Santos M1, Machado E1, Caetano C1, Souza C1, Freitas L1, Fernandes B1
1Pontifical Catholic University of Minas Gerais, Physiotherapy, Poços de Caldas, Brazil
Background: Low back pain is a major health and socioeconomic problem and one of the main causes of disability and absenteeism. The effect of the treatments recommended by guidelines for chronic low back pain is moderate. Exercise is the physical therapy treatment for chronic low back pain that shows the most lasting and positive effects.
Purpose: The aim of this study was to evaluate the effectiveness of Pilates Method and "Back School" program in the treatment of chronic non-specific low back pain.
Methods: This randomized controlled trial with blinded assessor was conducted at the Physical Therapy Clinic of the Pontifical Catholic University of Minas Gerais, Poços de Caldas campus, Brazil. Eighty-four patients of both genders with a mean age of 47.29±15.47 years who had low back pain for at least three months were allocated randomly into two groups: Pilates Group, consisting in 16 sessions of Pilates Method exercises, twice a week, for two months, and the Control Group, whose participants received only orientations from the "Back School" program, once a week, for 10 weeks.
Outcomes measured were pain (numerical rating scale), flexibility (fingertip-to-floor test), functional disability (Roland-Morris Disability Questionnaire, RMDQ), health-related quality of life (HRQoL; Short-Form 36 Health Survey, SF-36) and sleep quality (Pittsburgh Sleep Quality Index). Patients were assessed at baseline, at the end of treatment, and at 2 months after treatment. Intention-to-treat analysis was carried out using "last observation carried forward" method.
Results: The results showed that both groups presented significant improvement (P 0.05) in pain reduction and in two domains of quality of life (pain and functional capacity). In the Pilates Group, there was also improvement (P 0.05) in functional capacity, flexibility, sleep quality and three other domains of quality of life (physical aspects, vitality and general health status). At the end of treatment, the Pilates Group was superior to Control Group (P 0.05) in functional capacity and flexibility. At follow-up, Pilates Group was superior to Control Group (P 0.05) only in general health. It was concluded that, in the short term, both interventions can be considered as a valid alternative to reduce the pain of individuals with chronic low back pain. However, Pilates was superior to the "Back School" program in pain reduction and improving functional capacity, flexibility and in five domains of quality of life (pain, physical aspects, general health, functional capacity and vitality).
Conclusion(s): In the short term, both interventions can be considered as a valid alternative to reduce the pain of individuals with chronic low back pain. However, Pilates was superior to the "Back School" program in pain reduction and improving functional capacity, flexibility and in five domains of quality of life (pain, physical aspects, general health, functional capacity and vitality).
Thus, it can be inferred that the Pilates method was effective in the treatment of chronic nonspecific low back pain, however, these results need to be better investigated.
Implications: Pilates method exercises can therefore be recommended for the improvement of pain and disability, but no definitive conclusion can be made regarding the analyzed outcomes.
Keywords: low back pain, randomized controlled trial., exercise therapy
Funding acknowledgements: Program of Scientific Initiation Scholarships (PROBIC) of the Pontifical Catholic University of Minas Gerais
Purpose: The aim of this study was to evaluate the effectiveness of Pilates Method and "Back School" program in the treatment of chronic non-specific low back pain.
Methods: This randomized controlled trial with blinded assessor was conducted at the Physical Therapy Clinic of the Pontifical Catholic University of Minas Gerais, Poços de Caldas campus, Brazil. Eighty-four patients of both genders with a mean age of 47.29±15.47 years who had low back pain for at least three months were allocated randomly into two groups: Pilates Group, consisting in 16 sessions of Pilates Method exercises, twice a week, for two months, and the Control Group, whose participants received only orientations from the "Back School" program, once a week, for 10 weeks.
Outcomes measured were pain (numerical rating scale), flexibility (fingertip-to-floor test), functional disability (Roland-Morris Disability Questionnaire, RMDQ), health-related quality of life (HRQoL; Short-Form 36 Health Survey, SF-36) and sleep quality (Pittsburgh Sleep Quality Index). Patients were assessed at baseline, at the end of treatment, and at 2 months after treatment. Intention-to-treat analysis was carried out using "last observation carried forward" method.
Results: The results showed that both groups presented significant improvement (P 0.05) in pain reduction and in two domains of quality of life (pain and functional capacity). In the Pilates Group, there was also improvement (P 0.05) in functional capacity, flexibility, sleep quality and three other domains of quality of life (physical aspects, vitality and general health status). At the end of treatment, the Pilates Group was superior to Control Group (P 0.05) in functional capacity and flexibility. At follow-up, Pilates Group was superior to Control Group (P 0.05) only in general health. It was concluded that, in the short term, both interventions can be considered as a valid alternative to reduce the pain of individuals with chronic low back pain. However, Pilates was superior to the "Back School" program in pain reduction and improving functional capacity, flexibility and in five domains of quality of life (pain, physical aspects, general health, functional capacity and vitality).
Conclusion(s): In the short term, both interventions can be considered as a valid alternative to reduce the pain of individuals with chronic low back pain. However, Pilates was superior to the "Back School" program in pain reduction and improving functional capacity, flexibility and in five domains of quality of life (pain, physical aspects, general health, functional capacity and vitality).
Thus, it can be inferred that the Pilates method was effective in the treatment of chronic nonspecific low back pain, however, these results need to be better investigated.
Implications: Pilates method exercises can therefore be recommended for the improvement of pain and disability, but no definitive conclusion can be made regarding the analyzed outcomes.
Keywords: low back pain, randomized controlled trial., exercise therapy
Funding acknowledgements: Program of Scientific Initiation Scholarships (PROBIC) of the Pontifical Catholic University of Minas Gerais
Topic: Musculoskeletal: spine; Disability & rehabilitation; Pain & pain management
Ethics approval required: Yes
Institution: Pontifical Catholic University of Minas Gerais - PUC MG
Ethics committee: Ethics Committee - Pontifical Catholic University of Minas Gerais
Ethics number: CAAE: 36579514.1.0000.5137.
All authors, affiliations and abstracts have been published as submitted.
