Effects of Therapeutic Aquatic Exercise Versus Physical Therapy Modalities on Pain and Disability in People With Chronic Low Back Pain: Potential Mediating Roles of Kinesiophobia, Anxiety, and Depression

Key Points

• To compare the effects of therapeutic aquatic exercise and physical therapy modalities on pain and disability in chronic low back pain while assessing the roles of kinesiophobia, anxiety, and depression.
• Conducted a clinical trial registered with ChiCTR
• Compared outcomes between therapeutic aquatic exercise and physical therapy modalities
• Evaluated the mediating effects of kinesiophobia, anxiety, and depression on outcomes
• Participants in the aquatic exercise group reported greater reductions in pain compared to those in physical therapy
• Disability levels were also lower in the aquatic exercise group
• Kinesiophobia, anxiety, and depression were found to mediate the relationship between treatment type and outcomes