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Combined aquatic and Pilates exercise improves outcomes in women with lumbar disc herniation

Combined aquatic and Pilates exercise improves outcomes in women with lumbar disc herniation
Photo by Ahmet Kurt / Unsplash
Key Takeaway
Consider combined aquatic-Pilates exercise for women with mild LDH, but note limited evidence from small, short-term trial.

A randomized controlled trial evaluated 45 women aged 30-50 years with MRI-confirmed mild to moderate lumbar disc herniation. Participants were assigned to one of three groups for 8 weeks: combined aquatic and Pilates exercise (n=15), aquatic exercise alone (n=15), or a control group (n=15). The primary outcome was not reported; secondary outcomes included pain, spinal mobility, functional disability, and quality of life.

Both intervention groups showed significant improvements in all measured outcomes compared to the control group (p < 0.001). The combined aquatic-Pilates group demonstrated greater improvement than the aquatic-only group in spinal mobility (p = 0.027), functional disability (p = 0.042), and quality of life (p = 0.046). Exact effect sizes and absolute numbers were not reported.

Safety and tolerability data were not reported, and no adverse events or discontinuations were mentioned. The study had several limitations: small sample size (15 participants per group), restriction to women aged 30-50 with mild to moderate disease, and short 8-week follow-up period. Funding sources and conflicts of interest were not disclosed.

While this RCT suggests that combining aquatic exercise with Pilates may offer additional benefits over aquatic exercise alone for specific outcomes in this population, clinicians should interpret these findings cautiously due to the limited sample and demographic constraints. The results support further investigation of multimodal exercise approaches in lumbar disc herniation rehabilitation.

Study Details

Study typeRct
Sample sizen = 15
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
BackgroundLumbar disc herniation (LDH) is a common musculoskeletal condition that negatively impacts pain, mobility, functional ability, and quality of life, especially in women. While aquatic and Pilates exercises each offer benefits, limited research has explored their combined effects in LDH rehabilitation.ObjectiveTo compare the effects of aquatic exercise alone versus a combination of aquatic and Pilates exercises on pain, spinal mobility, functional disability, and quality of life in women with mild to moderate LDH.MethodsIn this randomized controlled trial, 45 women aged 30-50 years with MRI-confirmed mild to moderate LDH were assigned to one of three groups: control (n = 15), aquatic exercise (n = 15), and combined aquatic + Pilates exercise (n = 15). The intervention lasted eight weeks, with three supervised sessions per week. Outcomes were assessed using the Visual Numeric Scale (pain), Modified-Modified Schober Test (mobility), Oswestry Disability Index (disability), and SF-36 (quality of life). Data were analyzed using mixed-model ANOVA and Scheffé post hoc tests.ResultsBoth intervention groups showed significant improvements in all outcomes compared to the control group ( 0.001). The combined aquatic + Pilates group showed greater improvements in spinal mobility ( = 0.027), functional disability ( = 0.042), and quality of life ( = 0.046) compared to the aquatic-only group.ConclusionAn eight-week program combining aquatic and Pilates exercises is more effective than aquatic exercise alone for improving pain, mobility, disability, and quality of life in women with LDH. This multi-modal, non-invasive approach may enhance clinical rehabilitation outcomes.
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