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Sepiddar F, Barati AH, Yarahmadi Y. The effect of pelvic clock exercises on pain reduction and lumbopelvic proprioception in middle-aged women with chronic nonspecific low back pain (CNSLBP). J Bodyw Mov Ther 2024; 38:615-620. [PMID: 38763616 DOI: 10.1016/j.jbmt.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 08/03/2023] [Accepted: 11/12/2023] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Low-back pain (LBP) is one of the most common causes of disability in adults. There are many non-invasive interventions to improve this condition, of which the use of exercise therapy is one of the most widely used. But there is contradictory evidence regarding the effectiveness of different types of exercise methods. Therefore, the current research aimed to investigate the effect of pelvic clock exercises on pain reduction and lumbopelvic proprioception in women with chronic nonspecific low back pain (CNSLBP). MATERIALS AND METHODS This was a quasi-experimental study with a controlled pre-test-post-test design. The study population included middle-aged women with CNSLBP with an age range of 35-50 years. A total of 30 eligible middle-aged women with CNSLBP were selected using purposive and convenience sampling. The pelvic clock exercise was carried out by the researcher in a gym for eight 45- min sessions each week (three sessions each week). A visual analog scale (VAS) and goniometer were used to measure pain and lumbopelvic proprioception, respectively. However, the control group only participated in the pre-test and post-test stages. For intra-group and inter-group comparisons, paired t-test and independent t-test were used at P < 0.05, respectively. RESULTS The results showed that eight-week pelvic clock exercises had an effect on decreased pain and increase lumbopelvic proprioception in middle-aged women with CNSLBP, but no effect was observed in the control group (P > 0.05). CONCLUSION According to the results of the present study, pelvic clock exercises should be used as a new and practical method to reduce pain and improve lumbopelvic proprioception in middle-aged women with CNSLBP.
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Affiliation(s)
- Forough Sepiddar
- Islamic Azad University, Science and Research Branch, Faculty of Literature and Humanities, Department of Physical Education and Sports Science, Tehran, Iran
| | - Amir Hosein Barati
- Department of Health and Sports Rehabilitation, Faculty of Sports Science, Shahid Beheshti University, Tehran, Iran.
| | - Yousef Yarahmadi
- Department of Biomechanics and Sport Injuries, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
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Siriteerathitikul P, Wongmanakul S, Kunyalue M, Khamthai P. Comparison of the efficacy of acupuncture at the TUNG’s extra points and the traditional Chinese medicine points for elderly patients with chronic low back pain in Thailand. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2022. [PMCID: PMC9638471 DOI: 10.1007/s11726-022-1331-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective To compare the efficacy of acupuncture at TUNG’s extra points and traditional Chinese medicine (TCM) points for elderly patients with chronic low back pain (CLBP) in Thailand. Methods A single-blinded, randomized controlled trial with 84 elderly volunteers with CLBP was designed. The patients were randomly assigned either to the group getting acupuncture at TUNG’s extra points or to the group getting acupuncture at TCM points. The treatment period was 30 min per session for seven consecutive days. Before and after treatment, the score of the numeric rating scale (NRS), the back range of motion (BROM), and the back strength were measured and compared. Results After treatment, both groups were found with decreased NRS scores and increased BROM (P<0.05), but with no statistical difference in their back strength in comparison with that before treatment in the same group (P>0.05). Regarding the between-group comparison, no significant differences were found in the NRS score or BROM in the direction of forward flexion and right lateral flexion or the back strength after treatment (P>0.05). However, statistical differences were found in the BROM in directions of back extension (P<0.01) and left lateral flexion (P<0.05). Conclusion Acupuncture at TUNG’s extra points can decrease the low back pain NRS score and increase the back strength and the BROM in directions of forward flexion and right lateral flexion, equivalent to acupuncture at TCM points. Acupuncture at TCM points has a better effect in increasing the BROM in directions of back extension and left lateral flexion; acupuncture at TUNG’s extra points is suitable for elderly CLBP patients, and it should be supported and promoted.
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Grooten WJA, Boström C, Dedering Å, Halvorsen M, Kuster RP, Nilsson-Wikmar L, Olsson CB, Rovner G, Tseli E, Rasmussen-Barr E. Summarizing the effects of different exercise types in chronic low back pain - a systematic review of systematic reviews. BMC Musculoskelet Disord 2022; 23:801. [PMID: 35996124 PMCID: PMC9394044 DOI: 10.1186/s12891-022-05722-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 08/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background In chronic LBP (CLBP), guideline-endorsed treatment is to stay active, return to normal activity, and to exercise. Several reviews on various exercise types used in CLBP have been published. We aimed to identify systematic reviews of common exercise types used in CLBP, to appraise their quality, and to summarize and compare their effect on pain and disability. Methods We searched the databases OVID MEDLINE, EMBASE, COCHRANE LIBRARY, and WEB OF SCIENCE (Core collection) for systematic reviews and meta-analyses on adults between 18 and 70 years of age suffering from chronic or recurrent LBP for a period of at least 12 weeks, which investigated the effects of exercises on pain and disability. All searches were conducted without language restriction. The search was performed up until 2022–01-26. The included reviews were grouped into nine exercise types: aerobic training, aquatic exercises, motor control exercises (MCE), resistance training, Pilates, sling exercises, traditional Chinese exercises (TCE), walking, and yoga. The study quality was assessed with AMSTAR-2. For each exercise type, a narrative analysis was performed, and the level of evidence for the effects of exercise was assessed through GRADE. Results Our database search resulted in 3,475 systematic reviews. Out of the 253 full texts that were screened, we included 45 systematic reviews and meta-analyses. The quality of the included reviews ranged from high to critically low. Due to large heterogeneity, no meta-analyses were performed. We found low-to-moderate evidence of mainly short-term and small beneficial effects on pain and disability for MCE, Pilates, resistance training, TCE, and yoga compared to no or minimal intervention. Conclusions Our findings show that the effect of various exercise types used in CLBP on pain and disability varies with no major difference between exercise types. Many of the included systematic reviews were of low-to-moderate quality and based on randomized controlled trials with high risk of bias. The conflicting results seen, undermine the certainty of the results leading to very-low-to-moderate quality of evidence for our results. Future systematic reviews should be of higher quality to minimize waste of resources. Trial registration PROSPERO: Reg no 190409 Registration date 01AUG 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05722-x.
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Affiliation(s)
- Wilhelmus Johannes Andreas Grooten
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden.,Department of Occupational Therapy and Physiotherapy, Women's Health and Allied Health Professionals' Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Carina Boström
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden.,Department of Occupational Therapy and Physiotherapy, Women's Health and Allied Health Professionals' Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Åsa Dedering
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden.,The Health and Medical Care Administration, Region Dalarna, Falun, Sweden
| | - Marie Halvorsen
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden.,Department of Occupational Therapy and Physiotherapy, Women's Health and Allied Health Professionals' Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Roman P Kuster
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden
| | - Lena Nilsson-Wikmar
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden
| | - Christina B Olsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden.,Academic Primary Healthcare Centre, Region Stockholm, Stockholm, Sweden
| | - Graciela Rovner
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden.,ACT Institutet Sweden, Gothenburg, Sweden
| | - Elena Tseli
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden.,School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Eva Rasmussen-Barr
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden.
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Denham-Jones L, Gaskell L, Spence N, Pigott T. A systematic review of the effectiveness of Pilates on pain, disability, physical function, and quality of life in older adults with chronic musculoskeletal conditions. Musculoskeletal Care 2021; 20:10-30. [PMID: 34028164 DOI: 10.1002/msc.1563] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/08/2021] [Accepted: 05/09/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This systematic review aims to evaluate the effectiveness and delivery of Pilates to reduce pain and disability and to improve physical function and quality of life in middle-aged to older adults with a range of chronic musculoskeletal conditions. METHODS Searches were conducted using CENTRAL, CINAHL, SCOPUS, Pubmed, PsycInfo, Web of Science Core Collection and Google Scholar. Inclusion criteria were controlled trials and observational studies, population mean age 50 years and over with chronic musculoskeletal conditions, using mat-based Pilates exercise. Outcomes included pain, disability, physical function and quality of life. RESULTS Seven studies were included, with a combined total sample of 397 participants (73% female). Pilates was significantly effective (p ≤ 0.05) for reducing back pain, neck pain and pain associated with knee osteoarthritis and osteoporosis. Additional significant disability, physical functioning and quality of life effects were found for back pain, osteoporosis, and knee OA. Overall Pilates was as effective as other exercise. Adherence to group exercise was good, but poor for home exercise. No significant adverse effects were reported. CONCLUSION Pilates is a safe and effective exercise intervention for adults over 50 with a diverse range of musculoskeletal conditions which may otherwise put them at risk of becoming sedentary. Although no overall significant superiority was found over other exercise, participants reported psychosocial benefits particular to the Pilates group exercise, with enjoyment a possible positive factor in adherence. Further research on Pilates exercises for various pathologies could inform teaching and improve engagement with older adults, including those with chronic conditions.
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Affiliation(s)
| | - Lynne Gaskell
- School of Health & Society, University of Salford, Salford, UK
| | - Nicola Spence
- School of Health & Society, University of Salford, Salford, UK
| | - Tim Pigott
- School of Health & Society, University of Salford, Salford, UK
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The effect of pilates on metabolic control and oxidative stress of diabetics type 2 - A randomized controlled clinical trial. J Bodyw Mov Ther 2021; 27:60-66. [PMID: 34391294 DOI: 10.1016/j.jbmt.2021.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/28/2020] [Accepted: 01/13/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The Pilates method is an approach to body and mind exercises that has as its foundation the gain of stability, strength and flexibility, and the work of muscular control, posture and breathing, which can generate repercussions on oxidative stress and ROS production, it is expected that Pilates can satisfactorily influence glycemic and oxidative stress reduction in elderly diabetes. AIM To analyze the effect of a Pilates protocol on variables indicative of metabolic control and oxidative stress in patients with Type 2 Diabetes Mellitus. METHOD Randomized clinical trial in type 2 diabetics enrolled in Hiperdia Parnaíba. A Pilates protocol was performed for 8 weeks, with 2 weekly consultations. The tested variables were: blood glucose, glycated hemoglobin, lipid profile, C-reactive protein and malondialdehyde. ANOVA tests, correlation of Wilcoxon, Friedman and Spearman, were used, with a significance level of 5%. RESULTS 44 diabetics participated in the study (intervention group: 22; control: 22), with a mean age of 61.23 ± 8.49years, the majority being female (77.3%), married (59.1%), literate (31.8%), with an average BMI of 26.96 ± 4.35 kg/m2. When analyzing the effects of the protocol, there was a significant reduction in glycated hemoglobin (p = 0.002) and oxidative stress (p = 0.004) in the intervention group, however, there were no differences in fasting glucose (p = 0.055) and in the profile lipid, expressed by the total cholesterol (p = 0.654), HDL (p = 0.591), LDL (p = 0.564) and triglycerides (0.192). There was a moderate positive correlation between oxidative stress and glycated hemoglobin (r = 0.44, p = 0.000). CONCLUSION The exercise protocol based on the Pilates method produced a reduction in glycated hemoglobin and oxidative stress.
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Panhan AC, Gonçalves M, Eltz GD, Villalba MM, Cardozo AC, Bérzin F. Core muscle activation during Pilates exercises on the Wunda chair. J Bodyw Mov Ther 2020; 25:165-169. [PMID: 33714490 DOI: 10.1016/j.jbmt.2020.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 09/21/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
Abstract
OBJETIVES The Pilates method, developed by Joseph Pilates (1886-1967), has been widely used to improve trunk stability, muscle flexibility and strength, physical fitness, and body awareness. To measure the electromyography of four trunk muscles during three Pilates exercises carried out of the wunda chair. DESING: cross-section study. METHODS Sixteen women participated in this study with a height and body weight of 1.64 ± 0.04 m and 58.7 ± 7.4 kg, respectively, and a mean age of 27.6 ± 3.7 years. Rectus abdominis (RA), internal oblique (IO), longissimus (LO), and multifidus (MU) muscles was evaluated by electromyographic (EMG) tests activity during three Pilates exercises: going up front (GF), mountain climb (MC), and swan (SW). EMG was normalized and expressed in the time domain, by the RMS. RESULTS The highest EMG values concerning the four muscles were observed for the MC exercise, followed by GF and SW (ANOVA: p = 0.0001, p = 0.04, p = 0.0002, and p = 0.0013, respectively). Our results show that the three Pilates exercises could recruit all the muscles, with a moderate activity intensity. The ANOVA; p < 0.05 showed significant difference between the muscles, concerning SW (p = 0.0002). CONCLUSION Our results show that the three Pilates exercises could recruit all the muscles, with a moderate activity intensity.
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Affiliation(s)
- Ana C Panhan
- Department of Morphology (Anatomy), Piracicaba Dental School, UNICAMP. Piracicaba, São Paulo, Brazil.
| | - Mauro Gonçalves
- Department of Physical Education, São Paulo State University, UNESP. Rio Claro, São Paulo, Brazil
| | - Giovana D Eltz
- Department of Physical Education, São Paulo State University, UNESP. Rio Claro, São Paulo, Brazil
| | - Marina M Villalba
- Department of Physical Education, São Paulo State University, UNESP. Rio Claro, São Paulo, Brazil
| | - Adalgiso C Cardozo
- Department of Physical Education, São Paulo State University, UNESP. Rio Claro, São Paulo, Brazil
| | - Fausto Bérzin
- Department of Morphology (Anatomy), Piracicaba Dental School, UNICAMP. Piracicaba, São Paulo, Brazil
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de Medeiros SA, de Almeida Silva HJ, do Nascimento RM, da Silva Maia JB, de Almeida Lins CA, de Souza MC. Mat Pilates is as effective as aquatic aerobic exercise in treating women with fibromyalgia: a clinical, randomized and blind trial. Adv Rheumatol 2020; 60:21. [DOI: 10.1186/s42358-020-0124-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/25/2020] [Indexed: 01/07/2023] Open
Abstract
Abstract
Background
The mat Pilates method is the therapeutic modalities which can be used in fibromyalgia treatment. Although there are no well-designed studies that prove the effectiveness of the mat Pilates method in this population. The objective was to evaluate the effectiveness of the mat Pilates method for improving symptoms in women with fibromyalgia.
Methods
A single blind randomized controlled trial in which 42 women with fibromyalgia were randomized into two groups: mat Pilates and aquatic aerobic exercise. The exercises were performed twice a week for 12 weeks. Two evaluations were performed: one at baseline (T0), and another at 12 weeks after randomization (T12). The primary outcome was pain measured by the Visual Analogue Scale (VAS). Secondary outcomes were function (Fibromyalgia Impact Questionnaire), sleep (Pittsburgh Sleep Quality Index [PSQI]), quality of life (Short Form 36 [SF-36]), fear avoidance (Fear Avoidance Beliefs Questionnaire [FABQ-BR]) and pain catastrophizing (Pain-Related Catastrophizing Thoughts Scale [PRCTS]).
Results
There was improvement in both groups in relation to pain and function (p < 0.05). The aspects related to quality of life and the FABQ questionnaire only showed improvement in the mat Pilates group (p < 0.05). There was improvement in the PSQI and PRCTS variables only in the aquatic aerobic exercise group (p < 0.05), but no differences were observed between the groups for any of the evaluated variables.
Conclusion
Significant improvements were observed in the two groups in relation to the disease symptoms, and no differences were observed between mat Pilates and aquatic aerobic exercise in any of the measured variables.
Trial registration
ClinicalTrials.gov Identifier (NCT03149198), May 11, 2017. Approved by the Ethics Committee of FACISA/UFRN (Number: 2.116.314).
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Alves MC, de Souza Neto RJ, Barbosa RI, Marcolino AM, Kuriki HU. Effects of a Pilates protocol in individuals with non-specific low back pain compared with healthy individuals: Clinical and electromyographic analysis. Clin Biomech (Bristol, Avon) 2020; 72:172-178. [PMID: 31895994 DOI: 10.1016/j.clinbiomech.2019.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/01/2019] [Accepted: 12/16/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Electromyography may be useful for assessing and understanding trunk muscle activation, and Pilates is commonly used as a treatment for low back pain. The objective of this study was to verify electromyography of trunk muscles after a Pilates protocol in individuals with non-specific low back pain and in healthy individuals. METHODS Volunteers were divided into two groups: non-specific low back pain (n = 19) and clinically healthy (n = 16) groups. Clinical assessments, classification of patients into subgroups, electromyography evaluations of the right lumbar extensor and right transverse abdominal/internal oblique muscle of the abdomen were performed before and after an 8-week Pilates protocol. FINDINGS Comparisons were made before and after the protocol and with the control group. There was significant improvement in pain, flexibility, resistance and strength of trunk muscles. In addition, after the Pilates, there was a decrease in the time elapsed between the onset and peak of lumbar muscle activation during the evaluation of trunk extension in the low back pain group, coming closer to the time of the abdominal muscle, as it also occurred in the control group. INTERPRETATION Pilates caused clinical improvement and balanced trunk muscle activation in the low back group, becoming similar to that of the control group. Furthermore, the effects of the proposed protocol were the same between the groups. Thus, Pilates may be indicated for management of non-specific low back pain.
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Affiliation(s)
- Morgana Cardoso Alves
- Programa de Pós Graduação em Ciências da Reabilitação da Universidade Federal de Santa Catarina (PPGCR-UFSC), Araranguá, SC, Brazil; Laboratório de Avaliação e Reabilitação do Aparelho Locomotor da Universidade Federal de Santa Catarina (LARAL-UFSC), Araranguá, SC, Brazil
| | - Romeu Joaquim de Souza Neto
- Laboratório de Avaliação e Reabilitação do Aparelho Locomotor da Universidade Federal de Santa Catarina (LARAL-UFSC), Araranguá, SC, Brazil
| | - Rafael Inácio Barbosa
- Programa de Pós Graduação em Ciências da Reabilitação da Universidade Federal de Santa Catarina (PPGCR-UFSC), Araranguá, SC, Brazil; Laboratório de Avaliação e Reabilitação do Aparelho Locomotor da Universidade Federal de Santa Catarina (LARAL-UFSC), Araranguá, SC, Brazil
| | - Alexandre Márcio Marcolino
- Programa de Pós Graduação em Ciências da Reabilitação da Universidade Federal de Santa Catarina (PPGCR-UFSC), Araranguá, SC, Brazil; Laboratório de Avaliação e Reabilitação do Aparelho Locomotor da Universidade Federal de Santa Catarina (LARAL-UFSC), Araranguá, SC, Brazil
| | - Heloyse Uliam Kuriki
- Programa de Pós Graduação em Ciências da Reabilitação da Universidade Federal de Santa Catarina (PPGCR-UFSC), Araranguá, SC, Brazil; Laboratório de Avaliação e Reabilitação do Aparelho Locomotor da Universidade Federal de Santa Catarina (LARAL-UFSC), Araranguá, SC, Brazil.
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Lorenc A, Feder G, MacPherson H, Little P, Mercer SW, Sharp D. Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions. BMJ Open 2018; 8:e020222. [PMID: 30327397 PMCID: PMC6196876 DOI: 10.1136/bmjopen-2017-020222] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To identify potentially effective complementary approaches for musculoskeletal (MSK)-mental health (MH) comorbidity, by synthesising evidence on effectiveness, cost-effectiveness and safety from systematic reviews (SRs). DESIGN Scoping review of SRs. METHODS We searched literature databases, registries and reference lists, and contacted key authors and professional organisations to identify SRs of randomised controlled trials for complementary medicine for MSK or MH. Inclusion criteria were: published after 2004, studying adults, in English and scoring >50% on Assessing the Methodological Quality of Systematic Reviews (AMSTAR); quality appraisal checklist). SRs were synthesised to identify research priorities, based on moderate/good quality evidence, sample size and indication of cost-effectiveness and safety. RESULTS We included 84 MSK SRs and 27 MH SRs. Only one focused on MSK-MH comorbidity. Meditative approaches and yoga may improve MH outcomes in MSK populations. Yoga and tai chi had moderate/good evidence for MSK and MH conditions. SRs reported moderate/good quality evidence (any comparator) in a moderate/large population for: low back pain (LBP) (yoga, acupuncture, spinal manipulation/mobilisation, osteopathy), osteoarthritis (OA) (acupuncture, tai chi), neck pain (acupuncture, manipulation/manual therapy), myofascial trigger point pain (acupuncture), depression (mindfulness-based stress reduction (MBSR), meditation, tai chi, relaxation), anxiety (meditation/MBSR, moving meditation, yoga), sleep disorders (meditative/mind-body movement) and stress/distress (mindfulness). The majority of these complementary approaches had some evidence of safety-only three had evidence of harm. There was some evidence of cost-effectiveness for spinal manipulation/mobilisation and acupuncture for LBP, and manual therapy/manipulation for neck pain, but few SRs reviewed cost-effectiveness and many found no data. CONCLUSIONS Only one SR studied MSK-MH comorbidity. Research priorities for complementary medicine for both MSK and MH (LBP, OA, depression, anxiety and sleep problems) are yoga, mindfulness and tai chi. Despite the large number of SRs and the prevalence of comorbidity, more high-quality, large randomised controlled trials in comorbid populations are needed.
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Affiliation(s)
- Ava Lorenc
- Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Gene Feder
- Population Health Sciences, Bristol Medical School, Bristol, UK
| | | | - Paul Little
- Primary Care and Population Science Unit, University of Southampton, Southampton, UK
| | - Stewart W Mercer
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Deborah Sharp
- Population Health Sciences, Bristol Medical School, Bristol, UK
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de Araujo Cazotti L, Jones A, Roger-Silva D, Ribeiro LHC, Natour J. Effectiveness of the Pilates Method in the Treatment of Chronic Mechanical Neck Pain: A Randomized Controlled Trial. Arch Phys Med Rehabil 2018; 99:1740-1746. [DOI: 10.1016/j.apmr.2018.04.018] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 11/29/2022]
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Fleming KM, Herring MP. The effects of pilates on mental health outcomes: A meta-analysis of controlled trials. Complement Ther Med 2018; 37:80-95. [DOI: 10.1016/j.ctim.2018.02.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 02/07/2018] [Accepted: 02/12/2018] [Indexed: 12/11/2022] Open
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Yun SM, Park SK, Lim HS. Influence of pilates training on the quality of life of chronic stroke patients. J Phys Ther Sci 2017; 29:1830-1835. [PMID: 29184300 PMCID: PMC5684021 DOI: 10.1589/jpts.29.1830] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 07/18/2017] [Indexed: 01/17/2023] Open
Abstract
[Purpose] This study was to observe the influence of Pilates training on the quality of
life in chronic stoke patients. [Subjects and Methods] Forty chronic stroke patients
participated in this study. They were divided into same number of experimental group (EG)
and control group (CG). EG participated in a 60-min Pilates training program, twice a week
for 12 weeks, while the CG did not participate in any exercise-related activities for the
duration and participating in general occupational therapy without any exercise-related
activities. Then the MMSE-K was performed before and after Pilates training to observe the
influence of Pilates training on the quality of life in chronic stroke patients. [Results]
Statistically significant improvement in the physical, social, and psychological domains
was found in EG after the training. No statistically significant difference was found in
all three quality of life domains for the CG. EG experienced a statistically significant
improvement in all quality of life domains compared with that of CG. [Conclusion]
Therefore, participation in Pilates training was found to effectively improve the quality
of life in stroke patients. Pilates training involves low and intermediate intensity
resistance and repetition that match the patient’s physical ability and can be a remedial
exercise program that can improve physical ability and influence quality of life.
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Affiliation(s)
- Seok-Min Yun
- Department of Rehabilitation Sports Lab, Korea Nazarene University, Republic of Korea
| | - Sang-Kyoon Park
- Department of Physical Education, Korea National Sport University, Republic of Korea
| | - Hee Sung Lim
- Department of Physical Therapy, Gang Dong University: Janghowon-Eup Post Office Box-1, Inchen-si 138-763, Republic of Korea
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Martínez-Pubil J, Acebal-González A, Fernández Álvarez R, Vega-Álvarez J. Pilates en pacientes con espondilitis anquilosante: repercusión en la función pulmonar. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.ft.2017.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Mazloum V, Sahebozamani M, Barati A, Nakhaee N, Rabiei P. The effects of selective Pilates versus extension-based exercises on rehabilitation of low back pain. J Bodyw Mov Ther 2017; 22:999-1003. [PMID: 30368347 DOI: 10.1016/j.jbmt.2017.09.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 09/10/2017] [Accepted: 09/17/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Chronic non-specific low back pain (LBP) may lead to functional impairment and physical disability. The aim of this study was to compare the effects of selective Pilates (SP) and extension-based (EB) exercises on pain, lumbar spine curvature, lumbar forward flexion range of motion (ROM), and physical disability in such individuals. MATERIALS AND METHODS In this randomized clinical trial, Forty-seven patients with chronic non-specific LBP (Mean of age: 39.7 years) were randomly allocated into either SP (N = 16), EB (N = 15), or control (N = 16) groups. The measurements included pain intensity, physical disability, lumbar forward bending ROM, and lumbar spine curvature at the baseline, after receiving the 6-week interventions, and also following one month of cessation of the exercises The analysis of co-variance (ANCOVA) and Post-hoc Bonferroni tests were administered to compare the three groups after the interventions and one month later (P < 0.05). RESULTS More significant improvement was observed in SP group compared to the subjects receiving EB exercises in terms of pain, ROM, and physical disability (P < 0.001), however, there was no significant difference between the two experimental groups for lumbar curvature (P > 0.05). Furthermore; in follow-up, the patients in SP group significantly achieved a higher level of pain intensity improvement and lumbar flexion ROM than the EB exercises (P < 0.001). CONCLUSIONS It is estimated that core muscles activation and improving lumbopelvic rhythm in SP training may play a role in decreasing pain and physical disability in chronic LBP patients. Further high-quality studies are required to investigate the details of this mechanism.
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Affiliation(s)
- Vahid Mazloum
- Department of Physical Education and Sports Sciences, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Mansour Sahebozamani
- Department of Physical Education and Sports Sciences, Shahid Bahoonar University of Kerman, Kerman, Iran
| | - Amirhossein Barati
- Department of Physical Education and Sports Sciences, Shahid Beheshti University, Tehran, Iran
| | - Nouzar Nakhaee
- Department of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Pouya Rabiei
- Department of Physical Education and Sports Sciences, Karaj Branch, Islamic Azad University, Karaj, Iran.
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Roller M, Kachingwe A, Beling J, Ickes DM, Cabot A, Shrier G. Pilates Reformer exercises for fall risk reduction in older adults: A randomized controlled trial. J Bodyw Mov Ther 2017; 22:983-998. [PMID: 30368346 DOI: 10.1016/j.jbmt.2017.09.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 08/16/2017] [Accepted: 09/03/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the effects of Pilates exercises using a Reformer on measures of fall risk, balance and mobility, self-efficacy, and active range of motion in adults age 65 and over at risk for falls compared to a control group. DESIGN Randomized Controlled Trial. METHODS Fifty-five subjects (27 Pilates intervention, 28 control; 38 females, 17 males; mean age 77.6 years, range 65-95) were randomly assigned to either a Pilates Reformer intervention group or a control group (no intervention). Subjects in the intervention group attended a Pilates Reformer exercise program in a group format once a week over a 10-week period. The primary outcome measures were the Sensory Organization Test (SOT) composite scores on the NeuroCom® system, Timed Up-and-Go (TUG), and Activities-specific Balance Confidence (ABC) scale. The secondary outcome measures were the Adaptation Test (ADT), straight leg raise (SLR), hip extension, and ankle dorsiflexion active range of motion (AROM), Berg Balance Scale (BBS), and 10 Meter Walk Test (10MWT). RESULTS There was a significant interaction between group and time on the TUG, BBS, 10MWT, and SLR, hip extension, and ankle dorsiflexion AROM measurements. Over time, subjects in the Pilates intervention group improved their scores significantly on all mentioned measures, whereas subjects in the control group did not (P ≤ 0.05). Significantly improved AROM was found between groups following the Pilates intervention for hip extension, left SLR, and right ankle dorsiflexion. CONCLUSION Pilates Reformer exercises performed once per week for 10 weeks resulted in reduced fall risk and significant improvements in static and dynamic balance, functional mobility, balance self-efficacy, and lower extremity AROM in adults age 65 and older at risk for falling, whereas the control group did not significantly improve in any measures. Pilates Reformer exercises are more effective compared to no exercise intervention at improving hip and ankle AROM.
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Affiliation(s)
- Margaret Roller
- Department of Physical Therapy, California State University, Northridge, Northridge, CA, United States.
| | - Aimie Kachingwe
- Department of Physical Therapy, California State University, Northridge, Northridge, CA, United States
| | - Janna Beling
- Department of Physical Therapy, California State University, Northridge, Northridge, CA, United States
| | - Dawn-Marie Ickes
- Department of Physical Therapy, Mount Saint Mary's University, Los Angeles, CA, United States
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Lin HT, Hung WC, Hung JL, Wu PS, Liaw LJ, Chang JH. Effects of pilates on patients with chronic non-specific low back pain: a systematic review. J Phys Ther Sci 2016; 28:2961-2969. [PMID: 27821970 PMCID: PMC5088161 DOI: 10.1589/jpts.28.2961] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/16/2016] [Indexed: 02/07/2023] Open
Abstract
[Purpose] To evaluate the effects of Pilates on patients with chronic low back pain
through a systematic review of high-quality articles on randomized controlled trials.
[Subjects and Methods] Keywords and synonyms for “Pilates” and “Chronic low back pain”
were used in database searches. The databases included PubMed, Physiotherapy Evidence
Database (PEDro), Medline, and the Cochrane Library. Articles involving randomized
controlled trials with higher than 5 points on the PEDro scale were reviewed for
suitability and inclusion. The methodological quality of the included randomized
controlled trials was evaluated using the PEDro scale. Relevant information was extracted
by 3 reviewers. [Results] Eight randomized controlled trial articles were included.
Patients with chronic low back pain showed statistically significant improvement in pain
relief and functional ability compared to patients who only performed usual or routine
health care. However, other forms of exercise were similar to Pilates in the improvement
of pain relief and functional capacity. [Conclusion] In patients with chronic low back
pain, Pilates showed significant improvement in pain relief and functional enhancement.
Other exercises showed effects similar to those of Pilates, if waist or torso movement was
included and the exercises were performed for 20 cumulative hours.
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Affiliation(s)
- Hui-Ting Lin
- Department of Physical Therapy, I-Shou University, Taiwan
| | - Wei-Ching Hung
- Department of Biomedical Engineering, National Cheng Kung University, Taiwan
| | - Jia-Ling Hung
- Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Taiwan
| | - Pei-Shan Wu
- Department of Physical Therapy, I-Shou University, Taiwan
| | - Li-Jin Liaw
- Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Taiwan
| | - Jia-Hao Chang
- Department of Physical Education, National Taiwan Normal University, Taiwan
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Lim HS, Kim YL, Lee SM. The effects of Pilates exercise training on static and dynamic balance in chronic stroke patients: a randomized controlled trial. J Phys Ther Sci 2016; 28:1819-24. [PMID: 27390424 PMCID: PMC4932065 DOI: 10.1589/jpts.28.1819] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 03/12/2016] [Indexed: 01/13/2023] Open
Abstract
[Purpose] The purpose of this study was to analyze the effects of Pilates exercise on
static and dynamic balance in chronic stroke patients. [Subjects and Methods] Nineteen
individuals with unilateral chronic hemiparetic stroke (age, 64.7 ± 6.9 years; height,
161.7 ± 7.9 cm; weight, 67.0 ± 11.1 kg) were randomly allocated to either a Pilates
exercise group (PG, n=10) or a control group (CG, n=9). The PG attended 24 exercise
sessions conducted over an 8-week period (3 sessions/week). Center of pressure (COP) sway
and COP velocity were measured one week before and after the exercise program and compared
to assess training effects. [Results] Pilates exercise positively affected both static and
dynamic balance in patients with chronic stroke. For static balance, COP sway and velocity
in the medial-lateral (M-L) and anterior-posterior (A-P) directions were significantly
decreased in the PG after training while no significant differences were found in the CG.
For dynamic balance, measured during treadmill walking, the PG showed significantly
reduced COP sway and velocity in the M-L and A-P directions for both the paretic and
non-paretic leg. [Conclusions] The findings provide initial evidence that Pilates exercise
can enhance static and dynamic balance in patients with chronic stroke.
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Affiliation(s)
- Hee Sung Lim
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - You Lim Kim
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - Suk Min Lee
- Department of Physical Therapy, Sahmyook University, Republic of Korea
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Abstract
STUDY DESIGN Systematic review. OBJECTIVE To determine the effects of the Pilates method for patients with nonspecific acute, subacute, or chronic low back pain. SUMMARY OF BACKGROUND DATA The Pilates method is one of the most common forms of intervention based on exercise used for treating patients with low back pain. However, its effectiveness is not well established. METHODS We conducted searches on CENTRAL, MEDLINE, EMBASE, CINAHL, PEDro, and SPORTDiscus up to March 2014. We included randomized controlled trials examining the effectiveness of Pilates in patients with acute, subacute, or chronic nonspecific low back pain. The outcomes evaluated were pain, disability, function, and global impression of recovery. Two independent reviewers screened for potentially eligible studies, assessed risk of bias, and extracted the data. We evaluated the overall quality of evidence using the GRADE approach and treatment effect sizes were described using mean differences and 95% confidence intervals. RESULTS Searches retrieved 126 trials, of which 10 were included in the review (n = 510 participants). Seven studies were considered to have low risk of bias, and three were considered at high risk of bias. When compared to minimal intervention, Pilates reduces pain at short and intermediate term with low- to moderate-quality evidence and medium effect sizes. For disability, there is also a significant difference in favor to Pilates with low- to moderate-quality evidence and small effect size for short term and medium effect size for intermediate term compared with minimal intervention. It is unclear whether Pilates is better than other exercises for short-term pain, but there is low-quality evidence that Pilates reduces pain at intermediate term. For disability, there is moderate-quality evidence that there is no significant difference between Pilates and other exercises in either the short term or the intermediate term. CONCLUSION There is low- to moderate-quality evidence that Pilates is more effective than minimal intervention with most of the effect sizes being considered medium. However, there is no conclusive evidence that Pilates is superior to other forms of exercises. LEVEL OF EVIDENCE 1.
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Kamioka H, Tsutani K, Katsumata Y, Yoshizaki T, Okuizumi H, Okada S, Park SJ, Kitayuguchi J, Abe T, Mutoh Y. Effectiveness of Pilates exercise: A quality evaluation and summary of systematic reviews based on randomized controlled trials. Complement Ther Med 2016; 25:1-19. [DOI: 10.1016/j.ctim.2015.12.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/10/2015] [Accepted: 12/29/2015] [Indexed: 11/28/2022] Open
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Effectiveness and Cost-Effectiveness of Different Weekly Frequencies of Pilates for Chronic Low Back Pain: Randomized Controlled Trial. Phys Ther 2016; 96:382-9. [PMID: 26294680 DOI: 10.2522/ptj.20150404] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 08/09/2015] [Indexed: 02/09/2023]
Abstract
BACKGROUND The Pilates method has been recommended to patients with low back pain, but the evidence on effectiveness is inconclusive. In addition, there is still no evidence for the cost-effectiveness of this method or for the ideal number of sessions to achieve the highest effectiveness. OBJECTIVE The aim of this study will be to investigate the effectiveness and cost-effectiveness of the Pilates method with different weekly frequencies in the treatment of patients with nonspecific low back pain. DESIGN This is a randomized controlled trial with blinded assessor. SETTING This study will be conducted at a physical therapy clinic in São Paulo, Brazil. PARTICIPANTS Two hundred ninety-six patients with nonspecific low back pain between the ages of 18 and 80 years will be assessed and randomly allocated to 4 groups (n=74 patients per group). INTERVENTION All groups will receive an educational booklet. The booklet group will not receive additional exercises. Pilates group 1 will follow a Pilates-based program once a week, Pilates group 2 will follow the same program twice a week, and Pilates group 3 will follow the same program 3 times a week. The intervention will last 6 weeks. MEASUREMENTS A blinded assessor will evaluate pain, quality-adjusted life-years, general and specific disability, kinesiophobia, pain catastrophizing, and global perceived effect 6 weeks, 6 months, and 12 months after randomization. LIMITATIONS Therapists and patients will not be blinded. CONCLUSIONS This will be the first study to investigate different weekly frequencies of treatment sessions for nonspecific low back pain. The results of this study will contribute to a better definition of treatment programs for this population.
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Oliveira LCD, Guedes CA, Jassi FJ, Martini FAN, Oliveira RGD. Effects of the Pilates method on variables related to functionality of a patient with traumatic spondylolisthesis at L4-L5: A case study. J Bodyw Mov Ther 2016; 20:123-131. [PMID: 26891647 DOI: 10.1016/j.jbmt.2015.07.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/17/2015] [Accepted: 07/19/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Traumatic spondylolisthesis at L4-L5 is a rare complication in the spine, which impairs variables related to the functionality of the person affected. OBJECTIVE To verify the effects of the Pilates method on strength and muscular resistance, flexibility, postural balance and level of pain in a patient with traumatic spondylolisthesis at L4-L5. METHODS The following evaluations were performed pre and post-intervention: resistance of the flexor and extensor muscles of the trunk; isokinetic peak torque of the extensor and flexor muscles of the knee; hip and torso flexibility; static postural balance; and the visual analog scale of pain. The treatment consisted of three weekly sessions of Pilates, performed over 12 weeks. RESULTS There was improvement in all the tests, except for one variable related to postural balance. CONCLUSIONS The Pilates method was effective for improving muscle resistance and strength, flexibility, postural balance and pain, in a patient with traumatic spondylolisthesis at L4-L5.
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Affiliation(s)
| | | | - Fabrício José Jassi
- Health Sciences Center, State University of North Parana, Jacarezinho, Paraná, Brazil
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Pilates Method for Women's Health: Systematic Review of Randomized Controlled Trials. Arch Phys Med Rehabil 2015; 96:2231-42. [DOI: 10.1016/j.apmr.2015.04.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 04/01/2015] [Accepted: 04/06/2015] [Indexed: 01/10/2023]
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Cruz-Díaz D, Martínez-Amat A, Osuna-Pérez MC, De la Torre-Cruz MJ, Hita-Contreras F. Short- and long-term effects of a six-week clinical Pilates program in addition to physical therapy on postmenopausal women with chronic low back pain: a randomized controlled trial. Disabil Rehabil 2015; 38:1300-8. [DOI: 10.3109/09638288.2015.1090485] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yamato TP, Maher CG, Saragiotto BT, Hancock MJ, Ostelo RWJG, Cabral CMN, Menezes Costa LC, Costa LOP. Pilates for low back pain. Cochrane Database Syst Rev 2015; 2015:CD010265. [PMID: 26133923 PMCID: PMC8078578 DOI: 10.1002/14651858.cd010265.pub2] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Non-specific low back pain is a major health problem worldwide. Interventions based on exercises have been the most commonly used treatments for patients with this condition. Over the past few years, the Pilates method has been one of the most popular exercise programmes used in clinical practice. OBJECTIVES To determine the effects of the Pilates method for patients with non-specific acute, subacute or chronic low back pain. SEARCH METHODS We conducted the searches in CENTRAL, MEDLINE, EMBASE, CINAHL, PEDro and SPORTDiscus from the date of their inception to March 2014. We updated the search in June 2015 but these results have not yet been incorporated. We also searched the reference lists of eligible papers as well as six trial registry websites. We placed no limitations on language or date of publication. SELECTION CRITERIA We only included randomised controlled trials that examined the effectiveness of Pilates intervention in adults with acute, subacute or chronic non-specific low back pain. The primary outcomes considered were pain, disability, global impression of recovery and quality of life. DATA COLLECTION AND ANALYSIS Two independent raters performed the assessment of risk of bias in the included studies using the 'Risk of bias' assessment tool recommended by The Cochrane Collaboration. We also assessed clinical relevance by scoring five questions related to this domain as 'yes', 'no' or 'unclear'. We evaluated the overall quality of evidence using the GRADE approach and for effect sizes we used three levels: small (mean difference (MD) < 10% of the scale), medium (MD 10% to 20% of the scale) or large (MD > 20% of the scale). We converted outcome measures to a common 0 to 100 scale when different scales were used. MAIN RESULTS The search retrieved 126 trials; 10 fulfilled the inclusion criteria and we included them in the review (a total sample of 510 participants). Seven studies were considered to have low risk of bias, and three were considered as high risk of bias.A total of six trials compared Pilates to minimal intervention. There is low quality evidence that Pilates reduces pain compared with minimal intervention, with a medium effect size at short-term follow-up (less than three months after randomisation) (MD -14.05, 95% confidence interval (CI) -18.91 to -9.19). For intermediate-term follow-up (at least three months but less than 12 months after randomisation), two trials provided moderate quality evidence that Pilates reduces pain compared to minimal intervention, with a medium effect size (MD -10.54, 95% CI -18.46 to -2.62). Based on five trials, there is low quality evidence that Pilates improves disability compared with minimal intervention, with a small effect size at short-term follow-up (MD -7.95, 95% CI -13.23 to -2.67), and moderate quality evidence for an intermediate-term effect with a medium effect size (MD -11.17, 95% CI -18.41 to -3.92). Based on one trial and low quality evidence, a significant short-term effect with a small effect size was reported for function (MD 1.10, 95% CI 0.23 to 1.97) and global impression of recovery (MD 1.50, 95% CI 0.70 to 2.30), but not at intermediate-term follow-up for either outcome.Four trials compared Pilates to other exercises. For the outcome pain, we presented the results as a narrative synthesis due to the high level of heterogeneity. At short-term follow-up, based on low quality evidence, two trials demonstrated a significant effect in favour of Pilates and one trial did not find a significant difference. At intermediate-term follow-up, based on low quality evidence, one trial reported a significant effect in favour of Pilates, and one trial reported a non-significant difference for this comparison. For disability, there is moderate quality evidence that there is no significant difference between Pilates and other exercise either in the short term (MD -3.29, 95% CI -6.82 to 0.24) or in the intermediate term (MD -0.91, 95% CI -5.02 to 3.20) based on two studies for each comparison. Based on low quality evidence and one trial, there was no significant difference in function between Pilates and other exercises at short-term follow-up (MD 0.10, 95% CI -2.44 to 2.64), but there was a significant effect in favour of other exercises for intermediate-term function, with a small effect size (MD -3.60, 95% CI -7.00 to -0.20). Global impression of recovery was not assessed in this comparison and none of the trials included quality of life outcomes. Two trials assessed adverse events in this review, one did not find any adverse events, and another reported minor events. AUTHORS' CONCLUSIONS We did not find any high quality evidence for any of the treatment comparisons, outcomes or follow-up periods investigated. However, there is low to moderate quality evidence that Pilates is more effective than minimal intervention for pain and disability. When Pilates was compared with other exercises we found a small effect for function at intermediate-term follow-up. Thus, while there is some evidence for the effectiveness of Pilates for low back pain, there is no conclusive evidence that it is superior to other forms of exercises. The decision to use Pilates for low back pain may be based on the patient's or care provider's preferences, and costs.
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Affiliation(s)
- Tiê P Yamato
- Sydney Medical School, The University of SydneyMusculoskeletal Division, The George Institute for Global HealthSydneyAustralia
| | - Christopher G Maher
- Sydney Medical School, The University of SydneyMusculoskeletal Division, The George Institute for Global HealthSydneyAustralia
| | - Bruno T Saragiotto
- Sydney Medical School, The University of SydneyMusculoskeletal Division, The George Institute for Global HealthSydneyAustralia
| | - Mark J Hancock
- Macquarie UniversityFaculty of Human SciencesGround floor, 75 Talavera Rd.Macquarie ParkSydneyAustralia
| | - Raymond WJG Ostelo
- VU UniversityDepartment of Health Sciences, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
| | - Cristina MN Cabral
- Universidade Cidade de São PauloMasters and Doctoral Programs in Physical TherapyRua Cesário Galeno,448São PauloBrazil03071‐000
| | - Luciola C Menezes Costa
- Universidade Cidade de São PauloMasters and Doctoral Programs in Physical TherapyRua Cesário Galeno,448São PauloBrazil03071‐000
| | - Leonardo OP Costa
- Universidade Cidade de São PauloMasters and Doctoral Programs in Physical TherapyRua Cesário Galeno,448São PauloBrazil03071‐000
- The George Institute for Global HealthFaculty of Medicine, The University of Sydney, AustraliaLevel 7, 341 George St.SydneyAustraliaNSW 2000
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Miyamoto GC, Costa LOP, Cabral CMN. Efficacy of the Pilates method for pain and disability in patients with chronic nonspecific low back pain: a systematic review with meta-analysis. Braz J Phys Ther 2015; 17:517-32. [PMID: 24346291 PMCID: PMC4207151 DOI: 10.1590/s1413-35552012005000127] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 06/18/2013] [Indexed: 11/23/2022] Open
Abstract
Objective To systematically review the available evidence on the efficacy of the
Pilates method in patients with chronic nonspecific low back pain. Method Searches were performed in MEDLINE, EMBASE, PEDro, SciELO, LILACS, CINAHL and
CENTRAL in March 2013. Randomized controlled trials that tested the
effectiveness of the Pilates method (against a nontreatment group, minimal
intervention or other types of interventions) in adults with chronic low
back pain were included regardless the language of publication. The outcome
data were extracted from the eligible studies and were combined using a
meta-analysis approach. Results The searches identified a total of 1,545 articles. From these, eight trials
were considered eligible, and seven trials were combined in the
meta-analysis. The comparison groups were as follows: Pilates versus other
types of exercises (n=2 trials), and Pilates versus no treatment group or
minimal intervention (n=4 trials) for short term pain; Pilates versus
minimal intervention for short-term disability (n=4).We determined that
Pilates was not better than other types of exercises for reducing pain
intensity. However, Pilates was better than a minimal intervention for
reducing short-term pain and disability (pain: pooled mean difference=1.6
points; 95% CI 1.4 to 1.8; disability: pooled mean difference=5.2 points;
95% CI 4.3 to 6.1). Conclusions Pilates was better than a minimal intervention for reducing pain and
disability in patients with chronic low back pain. Pilates was not better
than other types of exercise for short-term pain reduction.
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Patti A, Bianco A, Paoli A, Messina G, Montalto MA, Bellafiore M, Battaglia G, Iovane A, Palma A. Effects of Pilates exercise programs in people with chronic low back pain: a systematic review. Medicine (Baltimore) 2015; 94:e383. [PMID: 25634166 PMCID: PMC4602949 DOI: 10.1097/md.0000000000000383] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The Pilates method has recently become a fast-growing popular way of exercise recommended for healthy individuals and those engaged in rehabilitation. Several published studies have examined the effects of Pilates method in people with chronic low back pain (LBP). The objective of this study is to describe and provide an extensive overview of the scientific literature comparing the effectiveness of the Pilates method on pain and disability in patients with chronic nonspecific LBP. The study is based on the data from the following sources: MEDLINE-NLM, MEDLINE-EBSCO, Scopus Elsevier, Cochrane, DOAJ, SciELO, and PLOSONE. Original articles and systematic reviews of adults with chronic nonspecific LBP that evaluated pain and/or disability were included in this study; studies in which the primary treatment was based on Pilates method exercises compared with no treatment, minimal intervention, other types of intervention, or other types of exercises. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adopted. The literature search included 7 electronic databases and the reference list of relevant systematic reviews and original articles to July 2014. Two independent investigators conducted the literature search and performed the synthesis as follows: Study Design; Sample (n); Disability measure; Intervention; and Main results. The searches identified a total of 128 articles. From these, 29 were considered eligible and were included in the analysis. The items were stratified as follows: Pilates method versus other kind of exercises (n = 6 trials) and Pilates method versus no treatment group or minimal intervention for short-term pain (n = 9 trials); the therapeutic effect of the Pilates method in randomized cohorts (n = 5); and analysis of reviews (n = 9). We found that there is a dearth of studies that clearly demonstrates the efficacy of a specific Pilates exercise program over another in the treatment of chronic pain. However, the consensus in the field suggests that Pilates method is more effective than minimal physical exercise intervention in reducing pain. These conclusions need to be supported by other proper investigations.
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Affiliation(s)
- Antonino Patti
- Sport and Exercise Sciences Research Unit (A Patti, AB, GM, MAM, MB, GB, AI, A Palma), University of Palermo; Posturalab (A Patti, GM), Italy; and Department of Biomedical Science (A Paoli), University of Padua, Padua, Italy
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The Pilates breathing technique increases the electromyographic amplitude level of the deep abdominal muscles in untrained people. J Bodyw Mov Ther 2015; 19:57-61. [DOI: 10.1016/j.jbmt.2014.05.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 05/12/2014] [Accepted: 05/23/2014] [Indexed: 11/19/2022]
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Mostagi FQRC, Dias JM, Pereira LM, Obara K, Mazuquin BF, Silva MF, Silva MAC, de Campos RR, Barreto MST, Nogueira JF, Lima TB, Carregaro RL, Cardoso JR. Pilates versus general exercise effectiveness on pain and functionality in non-specific chronic low back pain subjects. J Bodyw Mov Ther 2014; 19:636-45. [PMID: 26592221 DOI: 10.1016/j.jbmt.2014.11.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 11/05/2014] [Accepted: 11/11/2014] [Indexed: 11/25/2022]
Abstract
Low back pain (LBP) is one of the most common causes of disability, and the Pilates method has been associated with improvements in symptoms. The purpose of this study was to assess the effectiveness of the Pilates method, when compared to general exercises, on pain and functionality after eight weeks (16 sessions, 2×/week) and a follow-up of three months, in subjects with non-specific chronic low back pain (NSCLBP). A randomised controlled trial composed of 22 subjects was proposed. Subjects were allocated into two groups: the Pilates group (PG) (n = 11) and the general exercise group (GEG) (n = 11). The PG protocol was based on the Pilates method and the GEG performed exercises to manage NSCLBP. There were no differences between the groups. When analysed over time, the GEG demonstrated improvements in functionality between baseline and the end of treatment (P = .02; Cohen'sd¯ = 0.34) and baseline and follow-up (P = .04; Cohen'sd¯ = 0.31). There were no differences between the Pilates and general exercises with regard to pain and functionality in NSCLBP subjects but general exercises were better than Pilates for increasing functionality and flexibility.
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Affiliation(s)
| | - Josilainne Marcelino Dias
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Ligia Maxwell Pereira
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Karen Obara
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Bruno Fles Mazuquin
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil; Allied Health Research Unit, University of Central Lancashire, Preston, United Kingdom
| | - Mariana Felipe Silva
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | | | - Renata Rosa de Campos
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | | | - Jéssyca Fernandes Nogueira
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | | | | | - Jefferson Rosa Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil.
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Dias JM, Menacho MDO, Mazuquin BF, Obara K, Mostagi FQRC, Lima TB, Moura FA, Abrão T, Iversen MD, Cardoso JR. Comparison of the electromyographic activity of the anterior trunk during the execution of two Pilates exercises – teaser and longspine – for healthy people. J Electromyogr Kinesiol 2014; 24:689-97. [DOI: 10.1016/j.jelekin.2014.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 06/11/2014] [Accepted: 06/11/2014] [Indexed: 10/25/2022] Open
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Effects of Pilates method in physical fitness on older adults. A systematic review. Eur Rev Aging Phys Act 2014. [DOI: 10.1007/s11556-014-0143-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Wells C, Kolt GS, Marshall P, Hill B, Bialocerkowski A. The effectiveness of Pilates exercise in people with chronic low back pain: a systematic review. PLoS One 2014; 9:e100402. [PMID: 24984069 PMCID: PMC4077575 DOI: 10.1371/journal.pone.0100402] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 05/26/2014] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To evaluate the effectiveness of Pilates exercise in people with chronic low back pain (CLBP) through a systematic review of randomised controlled trials (RCTs). DATA SOURCES A search for RCTs was undertaken using Medical Search Terms and synonyms for "Pilates" and "low back pain" within the maximal date range of 10 databases. Databases included the Cumulative Index to Nursing and Allied Health Literature; Cochrane Library; Medline; Physiotherapy Evidence Database; ProQuest: Health and Medical Complete, Nursing and Allied Health Source, Dissertation and Theses; Scopus; Sport Discus; Web of Science. STUDY SELECTION Two independent reviewers were involved in the selection of evidence. To be included, relevant RCTs needed to be published in the English language. From 152 studies, 14 RCTs were included. DATA EXTRACTION Two independent reviewers appraised the methodological quality of RCTs using the McMaster Critical Review Form for Quantitative Studies. The author(s), year of publication, and details regarding participants, Pilates exercise, comparison treatments, and outcome measures, and findings, were then extracted. DATA SYNTHESIS The methodological quality of RCTs ranged from "poor" to "excellent". A meta-analysis of RCTs was not undertaken due to the heterogeneity of RCTs. Pilates exercise provided statistically significant improvements in pain and functional ability compared to usual care and physical activity between 4 and 15 weeks, but not at 24 weeks. There were no consistent statistically significant differences in improvements in pain and functional ability with Pilates exercise, massage therapy, or other forms of exercise at any time period. CONCLUSIONS Pilates exercise offers greater improvements in pain and functional ability compared to usual care and physical activity in the short term. Pilates exercise offers equivalent improvements to massage therapy and other forms of exercise. Future research should explore optimal Pilates exercise designs, and whether some people with CLBP may benefit from Pilates exercise more than others.
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Affiliation(s)
- Cherie Wells
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- School of Science and Health, University of Western Sydney, Campbelltown, New South Wales, Australia
| | - Gregory S. Kolt
- School of Science and Health, University of Western Sydney, Campbelltown, New South Wales, Australia
| | - Paul Marshall
- School of Science and Health, University of Western Sydney, Campbelltown, New South Wales, Australia
| | - Bridget Hill
- Epworth HealthCare, Richmond, Victoria, Australia
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Shea S, Moriello G. Feasibility and outcomes of a classical Pilates program on lower extremity strength, posture, balance, gait, and quality of life in someone with impairments due to a stroke. J Bodyw Mov Ther 2014; 18:332-60. [DOI: 10.1016/j.jbmt.2013.11.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 11/04/2013] [Accepted: 11/18/2013] [Indexed: 11/28/2022]
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Natour J, Cazotti LDA, Ribeiro LH, Baptista AS, Jones A. Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial. Clin Rehabil 2014; 29:59-68. [DOI: 10.1177/0269215514538981] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To assess the effectiveness of pilates method on patients with chronic non-specific low back pain (LBP). Method: A randomized controlled trial was carried out in sixty patients with a diagnosis of chronic non-specific LBP. Patients were randomly assigned to one of two groups: Experimental Group (EG) that maintained medication treatment with use of NSAID and underwent treatment with the pilates method and Control Group (CG) that continue medication treatment with use of NSAID and did not undergo any other intervention. A blinded assessor performed all evaluations at baseline (T0), after 45, 90, and 180 days (T45, T90 and T180) for: pain (VAS), function (Roland Morris questionnaire), quality of life (SF-36), satisfaction with treatment (Likert scale), flexibility (sit and reach test) and NSAID intake. Results: The groups were homogeneous at baseline. Statistical differences favoring the EG were found with regard to pain ( P < 0.001), function ( P < 0.001) and the quality of life domains of functional capacity ( P < 0.046), pain ( P < 0.010) and vitality ( P < 0.029). Statistical differences were also found between groups regarding the use of pain medication at T45, T90 and T180 ( P < 0.010), with the EG taking fewer NSAIDs than the CG. Conclusions: The pilates method can be used by patients with LBP to improve pain, function and aspects related to quality of life (functional capacity, pain and vitality). Moreover, this method has no harmful effects on such patients.
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Affiliation(s)
- Jamil Natour
- Universidade Federal de São Paulo, Rheumatology Division, São Paulo, SP, Brazil
| | | | | | | | - Anamaria Jones
- Universidade Federal de São Paulo, Rheumatology Division, São Paulo, SP, Brazil
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The definition and application of Pilates exercise to treat people with chronic low back pain: a Delphi survey of Australian physical therapists. Phys Ther 2014; 94:792-805. [PMID: 24179139 DOI: 10.2522/ptj.20130030] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pilates exercise is recommended for people with chronic low back pain (CLBP). In the literature, however, Pilates exercise is described and applied differently to treat people with CLBP. These differences in the definition and application of Pilates exercise make it difficult to evaluate its effectiveness. OBJECTIVE The aim of this study was to establish consensus regarding the definition and application of Pilates exercise to treat people with CLBP. METHODS A panel of Australian physical therapists who are experienced in treating people with CLBP using Pilates exercise were surveyed using the Delphi technique. Three electronic questionnaires were used to collect the respondents' opinions. Answers to open-ended questions were analyzed thematically, combined with systematic literature review findings, and translated into statements about Pilates exercise for people with CLBP. Participants then rated their level of agreement with these statements using a 6-point Likert scale. Consensus was achieved when 70% of the panel members strongly agreed, agreed, or somewhat agreed (or strongly disagreed, disagreed, or somewhat disagreed) with an item. RESULTS Thirty physical therapists completed all 3 questionnaires and reached consensus on the majority of items. Participants agreed that Pilates exercise requires body awareness, breathing, movement control, posture, and education. It was recommended that people with CLBP should undertake supervised sessions for 30 to 60 minutes, twice per week, for 3 to 6 months. Participants also suggested that people with CLBP would benefit from individualized assessment and exercise prescription, supervision and functional integration of exercises, and use of specialized equipment. LIMITATIONS Item consensus does not guarantee the accuracy of findings. This survey reflects the opinion of only 30 physical therapists and requires validation in future trials. CONCLUSION These findings contribute to a better understanding of Pilates exercise and how it is utilized by physical therapists to treat people with CLBP. This information provides direction for future research into Pilates exercise, but findings need to be interpreted within the context of study limitations.
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Effectiveness of mat Pilates or equipment-based Pilates exercises in patients with chronic nonspecific low back pain: a randomized controlled trial. Phys Ther 2014; 94:623-31. [PMID: 24435105 DOI: 10.2522/ptj.20130277] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Pilates method has been widely used to treat patients with chronic low back pain. Pilates exercises can be performed in 2 ways: by using specific equipment or without it (also known as mat Pilates). There are no studies, however, that have compared the effectiveness of mat Pilates with that of equipment-based Pilates. OBJECTIVE The aim of this study was to compare the effectiveness of mat Pilates and equipment-based Pilates in patients with chronic nonspecific low back pain. DESIGN A 2-arm randomized controlled trial with a blinded assessor was conducted. SETTING The study was conducted at a private physical therapy clinic in Brazil. PATIENTS Eighty-six patients with chronic nonspecific low back pain participated. INTERVENTION The patients were randomly allocated to 1 of 2 groups: a mat Pilates group (n=43) and an equipment-based Pilates group (n=43). The participants in both groups attended 12 Pilates sessions over a period of 6 weeks. MEASUREMENTS The primary outcomes were pain intensity and disability. The secondary outcomes were global perceived effect, patient's specific disability, and kinesiophobia. A blinded assessor evaluated the outcomes at baseline and 6 weeks and 6 months after randomization. RESULTS After 6 months, there was a statistically significant difference for disability (mean difference=3.0 points, 95% confidence interval [CI]=0.6 to 5.4), specific disability (mean difference=-1.1 points, 95% CI=-2.0 to -0.1), and kinesiophobia (mean difference=4.9 points, 95% CI=1.6 to 8.2) in favor of equipment-based Pilates. No differences were found for the remaining outcomes. CONCLUSIONS Equipment-based Pilates was superior to mat Pilates in the 6-month follow-up for the outcomes of disability and kinesiophobia. These benefits were not observed for pain intensity and global perceived effect in patients with chronic nonspecific low back pain.
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Immediate electromyographic changes of the biceps brachii and upper rectus abdominis muscles due to the Pilates centring technique. J Bodyw Mov Ther 2013; 17:385-90. [DOI: 10.1016/j.jbmt.2013.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 01/02/2013] [Accepted: 01/05/2013] [Indexed: 11/17/2022]
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Borges J, Baptista AF, Santana N, Souza I, Kruschewsky RA, Galvão-Castro B, Sá KN. Pilates exercises improve low back pain and quality of life in patients with HTLV-1 virus: a randomized crossover clinical trial. J Bodyw Mov Ther 2013; 18:68-74. [PMID: 24411152 DOI: 10.1016/j.jbmt.2013.05.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 04/15/2013] [Accepted: 05/05/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Low back pain is highly prevalent in patients with HTLV-1. The effects of physical activity on this condition are not known, but postural misalignment and motor deficits are frequently present. OBJECTIVES To assess the effect of Pilates exercises on chronic low back pain in these patients, and its impact on quality of life. METHODS A randomized crossover clinical trial was conducted, involving 22 patients from a reference center in Salvador, Bahia, Brazil. The VAS was used to evaluate the effect of Pilates on pain intensity and the SF-36 to assess its impact on quality of life. RESULTS Our results provide evidence of positive effects on pain intensity and almost all domains of quality of life when patients followed the Pilates exercise program described. CONCLUSION The Pilates method may be a useful tool in alleviating the symptoms of low back pain, and had a significant impact on quality of life in this sample of patients.
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Affiliation(s)
- Jaqueline Borges
- Escola Bahiana de Medicina e Saúde Pública, Post-graduation Program on Medicine and Human Health, Salvador, Bahia, Brazil; Escola Bahiana de Medicina e Saúde Pública, Neuromusculoskeletal Dynamics Research Group, Salvador, Bahia, Brazil
| | - Abrahão Fontes Baptista
- Escola Bahiana de Medicina e Saúde Pública, Post-graduation Program on Medicine and Human Health, Salvador, Bahia, Brazil; Universidade Federal da Bahia, Biomorphology Department, Salvador, Bahia, Brazil; Escola Bahiana de Medicina e Saúde Pública, Neuromusculoskeletal Dynamics Research Group, Salvador, Bahia, Brazil.
| | - Nayara Santana
- Escola Bahiana de Medicina e Saúde Pública, Neuromusculoskeletal Dynamics Research Group, Salvador, Bahia, Brazil
| | - Israel Souza
- Instituto Federal de Ciência e Tecnologia do Rio de Janeiro, Paracambi, Rio de Janeiro, Brazil
| | - Ramon A Kruschewsky
- Escola Bahiana de Medicina e Saúde Pública, Multidisciplinary Reference Center for HTLV and Human Retroviruses, Salvador, Bahia, Brazil
| | - Bernardo Galvão-Castro
- Escola Bahiana de Medicina e Saúde Pública, Post-graduation Program on Medicine and Human Health, Salvador, Bahia, Brazil; Escola Bahiana de Medicina e Saúde Pública, Multidisciplinary Reference Center for HTLV and Human Retroviruses, Salvador, Bahia, Brazil
| | - Katia Nunes Sá
- Escola Bahiana de Medicina e Saúde Pública, Post-graduation Program on Medicine and Human Health, Salvador, Bahia, Brazil; Escola Bahiana de Medicina e Saúde Pública, Neuromusculoskeletal Dynamics Research Group, Salvador, Bahia, Brazil; Escola Bahiana de Medicina e Saúde Pública, Multidisciplinary Reference Center for HTLV and Human Retroviruses, Salvador, Bahia, Brazil
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Wells C, Kolt GS, Marshall P, Hill B, Bialocerkowski A. Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews. BMC Med Res Methodol 2013; 13:7. [PMID: 23331384 PMCID: PMC3563510 DOI: 10.1186/1471-2288-13-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 01/16/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. METHODS This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. RESULTS A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. CONCLUSION There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words).
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Affiliation(s)
- Cherie Wells
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Gregory S Kolt
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Paul Marshall
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Bridget Hill
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW, 2751, Australia
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Wölfl C, Wöfl C, Englert S, Moghaddam AA, Zimmermann G, Schmidt-Gayk H, Schmidt-Gayk G, Höner B, Hogan A, Lehnhardt M, Grützner PA, Kolios L. Time course of 25(OH)D3 vitamin D3 as well as PTH (parathyroid hormone) during fracture healing of patients with normal and low bone mineral density (BMD). BMC Musculoskelet Disord 2013; 14:16. [PMID: 23298183 PMCID: PMC3544561 DOI: 10.1186/1471-2474-14-16] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 01/03/2013] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Until now the exact biochemical processes during healing of metaphyseal fractures of healthy and osteoporotic bone remain unclear. Especially the physiological time courses of 25(OH)D(3) (Vitamin D) as well as PTH (Parathyroid Hormone) the most important modulators of calcium and bone homeostasis are not yet examined sufficiently. The purpose of this study was to focus on the time course of these parameters during fracture healing. METHODS In the presented study, we analyse the time course of 25(OH)D3 and PTH during fracture healing of low BMD level fractures versus normal BMD level fractures in a matched pair analysis. Between March 2007 and February 2009 30 patients older than 50 years of age who had suffered a metaphyseal fracture of the proximal humerus, the distal radius or the proximal femur were included in our study. Osteoporosis was verified by DEXA measuring. The time courses of 25(OH)D(3) and PTH were examined over an eight week period. Friedmann test, the Wilcoxon signed rank test and the Mann-Withney U test were used as post-hoc tests. A p-value ≤ 0.05 was considered significant. RESULTS Serum levels of 25(OH)D(3) showed no differences in both groups. In the first phase of fracture healing PTH levels in the low BMD level group remained below those of the normal BMD group in absolute figures. Over all no significant differences between low BMD level bone and normal BMD level bone could be detected in our study. CONCLUSIONS The time course of 25(OH)D(3) and PTH during fracture healing of patients with normal and low bone mineral density were examined for the first time in humans in this setting and allowing molecular biological insights into fracture healing in metaphyseal bones on a molecural level. There were no significant differences between patients with normal and low BMD levels. Hence further studies will be necessary to obtain more detailed insight into fracture healing in order to provide reliable decision criteria for therapy and the monitoring of fracture healing.
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Affiliation(s)
| | - Christoph Wöfl
- Department of Trauma- and Orthopaedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
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Costa LOP, Hancock M, Maher CG, Ostelo RWJG, Cabral CMN, Menezes Costa LD. Pilates for low-back pain. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd010265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Aladro-Gonzalvo AR, Araya-Vargas GA, Machado-Díaz M, Salazar-Rojas W. Pilates-based exercise for persistent, non-specific low back pain and associated functional disability: a meta-analysis with meta-regression. J Bodyw Mov Ther 2012; 17:125-36. [PMID: 23294694 DOI: 10.1016/j.jbmt.2012.08.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 07/29/2012] [Accepted: 08/17/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purposes of this study were to systematically review and apply regression analysis to randomised controlled trials [RCTs] that evaluated the effectiveness of Pilates exercise in improving persistent, non-specific low back pain and functional disability. METHODS Electronic databases were searched from January 1950 to March 2011. Articles were eligible for inclusion if they were RCTs comparing Pilates exercise with a placebo treatment [PT], minimal intervention [MI] or another physiotherapeutic treatment [APT]. RESULTS Nine trials were included. Pilates was moderately superior to APT (pooled Effect Size [ES] weighted = -0.55, 95% confidence interval [CI] = -0.08 to -1.03) in reducing disability but not for pain relief. Pilates provided moderate to superior pain relief compared to MI (pooled ES weighted = -0.44, 95% CI = -0.09 to -0.80) and a similar decrease in disability. The statistical model used did not detect any predictor variable. CONCLUSIONS Due to the presence of co-interventions and the low methodological quality of some studies, these conclusions should be interpreted with caution.
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Effects of Pilates exercises on pain, functional status and quality of life in women with postmenopausal osteoporosis. J Bodyw Mov Ther 2012; 17:204-11. [PMID: 23561868 DOI: 10.1016/j.jbmt.2012.07.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 07/15/2012] [Accepted: 07/17/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The present study aimed to evaluate the effects of Pilates exercise program on pain, functional status and quality of life in women with postmenopausal osteoporosis. DESIGN The study was performed as a randomized, prospective, controlled and single-blind trial. PARTICIPATIONS: Seventy women (age range, 45-65 years) with the diagnosis of postmenopausal osteoporosis were included. METHODS AND INTERVENTIONS Patients were randomly allocated into two groups (home and Pilates exercise groups). Patients in the Pilates exercise group underwent a supervised Pilates exercise program twice a week for one year. Patients in the home exercise group were asked to perform a home exercise program consisting of thoracic extension exercises. Patients were evaluated at baseline and after one year of participation in the exercise programs. MAIN OUTCOME MEASUREMENTS Visual Analog Scale for pain, six-minute walking and sit-to-stand tests for functional status, and the Qualeffo-41 Questionnaire and the Short Form-36 (SF-36) for quality of life. Patients were also asked to report the number of falls during the intervention. RESULTS At the end of the study, the results of 60 patients were analyzed. A significant improvement was noted in all evaluation parameters at the end of the exercise program in the Pilates exercise group. Except for Qualeffo- Leisure Time Activities, SF-36 physical role limitation and emotional role limitation subscales, a significant improvement was noted in all other evaluation parameters at the end of the exercise program in the home exercise group. Improvement was significantly greater in the Pilates exercise group compared to the home exercise group in all parameters. CONCLUSION Pilates exercises may be a safe and an effective treatment alternative for the quality of life in patients with postmenopausal osteoporosis.
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DORADO CECILIA, CALBET JOSEA, LOPEZ-GORDILLO ANA, ALAYON SANTIAGO, SANCHIS-MOYSI JOAQUIN. Marked Effects of Pilates on the Abdominal Muscles. Med Sci Sports Exerc 2012; 44:1589-94. [DOI: 10.1249/mss.0b013e31824fb6ae] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Wells C, Kolt GS, Bialocerkowski A. Defining Pilates exercise: a systematic review. Complement Ther Med 2012; 20:253-62. [PMID: 22579438 DOI: 10.1016/j.ctim.2012.02.005] [Citation(s) in RCA: 190] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Revised: 12/15/2011] [Accepted: 02/08/2012] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To describe Pilates exercise according to peer-reviewed literature, and compare definitions used in papers with healthy participants and those with low back pain. DESIGN A systematic review of literature was conducted. A search for "pilates" within the maximal date ranges of the Cochrane Library, Medline, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, ProQuest: Nursing and Allied Health Source, Proquest: Medical and Health Complete, Scopus, Sport Discus, and Web of Science, was undertaken. To be included, papers needed to describe Pilates exercise, and be published in English within an academic, peer-reviewed journal. There were no restrictions on the methodological design or quality of papers. Content analysis was used to record qualitative definitions of Pilates. Frequencies were calculated for mention of content categories, equipment, and traditional Pilates principles. Frequencies were then compared statistically in papers with healthy participants and those with low back pain. RESULTS 119 papers fulfilled inclusion criteria. Findings suggest that Pilates is a mind-body exercise that focuses on strength, core stability, flexibility, muscle control, posture and breathing. Exercises can be mat-based or involve use of specialised equipment. Posture was discussed statistically significantly more often in papers with participants with low back pain compared to papers with healthy participants. Traditional Pilates principles of centering, concentration, control, precision, flow, and breathing were discussed on average in 23% of papers. Apart from breathing, these principles were not mentioned in papers with low back pain participants. CONCLUSIONS There is a general consensus in the literature of the definition of Pilates exercise. A greater emphasis may be placed on posture in people with low back pain, whilst traditional principles, apart from breathing, may be less relevant.
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Affiliation(s)
- Cherie Wells
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW, 2751, Australia.
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Cruz-Ferreira A, Fernandes J, Laranjo L, Bernardo LM, Silva A. A systematic review of the effects of pilates method of exercise in healthy people. Arch Phys Med Rehabil 2011; 92:2071-81. [PMID: 22030232 DOI: 10.1016/j.apmr.2011.06.018] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 06/14/2011] [Accepted: 06/14/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate evidence for the effectiveness of the Pilates method of exercise (PME) in healthy people. DATA SOURCES Published research was identified by searching Science Direct, MEDLINE, PubMed, SPORTDiscus, PEDro, Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. STUDY SELECTION Research studies published from inception to May 7, 2011 were selected for evaluation. Two reviewers independently applied the inclusion criteria to selected potential studies. Studies were included if they were published in a peer-reviewed journal, written in the English language, conducted as a randomized controlled trial (RCT) or quasi-RCT in healthy people, had an inactive and/or exercise control group(s), included key study outcomes, and used the PME as the study intervention in at least 1 study arm. DATA EXTRACTION Two reviewers independently extracted data (study, design, subjects, intervention, key outcomes results), applied the Physiotherapy Evidence Database (PEDro) scale to assess the method quality of selected studies, and determined the strength of the evidence using the best evidence synthesis grading system. DATA SYNTHESIS Sixteen studies met the inclusion criteria. PEDro scale values ranged from 3 to 7 (mean, 4.1), indicating a low level of scientific rigor. The outcomes studied most often were flexibility, muscular endurance, strength, and postural alignment. The PME appears to be effective in improving flexibility (strong evidence), dynamic balance (strong evidence), and muscular endurance (moderate evidence) in healthy people. CONCLUSIONS There was strong evidence to support the use of the PME at least to the end of training to improve flexibility and dynamic balance and moderate evidence to enhance muscular endurance. Future RCTs should focus on the components of blinding, concealed allocation, subject adherence, intention-to-treat analysis, and follow-up designs.
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Affiliation(s)
- Ana Cruz-Ferreira
- Department of Sport and Health, Health Science and Technology Research Centre, University of Évora, Portugal.
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