ack pain is a common cause of disability and work loss, creating a large socioeconomic burden in developed countries. 17,26,32,45 Between 60% and 80% of adults will be affected with low back pain during their lifetime. 4,18 It has been reported that between 30% and 40% of individuals with acute low back pain never completely recover, developing chronic low back pain. 31,39 In addition to its high prevalence, the source of pain is not well-established in the majority of individuals with back pain, and the term "nonspecific low back pain" is often used to describe this population. 21,35,37 In recent years, there has been a growing number of reports on the benefits of Pilates-based exercises for low back pain. 7,13,14,20,24,29,42,43 Concomitantly, an increasing number of healthcare practitioners are using the Pilates-based approach for rehabilitation.3 Despite the limited number of randomized controlled trials investigating this exercise approach, proponents have claimed improved torso or core strength, with mentions of greater range of motion, muscle symmetry, flexibility, 42 spinal and joint mobility, and proprioception, balance, and coordination. 7,44 In a previous systematic review, La Touche et al 27 highlighted the importance of distinguishing Pilates-based exercises from the classic Pilates Method. The Pilates Method is an exercise form that has been popular for decades among choreographers and dance instructors in the field of dance medicine,
T T OBJECTIVES:To compare pain and disability in individuals with persistent nonspecific low back pain who were treated with Pilates exercises compared to minimal or other interventions.
T T METHODS: Searches of Medline, CINAHL,Embase, Cochrane library, PEDro, and ProQuest Dissertations and Thesis databases were conducted. Randomized controlled trials (RCTs) were selected and reviewed if they compared pain and disability in individuals with persistent nonspecific low back pain who were treated with Pilates exercises compared to other treatment approaches. Quality of the trials was evaluated. Data for pain and disability scores were extracted. Narrative synthesis plus meta-analyses were performed, with either a fixed-effects or random-effects model, standardized mean differences (SMDs), and tests for heterogeneity.
T T RESULTS:Seven RCTs were identified and included in the meta-analyses. Data pooling was performed using RevMan 5. When compared to minimal intervention, Pilates-based exercise provided superior pain relief (pooled SMD, -2.72; 95% CI: -5.33, -0.11; P = .04) but the pooled disability scores were not significantly different (pooled SMD, -0.74; 95% CI: -1.81, 0.33; P = .17). No significant differences were found when comparing Pilates-based exercise to other forms of exercise for pain (pooled SMD, 0.03; 95% CI: -0.52, 0.58; P = .92) or disability scores (pooled SMD, -0.41; 95% CI: -0.96, 0.14; P = .14).
T T CONCLUSION:Pilates-based exercises are superior to minimal intervention for pain relief. Existing evidence does not establish superiority of Pilates-based...