All sessions are supervised to provide proper guidance, ensure safety, and adapt exercises to each participant's needs.
Before starting therapy, participants' pain levels, core strength, flexibility, spinal mobility, and ability to perform daily activities will be measured using simple and understandable assessments. These measures will be repeated at the end of the 4-week intervention to evaluate improvements and compare the effectiveness of each rehabilitation approach.
The study is safe and non-invasive. No surgery, injections, or medications are involved. Participants' personal information is kept confidential, and all collected data will be used solely for research purposes.
By participating in this study, patients may benefit from structured, supervised rehabilitation that could help reduce pain, improve mobility and strength, enhance balance and core stability, and increase confidence in performing daily activities. Patients' feedback during sessions will also help researchers understand their experiences and preferences, which can improve future treatment recommendations.
The results of this study will help patients, families, physiotherapists, and healthcare providers understand which type of rehabilitation is most effective for chronic low back pain. This information can guide treatment decisions, improve individualized care plans, and support patients in returning to normal activities with less discomfort and greater independence.
Overall, the study aims to provide clear, practical information about rehabilitation options for chronic low back pain, improve functional outcomes, and enhance quality of life. Participants' contributions will help generate evidence that may benefit others with similar conditions in the future, while also receiving safe and professional care throughout the study.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Active Aquatic Therapy | Experimental | Procedure: Active Aquatic TherapyParticipants perform exercises in water, actively moving their back, core, and legs. The buoyancy of water reduces stress on the spine and joints, making movements easier and safer. This therapy focuses on improving strength, flexibility, core stability, balance, and overall function. Each session is guided by a licensed physiotherapist who ensures proper technique and monitors participants for safety. This approach aims to reduce chronic low back pain, improve mobility, and enhance daily activity performance and quality of life. |
| Passive Aquatic Therapy | Experimental | Procedure: Passive Aquatic TherapyParticipants receive assisted movements in water guided by a trained physiotherapist. The therapist moves the participant's back, core, and legs gently, allowing for improved spinal mobility, reduced stiffness, and relaxation without stressing the lower back. Water resistance and support help increase flexibility and reduce pain. Each session is supervised to ensure safety, correct technique, and comfort. This method aims to relieve chronic low back pain, improve function, and enhance participants' ability to perform daily activities safely and comfortably. |
| Conventional Physiotherapy | Active comparator | Procedure: Conventional PhysiotherapyParticipants perform standard land-based exercises including stretching, strengthening, and core stabilization exercises under the supervision of a licensed physiotherapist. The therapy focuses on improving spinal mobility, core strength, posture, and functional ability, aiming to reduce pain and improve daily activities. Each session is tailored to the participant's abilities and monitored for safety and correct technique. This conventional physiotherapy serves as the standard comparator to evaluate the effectiveness of aquatic therapies in managing chronic low back pain and enhancing quality of life. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Adults aged 18 to 65 years.
- Diagnosed with nonspecific chronic low back pain (duration >3 months).
- Capable of attending sessions and providing written informed consent. -
Key exclusion criteria (5 listed)
- Acute low back pain or red flags (fractures, malignancy, infection).
- Recent spinal surgery (<6 months).
- Neurological disorders affecting balance or gait.
- Cardiopulmonary conditions contraindicating immersion.
- Pregnancy.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Active Aquatic TherapyActive Aquatic Therapy involves structured, therapist-guided exercises in a heated hydrotherapy pool (32-34°C). Water buoyancy and resistance reduce spinal load, facilitate movement, and enhance muscle activation. Sessions last 45-60 minutes, 3 times per week for 4 weeks, supervised by licensed physiotherapists. Each session includes warm-up (water marching, arm swings, trunk rotations), main exercises (lumbar spine function, core strengthening, balance, hip abduction, back extensions, aqua walking, arm/leg strengthening), and cool-down (floating, deep breathing, passive stretches). Intensity is monitored using the Borg RPE scale (60-80% max HR). This intervention uniquely uses active engagement in water to reduce pain and improve strength, flexibility, and function, distinguishing it from passive aquatic therapy and land-based physiotherapy. | Procedure or surgery | Active Aquatic Therapy |
| Passive Aquatic TherapyPassive Aquatic Therapy (Watsu) is a therapist-guided, passive aquatic technique performed in a warm hydrotherapy pool (35°C). The patient floats while the therapist gently moves their body in rhythmic, synchronized patterns, providing massage, stretching, joint mobilization, and acupressure. Sessions last 45-60 minutes, 3 times per week for 4 weeks, and include preparation/floating, cradling with passive movements, passive stretching and mobilization, acupressure, and final relaxation. Neck and knee supports are used for comfort. This intervention uniquely emphasizes passive relaxation and gentle mobilization, making it suitable for patients with severe movement limitations, distinguishing it from active aquatic therapy and conventional land-based physiotherapy. | Procedure or surgery | Passive Aquatic Therapy |
| Conventional PhysiotherapyConventional Physiotherapy is a land-based intervention for chronic low back pain, delivered in an outpatient physiotherapy clinic. Sessions last 45 minutes, 3 times per week for 4 weeks, and include hot pack application (10-12 min) to reduce stiffness, electrotherapy (TENS/Interferential, 15 min) for pain modulation, and supervised therapeutic exercises (15-20 min) focusing on lumbar mobility, core stability, and spinal strengthening. Exercises include William's flexion, prone press-ups, cat-cow mobilization, hamstring stretches, pelvic tilts, and abdominal bracing. This intervention emphasizes pain reduction, postural control, and strengthening deep abdominal and paraspinal muscles, distinguishing it from passive and active aquatic therapies, and serves as the standard comparator in this crossover study. | Procedure or surgery | Conventional Physiotherapy |
Primary outcome
Pain Intensity
Time frame: Measured at baseline (before any intervention) and after each 4-week intervention phase.
Pain intensity will be assessed using the Visual Analog Scale (VAS, 0-10 cm), where participants indicate their current level of low back pain from "no pain" to "worst imaginable pain." The VAS is a validated and reliable tool with high internal consistency and test-retest reliability. Purpose: To measure change in pain intensity associated with chronic low back pain.
2 secondary outcomes
Functional Disability Oswestry Disability Index (ODI)
Time frame: Measured at baseline and after each 4-week intervention phase.
Lumbar Range of Motion (ROM)
Time frame: Measured at baseline and after each 4-week intervention phase.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Dec 2025.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Active Aquatic Therapy, Passive Aquatic Therapy and Conventional Physiotherapy in people with Chronic Low Back Pain, run by Gulf Medical University at 1 site in United Arab Emirates.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 18 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Arab Emirates. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain Intensity (time frame: Measured at baseline (before any intervention) and after each 4-week intervention phase.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Dec 2025.