III.

BACKGROUND: Although the Pilates method has been reported to be effective in women with low back pain (LBP), the efficacy of Pilates exercises in pregnant women with LBP has not been evaluated widely. OBJECTIVE: The purpose of this study was to determine the effects of clinical Pilates exercises on lumbopelvic stabilization, pain, disability and quality of life in pregnant women with LBP. METHODS: Fourty pregnant women were randomized into either a Pilates exercise group (n= 20) or control group (n= 20). Subjects in the Pilates exercise group performed the exercises two times a week for eight weeks. Subjects in the control group followed regular prenatal care. Lumbopelvic stabilization was assessed with a pressure biofeedback unit, pain with the Visual Analog Scale, disability with the Oswestry Low Back Pain Questionnaire and quality of life with the Nottingham Health Profile (NHP). RESULTS: Pain and disability were significantly improved in the Pilates exercise group after intervention (p= 0.03, p< 0.001, respectively). There were also significant improvements in sleep, physical mobility sub-parameters of NHP and lumbopelvic stabilization after Pilates exercises (p= 0.048, p= 0.007, respectively). However, there were no statistically significant changes in all outcome measures in the control group (p> 0.05). CONCLUSIONS: Pilates exercises can be recommended as an effective and safe method for increasing lumbopelvic stabilization, reducing pain and disability, improving physical mobility and sleep problems in pregnant women with LBP.

Prospective comparative study, Level II.

Background:The relationship between one-leg static standing balance (OLSSB) and patellofemoral pain syndrome (PFPS) is unknown.Hypothesis:OLSSB decreases in patients with PFPS.Design:Prospective case series.Methods:Fifty-two women with unilateral PFPS were enrolled in this study. OLSSB was evaluated with a stabilometer. Q angle was measured with a lengthened-arm universal goniometer. Lower extremity alignment was analyzed with full-length standing anteroposterior teleroentgenograms. Quadriceps and hamstring strength was measured on an isokinetic dynamometer.Results:There were significant differences in OLSSB, Q angle, and strength of quadriceps and hamstring between the symptomatic and asymptomatic sides. There was a correlation between the strength of the quadriceps and hamstring and OLSSB, while there was no correlation between OLSSB and the severity of pain, lower extremity alignment, and Q angle on the symptomatic side.Conclusions:OLSSB and quadriceps and hamstring strength decreased and Q angle increased on the symptomatic side in PFPS patients. A relationship between OLSSB and pain, Q angle, and lower extremity alignment was not detected, while there was a correlation between the strength of the quadriceps and hamstring and OLSSB.Clinical Relevance:A quadriceps and hamstring strengthening may be beneficial to improve OLSSB in patients with PFPS.

Although muscle strength and functional performance clearly increased from the 6th to the 12th mo after surgery, coordination characteristics of involved side remained low. This pattern demonstrated that motor-coordination progression was not affected by strength development. Patients continued to have significant motor-coordination deficits even 12 mo postsurgery. Therefore, the authors recommend that neuromuscular-coordination exercises be included in long-term rehabilitation programs to improve motor coordination.