{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T01:11:04Z","timestamp":1790557864242,"version":"4.1.0"},"reference-count":102,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/04045\/2020"],"award-info":[{"award-number":["UIDB\/04045\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec024\">\n<jats:title>Background<\/jats:title>\n<jats:p>Chronic low back pain (CLBP) is a disease with significant functional, emotional and social impact. Several interventions are proposed for its management and exercise is one of main, land-based or water-based. This study describes a randomized controlled trial that will analyze the effect of a combined aquatic and land-based exercise program compared to an aquatic-based program on pain, functional incapacity and quality of life in adults with CLBP. Additionally, it will analyze the effects of exercise cessation in the same outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec025\">\n<jats:title>Methods and design<\/jats:title>\n<jats:p>A blind randomized controlled trial will be developed with a 1:1 allocation ratio. Around 30 adults with mechanical CLBP will be randomly allocated in two groups. The experimental group (ALG) will complete an aquatic and land-based exercise program and control group (AG) will carry out only an aquatic program, both for 8 weeks. Participants will be assessed with Visual Analogue Scale, Oswestry Disability Index, Short-Form 36, Tampa Scale of Kinesiophobia-13 and Modified-Modified Schober Test, collected at baseline (M0), after 8 weeks (M1) and 4 weeks after the end of the intervention (M2).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec026\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>This study may provide a relevant contribution to understand the potential effect of a combined land and aquatic exercise program on pain, functional disability, fear of movement, quality of life and lumbar mobility. The results may provide important information for CLBP management.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec027\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>This trial is registered with ClinicalTrials.gov (registration number: NCT06641570; date of registration: October 14, 2024).<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0320858","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T17:52:01Z","timestamp":1747763521000},"page":"e0320858","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of a land and aquatic exercise-based program on pain, mobility and quality of life in patients with chronic low back pain: a study protocol for a randomized controlled trial"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2633-0743","authenticated-orcid":true,"given":"Joana","family":"Borges","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7179-6814","authenticated-orcid":true,"given":"Diogo","family":"Monteiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8019-0729","authenticated-orcid":true,"given":"Fernanda M.","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1727-3537","authenticated-orcid":true,"given":"Miguel","family":"Jacinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0666-4913","authenticated-orcid":true,"given":"Tiago","family":"Pastilha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5055-2696","authenticated-orcid":true,"given":"Pedro","family":"Duarte-Mendes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"issue":"10294","key":"pone.0320858.ref001","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/S0140-6736(21)00733-9","article-title":"Low back pain","volume":"398","author":"NN Knezevic","year":"2021","journal-title":"Lancet"},{"key":"pone.0320858.ref002","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/B978-0-444-62627-1.00020-2","article-title":"Low-back pain","volume":"131","author":"FS Violante","year":"2015","journal-title":"Handb Clin Neurol"},{"key":"pone.0320858.ref003","article-title":"Global, regional, and national burden of low back pain, 1990\u20132020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021","volume":"5","author":"Collaborators GBD 2021 Low Back Pain","year":"2023","journal-title":"Lancet Rheumatol"},{"issue":"2","key":"pone.0320858.ref004","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.37371","article-title":"Risk Factors Associated With Transition From Acute to Chronic Low Back Pain in US Patients Seeking Primary Care","volume":"4","author":"JM Stevans","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"3","key":"pone.0320858.ref005","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1001\/archinternmed.2008.543","article-title":"The rising prevalence of chronic low back pain","volume":"169","author":"JK Freburger","year":"2009","journal-title":"Arch Intern Med"},{"key":"pone.0320858.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/S0034-8910.2015049005874","article-title":"Prevalence of chronic low back pain: systematic review","volume":"49","author":"RD Meucci","year":"2015","journal-title":"Rev Saude Publica"},{"issue":"9814","key":"pone.0320858.ref007","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/S0140-6736(11)60610-7","article-title":"Non-specific low back pain","volume":"379","author":"F Balagu\u00e9","year":"2012","journal-title":"Lancet"},{"issue":"1","key":"pone.0320858.ref008","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.spinee.2007.10.005","article-title":"A systematic review of low back pain cost of illness studies in the United States and internationally","volume":"8","author":"S Dagenais","year":"2008","journal-title":"Spine J"},{"issue":"1","key":"pone.0320858.ref009","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1038\/s41572-018-0052-1","article-title":"Low back pain","volume":"4","author":"JWS 9. 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