Pilates-Based Therapeutic Exercise: Effect on Subjects With Nonspecific Chronic Low Back Pain and Functional Disability: A Randomized Controlled Trial

Abstract

Study Design: A randomized controlled trial, pretest-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. Kingston, Ontario K7L 3N6, modified Pilates-based approach was more efficacious than usual care in a population with chronic, unresolved LBP.

The Pilates method in the rehabilitation of musculoskeletal disorders: a systematic review

“…The 14 studies included the following populations and samples: 31 university students of 22 ± 2 years of age (20) (25); 60 patients with breast ncer aged between 18 and 75 years (26); 39 physically active adults with a mean age of 34 ± 8 years for the control group and 37 ± 9 years for the exercise group (27); 40 healthy men and women with a mean age of 31.65 ± 6.21 years (11); 10 healthy subjects with a mean age of 33.1 ± 8.6 years in the Pilates group and 9 healthy individuals with a mean age of 28.6 ± 3.7 years in the Control group (28); 34 healthy adults equally divided into two groups, with a mean age of 27.3 ± 4 years in the control group and 27.5 ± 3.6 years of age in the Pilates group (29); 34 patients with chronic lower back pain and a mean age of 40.6 ± 9.7 years (8); 39 recently hospitalized, elderly patients (30). In the study of Gladwell et al (8), there were signi icant differences between the Pilates and Control groups in terms of age, however, not for the initial measures.…”

“…The aims of the studies of Table 1, were to evaluate the ef icacy of the Pilates Method regarding pain (20,23,25,27,8), lexibilidade (21,9,26,11), strength (22,28), balance (22,9,24,29), functionality (22,23,24,25,27,8), quality of life (23,24,26), muscular resistance (9), posture (9), fatigue (26), lumbo-pelvic stability (11), to quantify the effects of a Pilates program in the biomechanics of the shoulder and trunk (28), and to measure the participation and adherence to Pilates exercises (30).…”

“…The following instruments were used to evaluate pain: Borg CR10 scale (20), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (23), Oswestry Low Back Pain Disability Questionnaire (25), pain sub-scale of the Miami Back Index (25), pain sub-scale of the SF-36 (25) Numerical Rating Scale of 101 points (NRS-101) (27), and Roland Morris pain rating visual-analog scale (8). Flexibility was evaluated through: lexibility test on the Wells bench (21, 9, 11), leximeter (21), supine hamstring lexion test (9), and modi ied sit and reach test (26).…”

Analysis of lower limb force in foot work exercise of Pilates

“…The popularity of Pilates has stimulated the development of studies investigating its effectiveness, evaluating the effects of training programs on different parameters such as muscle strength and muscle endurance (1,2), lexibility (3,4), decreased pain (5,6), joint function restoration (5, 7) among others. Given the positive results, the method has been increasingly indicated and used in training and orthopedic rehabilitation programs, with emphasis on the rehabilitation of lower limbs (7,8).…”

Avaliação eletromiográfica comparativa de diferentes exercícios em quadrupedia do método Pilates

“…Estes exercícios são clinicamente recomendados 5,27,28 porque têm a finalidade de desafiar a estabilidade da musculatura do tronco, mantendo posições padrões de tronco e de pelve, enquanto ciclicamente movimenta o quadril em flexão e extensão 25,29 .…”