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Silva M.L.1, Miyamoto G.C.1, Ferro Moura Franco K.1, Cabral C.M.N.1
1Universidade Cidade de Sao Paulo, Master's and Doctoral Program in Physical Therapy, Sao Paulo, Brazil
Background: Low back pain is a serious public health problem with enormous costs, high level of disability and absenteeism. Pilates method has been recommended for the treatment of chronic low back pain to improve pain and disability. However, there is a lack of evidence about the daily assessment of pain during treatment with Pilates method and if different weekly frequencies can accelerate the improvement of symptoms in patients with chronic low back pain.
Purpose: To analyze whether different weekly frequencies of the Pilates method can accelerate the improvement of patients with chronic low back pain and the number of weeks that are necessary to reduce pain in 30%, 50% and 100%.
Methods: This study is a secondary analysis of a randomized controlled trial that analyzed 222 patients with chronic non-specific low back pain. These patients were randomized into three groups:
Pilates 1 (received treatment once week),
Pilates 2 (received treatment twice week) and
Pilates 3 (received treatment three times a week).
All groups received treatment based on the Pilates method during six weeks. Pain intensity was measured daily before and after treatment using the Pain Numerical Rating Scale. Statistical analysis was performed using survival analysis by the Kaplan-Meier method, and the groups were compared using the log-rank test.
Results: There was not statistically significant difference between the groups in any comparisons (p>0.05). All groups reduced 30%, 50% and 100% of pain intensity in the same speed after treatment. Pilates method improved 30% of pain intensity in a mean of 1.4 week, 50% in 1.6 week and 100% in 2.0 weeks in the three groups. After the first week of treatment, 44.6% of the patients in the group Pilates 3 showed complete pain improvement, followed by 37.8% of the patients in the group Pilates 2 and 29.7% in the group Pilates 1. After the last week of treatment, results showed that the percent of patients with reduction of 30 and 50% of pain intensity was very similar in the three groups (30% of reduction: 94.4% in Pilates 2, 91.9% in Pilates 1 and 3; 50% of reduction: 93.2% in Pilates 2, 91.9% in Pilates 1 and 3). However, 77% and 78.4% of patients obtained complete improvement of symptoms in the groups Pilates 2 and 3 respectively after the last week, while 71.6% of patients in the group Pilates 1 obtained this improvement at the end of the treatment.
Conclusion(s): Different weekly frequencies of treatment based in the Pilates method did not accelerate the improvement of pain intensity in patients with chronic non-specific low back pain. However, treatment with the Pilates method performed twice and three times a week can lead to complete improvement of symptoms in a bigger number of patients.
Implications: Despite higher weekly frequencies promote more patients to a complete improvement of symptoms, a lower weekly frequency can result in lower costs with respect to the treatment of this health condition. Thus, these results may help in clinical decision making.
Funding acknowledgements: Sao Paulo Research Foundation (FAPESP process numbers: 2013/26321-8 and 2016/0715-2) and National Council for Scientific and Technological Development (CNPq).
Topic: Musculoskeletal: spine
Ethics approval: Approved by the Research Ethics Committee of Universidade Cidade de São Paulo (CAAE: 29303014.7.0000.0064), Brazil.
All authors, affiliations and abstracts have been published as submitted.
