BACKGROUND: The Pilates method has been used to improve function and reduce pain in patients with chronic nonspecific low back pain, although there is little scientific evidence that describes its efficacy.
OBJECTIVE: The purpose of this study was to investigate the effectiveness of the addition of modified Pilates exercises to minimal intervention in patients with chronic low back pain.
DESIGN: A randomized controlled trial was conducted.
SETTING: The study was done in an outpatient physical therapy department in Brazil.
PATIENTS: Eighty-six patients with chronic nonspecific low back pain participated in the study.
INTERVENTION: All participants received an education booklet containing information about low back pain and were randomly allocated to receive 12 sessions, over 6 weeks, of exercises based upon Pilates principles (n=43) or of education alone (n=43).
MEASUREMENTS: Primary outcomes were pain intensity and disability measured at 6 weeks and 6 months. Secondary outcomes were patient-specific functional disability, global impression of recovery, and kinesiophobia measured at 6 weeks and 6 months. All outcomes were measured by a blinded assessor in all time points.
RESULTS: There was no loss to follow-up at any of the time points. Improvements were observed in pain (mean difference=2.2 points, 95% confidence interval [CI]=1.1 to 3.2), disability (mean difference=2.7 points, 95% CI=1.0 to 4.4), and global impression of recovery (mean difference=-1.5 points, 95% CI=-2.6 to -0.4) in favor of the Pilates group after intervention, but these differences were no longer statistically significant at 6 months.
LIMITATIONS: Treatment provider and participants could not be blinded to the interventions.
CONCLUSIONS: The addition of modified Pilates exercises to an educational booklet provides small benefits compared with education alone in patients with chronic nonspecific low back pain; however, these effects were not sustained over time.
PURPOSE: This single-assessor-blinded randomized controlled trial aimed to compare the efficacy of physiotherapy-delivered clinical Pilates and general exercise for chronic low back pain.
METHODS: Eighty-seven community volunteers with low back pain for ≥3 months and age 18-70 were randomized to either the Pilates (n = 44) or general exercise (n = 43) group. The primary outcome was pain/disability measured with the Quebec scale. Secondary outcomes included pain on a numeric rating scale, Patient-Specific Functional Scale, Pain Self-efficacy Questionnaire, quality of life, and global perceived effect of treatment. All participants attended 60-min exercise sessions twice weekly for 6 wk supervised by a physiotherapist and performed daily home exercises that were continued during the follow-up. Participants from the clinical Pilates group received an individualized direction-specific exercise program prescribed by the physiotherapist after a clinical examination. The general exercise group received a generic set of exercises that were multidirectional and nonspecific. Outcomes were assessed after 6 wk (primary time point) and at 12 and 24 wk. Differences in mean change were compared between groups using ANCOVA adjusted for baseline values of the outcome.
RESULTS: Eighty-three participants (96%) completed the 6-wk intervention and 60 (69%) completed the 24-wk follow-up. At 6 wk, no difference was found between groups for change in the Quebec scale (3.5, 95% confidence interval = -7.3 to 0.3, P = 0.07); both groups showed significant improvements. Similar results were found at the 12- and 24-wk follow-up and for the secondary outcome measures.
CONCLUSIONS: An individualized clinical Pilates program produced similar beneficial effects on self-reported disability, pain, function and health-related quality of life as a general exercise program in community volunteers with chronic low back pain.
BACKGROUND: Pilates has been advocated to be of benefit for patients with low back pain (LBP). The aim of this study was to investigate the possible benefits of attending Pilates classes for patients who had completed standard physiotherapy treatment but still had some symptoms. METHODS: Ethical approval was obtained. All LBP patient charts (n=181) who had completed physiotherapy treatment in the participating hospital during a 6 month period were screened for study inclusion. 29 women (16%) were recruited into the study. Subjects were randomly allocated either to attendance at a one hour Pilates mat class consisting of modified Pilates exercises for 8 weeks (n=15) or no further intervention (n=14). Outcome measures were evaluated by a blinded assessor using Visual Analogue Scale (VAS) for pain, Roland Morris Disability Questionnaire for disability and Sahrmann Abdominal Test for lumbopelvic control before and after the 8 week intervention period. RESULTS: Statistical Package for the Social Sciences (SPSS) version 15.0 was used to analyse data. The Mann-Whitley U test was used to identify any significant changes between the groups. There was a statistical (p=0.047) but not clinically significant improvement in pain in the Pilates group (9.5mm mean change on VAS) compared to the control group (−4.7mm). No significant difference in disability was noted between the groups at follow up (p=0.301). A trend towards improvement in lumbopelvic control was observed in the Pilates group. CONCLUSION: Despite the small sample size this study provides some evidence to support the use an 8 week Pilates class to improve pain in women with ongoing LBP who have completed conventional physiotherapy treatment.
The objectives of this study were to compare the effects of three different Pilates regimes on chronic, mild low back pain symptoms and to determine whether the efficiency of load transfer through the pelvis is improved by those exercises.A between subjects equivalent group experimental design was used. The independent variable was the type of exercise training (three groups) and the two-dependent variables were low back pain symptoms and load transfer through the pelvis.The outcome measures of the first-dependent variable were a comparison between modified Oswestry Disability Questionnaires (one of the standard pain instruments) completed pre- and post-program and frequency, intensity and duration of low back pain.
The outcome measure of the second-dependent variable, efficiency of load transfer through the pelvis was the Stork test (one-legged standing test) in weight bearing.Although all groups experienced statistically significant reductions in frequency, intensity and duration of low back pain across the weeks of exercising, there were no significant differences between the groups relative to each other.
OBJECTIVE: To evaluate the effect of a program of modified Pilates for active individuals with chronic non-specific low back pain. DESIGN: A single blind randomized controlled trial. Participants: 49 individuals with chronic low back pain were randomly allocated to control (n = 24) or Pilates group (n = 25). Thirty-four individuals completed the study (14 and 20 individuals for control and Pilates group, respectively). INTERVENTION: The Pilates group undertook a six week program of Pilates. Both groups continued with normal activity. MAIN OUTCOME MEASURES: An assessor blinded to group allocation conducted functional and questionnaire-based assessments pre- and post- intervention. RESULTS: Improvements were seen in the Pilates group post- intervention period with increases (P < 0.05) in general health, sports functioning, flexibility, proprioception, and a decrease in pain. The control group showed no significant differences in the same measures post- intervention. CONCLUSIONS: These data suggest that Pilates used as a specific core stability exercise incorporating functional movements can improve non-specific chronic low back pain in an active population compared to no intervention. Additionally, Pilates can improve general health, pain level, sports functioning, flexibility, and proprioception in individuals with chronic low back pain.
STUDY DESIGN: A randomized controlled trial, prestest-posttest design, with a 3-, 6-, and 12-month follow-up.
OBJECTIVES: To investigate the efficacy of a therapeutic exercise approach in a population with chronic low back pain (LBP).
BACKGROUND: Therapeutic approaches developed from the Pilates method are becoming increasingly popular; however, there have been no reports on their efficacy.
METHODS AND MEASURES: Thirty-nine physically active subjects between 20 and 55 years old with chronic LBP were randomly assigned to 1 of 2 groups. The specific-exercise-training group participated in a 4-week program consisting of training on specialized (Pilates) exercise equipment, while the control group received the usual care, defined as consultation with a physician and other specialists and healthcare professionals, as necessary. Treatment sessions were designed to train the activation of specific muscles thought to stabilize the lumbar-pelvic region. Functional disability outcomes were measured with The Roland Morris Disability Questionnaire (RMQ/RMDQ-HK) and average pain intensity using a 101-point numerical rating scale.
RESULTS: There was a significantly lower level of functional disability (P = .023) and average pain intensity (P = .002) in the specific-exercise-training group than in the control group following the treatment intervention period. The posttest adjusted mean in functional disability level in the specific-exercise-training group was 2.0 (95% CI, 1.3 to 2.7) RMQ/RMDQ-HK points compared to a posttest adjusted mean in the control group of 3.2 (95% CI, 2.5 to 4.0) RMQ/RMDQ-HK points. The posttest adjusted mean in pain intensity in the specific-exercise-training group was 18.3 (95% CI, 11.8 to 24.8), as compared to 33.9 (95% CI, 26.9 to 41.0) in the control group. Improved disability scores in the specific-exercise-training group were maintained for up to 12 months following treatment intervention.
CONCLUSIONS: The individuals in the specific-exercise-training group reported a significant decrease in LBP and disability, which was maintained over a 12-month follow-up period. Treatment with a modified Pilates-based approach was more efficacious than usual care in a population with chronic, unresolved LBP.
The Pilates method has been used to improve function and reduce pain in patients with chronic nonspecific low back pain, although there is little scientific evidence that describes its efficacy.
OBJECTIVE:
The purpose of this study was to investigate the effectiveness of the addition of modified Pilates exercises to minimal intervention in patients with chronic low back pain.
DESIGN:
A randomized controlled trial was conducted.
SETTING:
The study was done in an outpatient physical therapy department in Brazil.
PATIENTS:
Eighty-six patients with chronic nonspecific low back pain participated in the study.
INTERVENTION:
All participants received an education booklet containing information about low back pain and were randomly allocated to receive 12 sessions, over 6 weeks, of exercises based upon Pilates principles (n=43) or of education alone (n=43).
MEASUREMENTS:
Primary outcomes were pain intensity and disability measured at 6 weeks and 6 months. Secondary outcomes were patient-specific functional disability, global impression of recovery, and kinesiophobia measured at 6 weeks and 6 months. All outcomes were measured by a blinded assessor in all time points.
RESULTS:
There was no loss to follow-up at any of the time points. Improvements were observed in pain (mean difference=2.2 points, 95% confidence interval [CI]=1.1 to 3.2), disability (mean difference=2.7 points, 95% CI=1.0 to 4.4), and global impression of recovery (mean difference=-1.5 points, 95% CI=-2.6 to -0.4) in favor of the Pilates group after intervention, but these differences were no longer statistically significant at 6 months.
LIMITATIONS:
Treatment provider and participants could not be blinded to the interventions.
CONCLUSIONS:
The addition of modified Pilates exercises to an educational booklet provides small benefits compared with education alone in patients with chronic nonspecific low back pain; however, these effects were not sustained over time.
