Combined Aquatic and Pilates Exercises Improve Pain,Mobility,Functional Disability,and Quality of Life in Women With Lumbar Disc Herniation: A Randomized Controlled Trial

Abstract

Background

Lumbar 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.

Objective

To 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.

Methods

In 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.

Results

Both intervention groups showed significant improvements in all outcomes compared to the control group (p < 0.001). The combined aquatic + Pilates group showed greater improvements in spinal mobility (p = 0.027), functional disability (p = 0.042), and quality of life (p = 0.046) compared to the aquatic-only group.

Conclusion

An 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.