A 4-week community aquatic physiotherapy program with Ai Chi or Bad Ragaz Ring Method improves disability and trunk muscle endurance in adults with chronic low back pain: A pilot study.

Chun Lung So (Corresponding Author), K.C.K Au, Joseph Kim Fai Ng

Research output: Journal article publicationJournal articleAcademic researchpeer-review


Abstract: OBJECTIVE: To investigate the efficacy of a 4-week community aquatic physiotherapy program with Ai Chi or the Bad Ragaz Ring Method (BRRM) on pain and disability in adults with chronic low back pain (CLBP). METHODS: Adults with CLBP (n= 44; mean ± SD age, 52.6 ± 5.5 y; 37 women) were randomly assigned to either an Ai Chi (n= 23) or BRRM (n= 21) program (4 weeks, twice weekly). RESULTS: Both the Ai Chi (-1.4; 95% CI -2.6 to -0.2; p= .025) and BRRM (-2.0, 95% CI -3.1 to -0.8; p= 0.003) groups demonstrated significant pre- to post-treatment decreases in Roland-Morris Disability Questionnaire scores and improvements in prone bridge duration (Ai Chi: 11.7 s; 95% CI 1.6 to 21.8; p= 0.025; BRRM: 19.0 s; 95% CI 6.1 to 31.8; p= 0.006). The Ai Chi group revealed a significant improvement in single-leg stand test duration (2.9 s; 95% CI 0.1 to 5.7; p= 0.045) and the BRRM group reported significant decrease in pain intensity (-11.6; 95% CI -19.1 to -4.2; p= 0.004). CONCLUSIONS: A 4-week aquatic physiotherapy program with Ai Chi or BRRM resulted in significant pre- to post-treatment improvements in disability and global core muscle endurance. Ai Chi appeared to have an additional benefit of improving single-leg standing balance and BRRM an additional benefit of reducing pain.

Keywords: Chronic low back pain, disability, Ai Chi, Bad Ragaz Ring Method, aquatic physiotherapy, water exercise
Original languageEnglish
Pages (from-to)755-767
Number of pages13
JournalJournal of Back and Musculoskeletal Rehabilitation
Issue number5
Publication statusPublished - 18 Jan 2019


  • Ai Chi
  • Bad Ragaz Ring Method
  • Chronic low back pain
  • aquatic physiotherapy
  • disability
  • water exercise

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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