# The Effects of Dynamic Stability Training with Inertial Load of Water on Dynamic Balance and Pain in Middle-Aged Women with Chronic Low Back Pain: A Randomized Clinical Trial

## TL;DR

This study shows that using water-based resistance during balance training helps middle-aged women with chronic back pain improve balance and reduce pain more effectively than traditional weighted training.

## Contribution

The study introduces water-based inertial loading as a novel method for dynamic stability training in chronic low back pain rehabilitation.

## Key findings

- The aquavest group showed greater improvement in Y-Balance Test reach distances of the non-dominant leg compared to the control group.
- The aquavest group demonstrated enhanced postural stability with reduced Center of Pressure Anterior–Posterior Root Mean Square.
- Both groups experienced reduced pain and fear of movement after the 12-week training program.

## Abstract

Background: Chronic low back pain (CLBP) is a common musculoskeletal disorder among middle-aged women, often leading to impaired dynamic balance and increased fear of movement. This study aimed to investigate the effects of dynamic stability training using the inertial load of water on balance ability and pain in middle-aged women with CLBP. Methods: Twenty-nine participants aged 40–65 years with CLBP were randomly assigned to an experimental or control group. The experimental group wore a water-filled aquavest, and the control group wore a weighted vest. Both groups performed 12 weeks of dynamic stability training twice per week. Outcome measures included the Y-Balance Test and Center of Pressure parameters, Visual Analogue Scale and Tampa Scale for Kinesiophobia. Data were analyzed using mixed-design two-way repeated-measures (between–within) analysis of variance to examine time, group, and interaction effects. Results: A significant group × time interaction effect was found in Y-Balance Test reach distances of the non-dominant leg, with the aquavest group showing greater improvements compared to the control group (p < 0.05). Center of Pressure analysis revealed decreased non-dominant leg Anterior–Posterior Root Mean Square in the aquavest group, indicating enhanced postural stability. Both groups showed decreased VAS and TSK. Conclusions: Dynamic stability training using inertial load of water effectively improved both quantitative and qualitative aspects of dynamic balance in middle-aged women with CLBP and can serve as a functional intervention for neuromuscular rehabilitation.