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Merlo JK, da Silva AV, Casonatto J, Ribeiro AS, de Oliveira Junior E, do Nascimento AP, de Oliveira RG, Buzzachera CF, da Silva RA, Aguiar AF. Effects of a Mat Pilates Exercise Program Associated with Photobiomodulation Therapy in Patients with Chronic Nonspecific Low Back Pain: A Randomized, Double-Blind, Sham-Controlled Trial. Healthcare (Basel) 2024; 12:1416. [PMID: 39057559 PMCID: PMC11276592 DOI: 10.3390/healthcare12141416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/26/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVE To investigate the effects of combining a Pilates program with photobiomodulation therapy (PBMT) in patients with chronic nonspecific low back pain (CNLBP). METHODS Thirty-eight adults with CNLBP were randomly assigned to two groups: Pilates exercise + active PBMT (PIL + PBMT) or Pilates exercise + sham PBMT (PIL + SHAM). Both groups performed an 8-week mat Pilates program and received PBMT on their lumbar muscles 10 min before and after each session. The following variables were assessed before and after intervention: peak pain intensity, postural balance (i.e., center of the pressure [A-COP], velocity anteroposterior [Vel AP], and velocity mediolateral [Vel ML]), perceived disability (i.e., Oswestry Disability Index [ODI] and Roland Morris Disability Questionnaire [RMDQ]), and pain-related fear of movement (i.e., Tampa Scale of Kinesiophobia [TSK], Fear Avoidance Beliefs Questionnaire [FABQ], and Pain Catastrophizing Scale [PCS]). RESULTS Postural balance variables showed no statistically significant differences (p > 0.05) across time or between groups. The groups showed similar (p < 0.05) reductions in peak pain intensity, ODI, RMDQ, and PCS scores, but no statistically significant difference (p > 0.05) in TSK and FABQ scores. CONCLUSION The mat Pilates program reduced peak pain intensity, perceived disability, and pain catastrophizing in adults with CNLBP, but PBMT had no additional effect on these variables. Mat Pilates alone or combined with PBMT was not able to improve postural balance.
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Affiliation(s)
- Jeanne Karlette Merlo
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
| | - Adriano Valmozino da Silva
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
| | - Juliano Casonatto
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
- Postgraduate Program in Physical Exercise in Health Promotion, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil;
| | - Alex Silva Ribeiro
- Postgraduate Program in Physical Exercise in Health Promotion, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil;
| | - Eros de Oliveira Junior
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
| | - Ana Paula do Nascimento
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
- Postgraduate Program in Human Movement Sciences, State University of Northern Paraná (UENP), Jacarezinho 86400-000, PR, Brazil
| | - Raphael Gonçalves de Oliveira
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
- Postgraduate Program in Human Movement Sciences, State University of Northern Paraná (UENP), Jacarezinho 86400-000, PR, Brazil
| | - Cosme Franklim Buzzachera
- Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy;
| | - Rubens Alexandre da Silva
- Program de Physiothérapie de L’université McGill Offert en Extension à L’UNIVERSITÉ du Québec à Chicoutimi (UQAC), Québec, QC G7H 5B8, Canada
| | - Andreo Fernando Aguiar
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
- Postgraduate Program in Physical Exercise in Health Promotion, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil;
- Postgraduate Program in Human Movement Sciences, State University of Northern Paraná (UENP), Jacarezinho 86400-000, PR, Brazil
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Ahn SE, Lee MY, Lee BH. Effects of Gluteal Muscle Strengthening Exercise-Based Core Stabilization Training on Pain and Quality of Life in Patients with Chronic Low Back Pain. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:849. [PMID: 38929466 PMCID: PMC11205821 DOI: 10.3390/medicina60060849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/02/2024] [Accepted: 05/17/2024] [Indexed: 06/28/2024]
Abstract
Background: The World Health Organization reports that back pain is a major cause of disorder worldwide. It is the most common musculoskeletal disorder with limited pain, muscle tension, and stiffness, and 70-80% of all individuals experience it once in their lifetime, with higher prevalence in women than in men. This study aimed to investigate the effects of gluteal muscle strengthening exercise- based core stabilization training (GSE-based CST) on pain, function, fear-avoidance patterns, and quality of life in patients with chronic back pain. Methods: This study included 34 patients with non-specific chronic low back pain. Seventeen individuals each were included in GSE-based CST and control groups. The GSE-based CST group performed GSE and CST for 15 min, three times a week for four weeks, and the control group performed CST for 30 min a day, three times a week for four weeks. The numeric pain rating scale was used to evaluate pain before and after treatment, Roland-Morris disability questionnaire was used to evaluate function, fear-avoidance beliefs questionnaire was used to evaluate fear-avoidance patterns, and quality of life was measured using the short form-36. Results: In this study, pain, function, and fear-avoidance pattern decreased significantly in both groups (All p < 0.05). During the evaluation of quality of life, both groups showed significant increase in physical and mental factors (p < 0.05). There were significant differences in pain and quality of life (p < 0.05) between the GSE-based CST and control groups. Conclusions: Therefore, GSE-based CST can be used as a basis for effective intervention to enhance pain, function, fear-avoidance patterns, and quality of life, emphasizing the need for gluteal muscle strengthening exercises in patients with non-specific chronic back pain in the future.
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Affiliation(s)
- Seung-Eon Ahn
- Graduate School of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Mi-Young Lee
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Byoung-Hee Lee
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
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Baroncini A, Maffulli N, Schäfer L, Manocchio N, Bossa M, Foti C, Klimuch A, Migliorini F. Physiotherapeutic and non-conventional approaches in patients with chronic low-back pain: a level I Bayesian network meta-analysis. Sci Rep 2024; 14:11546. [PMID: 38773302 PMCID: PMC11109223 DOI: 10.1038/s41598-024-62276-9] [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: 09/12/2023] [Accepted: 05/15/2024] [Indexed: 05/23/2024] Open
Abstract
Chronic low back pain (cLBP) is a major cause of disability and healthcare expenditure worldwide. Its prevalence is increasing globally from somatic and psychosocial factors. While non-pharmacological management, and in particular physiotherapy, has been recommended as a first-line treatment for cLBP, it is not clear what type of physiotherapeutic approach is the most effective in terms of pain reduction and function improvement. This analysis is rendered more difficult by the vast number of available therapies and a lack of a widely accepted classification that can effectively highlight the differences in the outcomes of different management options. This study was conducted according to the PRISMA guidelines. In January 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the randomised controlled trials (RCTs) which compared the efficacy of physiotherapy programs in patients with cLBP were accessed. Studies reporting on non-specific or mechanical cLPB were included. Data concerning the Visual Analogic Scale (VAS) or numeric rating scale (NRS), Roland Morris Disability Questionnaire (RMQ) and Oswestry Disability Index (ODI). Data from 12,773 patients were collected. The mean symptom duration was 61.2 ± 51.0 months and the mean follow-up was 4.3 ± 5.9 months. The mean age was 44.5 ± 9.4 years. The mean BMI was 25.8 ± 2.9 kg/m2. The Adapted Physical Exercise group evidenced the lowest pain score, followed by Multidisciplinary and Adapted Training Exercise/Complementary Medicine. The Adapted Physical Exercise group evidenced the lowest RMQ score followed by Therapeutic Exercises and Multidisciplinary. The Multidisciplinary group evidenced the lowest ODI score, followed by Adapted Physical Exercise and Physical Agent modalities. Within the considered physiotherapeutic and non-conventional approaches to manage nonspecific and/or mechanic cLBP, adapted physical exercise, physical agent modalities, and a multidisciplinary approach might represent the most effective strategy to reduce pain and disability.
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Affiliation(s)
- Alice Baroncini
- GSpine4, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milano, Italy
| | - Nicola Maffulli
- Department of Orthopaedics, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
- School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, Stoke on Trent, ST4 7QB, UK
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, E1 4DG, UK
| | - Luise Schäfer
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany
| | - Nicola Manocchio
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Michela Bossa
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Calogero Foti
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
| | - Alexandra Klimuch
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, 52074, Aachen, Germany.
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy.
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Parolini F, Bertolini G, Santos R, Abreu M, Nogueira AL, Bertoncello D. Unlocking the Potential: Increasing Muscle Strength in Lower Limbs of Youth Soccer Players over Five Weeks through Mat Pilates Training-A Pilot Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:473. [PMID: 38257568 PMCID: PMC10819903 DOI: 10.3390/s24020473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/06/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
The interest in soccer generally starts during childhood, with children and young people often looking for opportunities in sports. New exercise techniques can be effective in improving training. The aim of this study was to compare the effects on the strength and physical posture of a group practicing Pilates with another not practicing Pilates, both undergoing continuous football training. In this controlled randomized clinical trial, the participants were 15 soccer club members, who had a training frequency of least three times weekly. The sample was divided into a control group (n = 7) of players who did not undergo any therapeutic intervention (only the usual training) and a Pilates group (n = 8) of players who participated in the mat Pilates program. The intervention consisted of fifteen sessions. Postural evaluations were performed using biophotogrammetry and force analysis. Significant improvements were obtained in terms of increased muscle strength (p = 0.001) for the Pilates group, but there were no significant postural alterations when comparing the two groups. Five weeks of mat Pilates was sufficient to increase lower limb muscle strength in young football players. This pilot study indicates that Mat Pilates as a method that could be planned to be included in training.
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Affiliation(s)
- Franciele Parolini
- Human Movement Analysis Laboratory (LAHM), Federal University of Triângulo Mineiro (UFTM), Av. Getúlio Guaritá, 159, Nossa Sra. da Abadia, Uberaba 38025-440, MG, Brazil; (F.P.); (M.A.); (A.L.N.); (D.B.)
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, 4200-450 Porto, Portugal
| | - Gladson Bertolini
- Department of Physiotherapy, State University of Western Paraná (UNIOESTE), Cascavel 85819-110, PR, Brazil;
| | - Rubim Santos
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
| | - Manoela Abreu
- Human Movement Analysis Laboratory (LAHM), Federal University of Triângulo Mineiro (UFTM), Av. Getúlio Guaritá, 159, Nossa Sra. da Abadia, Uberaba 38025-440, MG, Brazil; (F.P.); (M.A.); (A.L.N.); (D.B.)
| | - Ana Laura Nogueira
- Human Movement Analysis Laboratory (LAHM), Federal University of Triângulo Mineiro (UFTM), Av. Getúlio Guaritá, 159, Nossa Sra. da Abadia, Uberaba 38025-440, MG, Brazil; (F.P.); (M.A.); (A.L.N.); (D.B.)
| | - Dernival Bertoncello
- Human Movement Analysis Laboratory (LAHM), Federal University of Triângulo Mineiro (UFTM), Av. Getúlio Guaritá, 159, Nossa Sra. da Abadia, Uberaba 38025-440, MG, Brazil; (F.P.); (M.A.); (A.L.N.); (D.B.)
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Innocenti T, Schleimer T, Salvioli S, Giagio S, Ostelo R, Chiarotto A. In trials of physiotherapy for chronic low back pain, clinical relevance is rarely interpreted, with great heterogeneity in the frameworks and thresholds used: a meta-research study. J Physiother 2024; 70:51-64. [PMID: 38072712 DOI: 10.1016/j.jphys.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/11/2023] [Accepted: 11/23/2023] [Indexed: 01/07/2024] Open
Abstract
QUESTIONS How do authors of randomised controlled trials (RCTs) interpret the clinical relevance of the effects of physiotherapy interventions compared with no intervention on pain intensity, physical function and time to recovery in people with chronic low back pain (CLBP)? How can the clinical relevance be re-interpreted based on the available smallest worthwhile effect (SWE) threshold for this comparison? Are the studies in this field adequately powered? DESIGN Cross-sectional meta-research study. PARTICIPANTS People with CLBP. OUTCOME MEASURES Pain intensity, physical function and time to recovery. RESULTS This review included 23 RCTs with 1,645 participants. Twenty-two and 18 studies were included in the analysis of pain intensity and physical function, respectively. No studies investigated time to recovery. Sixteen studies reported varying thresholds to interpret clinical relevance for physical function and pain intensity. Discrepancies between interpretation using the minimal important difference and SWE values were observed in five studies. Study power ranged from 9% to 98%, with only four studies having a power > 80%. CONCLUSION Little attention is given to the interpretation of clinical relevance in RCTs comparing physiotherapy with no intervention in CLBP, with great heterogeneity in the frameworks and thresholds used. Future trials should inform patients and clinicians on whether the effect of an intervention is large enough to be worthwhile, using a reliable and comprehensive approach like available SWE estimates. REGISTRATION medRxiv https://doi.org/10.1101/2022.12.14.22283454.
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Affiliation(s)
- Tiziano Innocenti
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands; GIMBE Foundation, Italy.
| | - Tim Schleimer
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit, Bochum, Germany
| | - Stefano Salvioli
- GIMBE Foundation, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Silvia Giagio
- Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Raymond Ostelo
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit, Amsterdam Movement Sciences Research Institute, The Netherlands
| | - Alessandro Chiarotto
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands; Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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Lytras D, Iakovidis P, Sykaras E, Kottaras A, Kasimis K, Myrogiannis I, Barouxakis A, Tarfali G. Effects of a tailored mat-Pilates exercise program for older adults on pain, functioning, and balance in women with chronic non-specific low back pain: a randomized controlled trial. Aging Clin Exp Res 2023; 35:3059-3071. [PMID: 37934400 DOI: 10.1007/s40520-023-02604-7] [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: 06/23/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Mat-Pilates exercise is effective for chronic non-specific low back pain (NSLBP), but its application in older women is understudied. AIM To examine the effects of a 10-week mat-Pilates program on pain, disability, and balance in older women with chronic NSLBP. METHODS Sixty-three women (≥ 65 years) with chronic NSLBP were randomly assigned to intervention (IG) or control (CG) groups. IG received individualized mat-Pilates sessions (45 min, twice weekly), while CG followed a home-based general exercise program. Primary outcomes included visual analog scale (VAS) for pain, Roland-Morris Disability Questionnaire (RMDQ), timed up-and-go (TUG), and Berg Balance Scale (BBS) at baseline, 10 weeks, and 6 months post-intervention. Repeated measures multivariate analysis of covariance (MANCOVA) was used, adjusted for exercise adherence and analgesic use. RESULTS IG significantly improved in VAS and RMDQ scores at 10 weeks and 6 months (p > 0.05). No significant differences were observed in TUG and BBS scores at any measurement point. No between-group differences were found in analgesic use or adherence to exercise during the 6-month follow-up. CONCLUSIONS A 10-week mat-Pilates program reduced pain and improved disability in older women with chronic NSLBP, effects which persisted at 6 months. However, no impact on balance, analgesic use, or exercise adherence was observed. TRIAL REGISTRATION NUMBER/DATE OF REGISTRATION NCT04752579/February 12, 2021.
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Affiliation(s)
- Dimitrios Lytras
- Department of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, Thermi, 57001, Thessaloniki, Greece.
- Laboratory of Biomechanics and Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University - Alexander Campus, Sindos, P.O. Box 141, 57 400, Thessaloniki, Greece.
| | - Paris Iakovidis
- Laboratory of Biomechanics and Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University - Alexander Campus, Sindos, P.O. Box 141, 57 400, Thessaloniki, Greece
| | - Evaggelos Sykaras
- Department of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, Thermi, 57001, Thessaloniki, Greece
| | - Anastasios Kottaras
- Laboratory of Biomechanics and Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University - Alexander Campus, Sindos, P.O. Box 141, 57 400, Thessaloniki, Greece
| | - Konstantinos Kasimis
- Laboratory of Biomechanics and Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University - Alexander Campus, Sindos, P.O. Box 141, 57 400, Thessaloniki, Greece
| | - Ioannis Myrogiannis
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124, Thessaloniki, Greece
| | - Aristeidis Barouxakis
- Laboratory of Biomechanics and Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University - Alexander Campus, Sindos, P.O. Box 141, 57 400, Thessaloniki, Greece
| | - Georgia Tarfali
- Biomedical Engineering Department, Faculty of Engineering, Strathclyde University, Glasgow, UK
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Li Y, Yan L, Hou L, Zhang X, Zhao H, Yan C, Li X, Li Y, Chen X, Ding X. Exercise intervention for patients with chronic low back pain: a systematic review and network meta-analysis. Front Public Health 2023; 11:1155225. [PMID: 38035307 PMCID: PMC10687566 DOI: 10.3389/fpubh.2023.1155225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/04/2023] [Indexed: 12/02/2023] Open
Abstract
Purpose Chronic low back pain (CLBP) is an aging and public health issue that is a leading cause of disability worldwide and has a significant economic impact on a global scale. Treatments for CLBP are varied, and there is currently no study with high-quality evidence to show which treatment works best. Exercise therapy has the characteristics of minor harm, low cost, and convenient implementation. It has become a mainstream treatment method in clinics for chronic low back pain. However, there is insufficient evidence on which specific exercise regimen is more effective for chronic non-specific low back pain. This network meta-analysis aimed to evaluate the effects of different exercise therapies on chronic low back pain and provide a reference for exercise regimens in CLBP patients. Methods We searched PubMed, EMBASE, Cochrane Library, and Web of Science from inception to 10 May 2022. Inclusion and exclusion criteria were used for selection. We collected information from studies to compare the effects of 20 exercise interventions on patients with chronic low back pain. Results This study included 75 randomized controlled trials (RCTs) with 5,254 participants. Network meta-analysis results showed that tai chi [standardized mean difference (SMD), -2.11; 95% CI, -3.62 to -0.61], yoga (SMD, -1.76; 95% CI -2.72 to -0.81), Pilates exercise (SMD, -1.52; 95% CI, -2.68, to -0.36), and sling exercise (SMD, -1.19; 95% CI, -2.07 to -0.30) showed a better pain improvement than conventional rehabilitation. Tai chi (SMD, -2.42; 95% CI, -3.81 to -1.03) and yoga (SMD, -2.07; 95% CI, -2.80 to -1.34) showed a better pain improvement than no intervention provided. Yoga (SMD, -1.72; 95% CI, -2.91 to -0.53) and core or stabilization exercises (SMD, -1.04; 95% CI, -1.80 to -0.28) showed a better physical function improvement than conventional rehabilitation. Yoga (SMD, -1.81; 95% CI, -2.78 to -0.83) and core or stabilization exercises (SMD, -1.13; 95% CI, -1.66 to -0.59) showed a better physical function improvement than no intervention provided. Conclusion Compared with conventional rehabilitation and no intervention provided, tai chi, toga, Pilates exercise, sling exercise, motor control exercise, and core or stabilization exercises significantly improved CLBP in patients. Compared with conventional rehabilitation and no intervention provided, yoga and core or stabilization exercises were statistically significant in improving physical function in patients with CLBP. Due to the limitations of the quality and quantity of the included studies, it is difficult to make a definitive recommendation before more large-scale and high-quality RCTs are conducted.
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Affiliation(s)
- Ying Li
- College of Sports Science, Jishou University, Jishou, Hunan, China
| | - Lei Yan
- Department of Orthopaedic Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
- Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Lingyu Hou
- Department of Nursing, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xiaoya Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Hanping Zhao
- College of Nursing, Weifang University of Science and Technology, Weifang, Shandong, China
| | - Chengkun Yan
- School of Nursing, Nanchang University, Nanchang, Jiangxi, China
| | - Xianhuang Li
- Digestive Endoscopy Center, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yuanhe Li
- College of Nursing, Weifang University of Science and Technology, Weifang, Shandong, China
| | - Xiaoan Chen
- College of Sports Science, Jishou University, Jishou, Hunan, China
| | - Xiaorong Ding
- Department of Nursing, Peking University Shenzhen Hospital, Shenzhen, China
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Rubí-Carnacea F, Masbernat-Almenara M, Climent-Sanz C, Soler-González J, García-Escudero M, Martínez-Navarro O, Valenzuela-Pascual F. Effectiveness of an exercise intervention based on preactivation of the abdominal transverse muscle in patients with chronic nonspecific low back pain in primary care: a randomized control trial. BMC PRIMARY CARE 2023; 24:180. [PMID: 37674205 PMCID: PMC10483714 DOI: 10.1186/s12875-023-02140-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Low back pain is one of the most common disabling pathologies in humanity worldwide. Physical exercises have been used in recent decades to reduce the pain, improve the functionality of the lumbar spine and avoid relapses. The purpose of the study is to analyze the effect of a program based on re-education exercises involving preactivation of the abdominal transverse muscle compared to conventional treatment in adults with chronic nonspecific low back pain. METHODS A two-arm, single-blind randomized control trial with 35 primary care patients with chronic nonspecific low back pain. Both groups received a 4-week intervention. Data were collected at baseline and at the end of the intervention. Sixteen patients participated in the intervention group, and 19 patients in the control group. RESULTS For the experimental group, the outcomes of disability and activation of the abdominal transverse muscle decreased significantly (MD -2.9; CI 95% -5.6 to -0.35; η2 = 0.14; p = 0.028) and (MD 2.3; CI 95% 0.91 to 3.67; η2 = 0.25; p = 0.002) respectively, with a large effect size, compared to the control group. There were no differences between the groups in pain intensity, thickness, and resistance of the transverse abdominal muscle. CONCLUSION A 4-week specific program based on re-education exercises of the preactivation of the abdominal transverse muscle is more effective than conventional treatment for reducing disability and increasing the activation of the abdominal transverse muscle measured by VAS scale and PBU. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT03097497. Date of registration: 31/03/2017.
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Affiliation(s)
- Francesc Rubí-Carnacea
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
| | - Maria Masbernat-Almenara
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España.
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España.
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España.
| | - Carolina Climent-Sanz
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
| | - Jorge Soler-González
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
- Catalan Institute of Health, Rambla de Ferran 44, 25007, Lleida, España
| | - María García-Escudero
- Faculty of Medicine and Health Sciences, Universidad Católica de Valencia San Vicente Mártir, Valencia, España
| | - Oriol Martínez-Navarro
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
| | - Fran Valenzuela-Pascual
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
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Kawabe R, Morino S, Ishihara M, Shimoura K, Yamashiro C, Negoro K, Chen CY, Koshi M, Kato N, Hatanaka H, Umezaki F, Yamashita M, Aoyama T, Nagai-Tanima M. Ultrasound Assessment of Abdominal Muscle Thickness With and Without Lumbopelvic Pain in Pregnant Women. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:2107-2114. [PMID: 37079609 DOI: 10.1002/jum.16232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/08/2023] [Accepted: 04/01/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Lumbopelvic pain (LPP) is a very common cause of discomfort during pregnancy, but its etiology remains unclear. The association between abdominal muscle thickness and LPP in pregnant women has not been studied extensively, despite the significant abdominal changes that occur during pregnancy. This study aimed to examine the relationship between abdominal muscle thickness and LPP in pregnant women. METHODS In this study, 49 pregnant women in their second trimester participated. The intensity of LPP was assessed using a numerical rating scale. Ultrasound imaging was used to measure the thickness of abdominal muscles, including the rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles. Participants were classified into two groups, the LPP group and non-LPP group, and the abdominal muscle thickness was compared between the two groups. The statistical significance level was set at P < .05. RESULTS There were 24 and 25 participants in the LPP and non-LPP groups, respectively. Internal oblique (IO) thickness was significantly thinner in the LPP group than in the non-LPP group (5.4 ± 0.2 mm versus 6.1 ± 0.2 mm; P = .042). Multivariate logistic regression analysis showed that IO thickness was significantly associated with LPP (odds ratio, 0.516; 95% confidence interval, 0.284-0.935; P = .019). CONCLUSIONS This study suggested that LPP in second trimester pregnancy might be related to IO thickness. Further longitudinal studies are needed to understand the role of this muscle as an LPP risk factor for pregnant women.
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Affiliation(s)
- Rika Kawabe
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Saori Morino
- Department of Rehabilitation Science, School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | | | - Kanako Shimoura
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chiaki Yamashiro
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kaho Negoro
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chang Yu Chen
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masumi Koshi
- Obstetrics and Gynecology, Medical Corporation Kishokai, Inazawa, Japan
| | - Naoko Kato
- Obstetrics and Gynecology, Medical Corporation Kishokai, Inazawa, Japan
| | - Hiroko Hatanaka
- Obstetrics and Gynecology, Medical Corporation Kishokai, Inazawa, Japan
| | - Fumiko Umezaki
- Obstetrics and Gynecology, Medical Corporation Kishokai, Inazawa, Japan
| | - Mamoru Yamashita
- Obstetrics and Gynecology, Medical Corporation Kishokai, Inazawa, Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Momoko Nagai-Tanima
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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10
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Patti A, Thornton JS, Giustino V, Drid P, Paoli A, Schulz JM, Palma A, Bianco A. Effectiveness of Pilates exercise on low back pain: a systematic review with meta-analysis. Disabil Rehabil 2023:1-14. [PMID: 37632387 DOI: 10.1080/09638288.2023.2251404] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE Low back pain is the most frequently reported musculoskeletal disorder and represents one of the highest patient burdens in healthcare. This systematic review and meta-analysis aimed to investigate the effectiveness of Pilates exercise on pain intensity and functional disability caused by low back pain (LBP). MATERIALS AND METHODS A Systematic review with meta-analysis was conducted. Data sources: MEDLINE-NLM and MEDLINE-EBSCO. We also searched on Scopus Elsevier, Cochrane, DOAJ, SciELO, PEDro, and PLOS ONE databases. Eligibility criteria: randomized controlled trials (RCTs) evaluating LBP in which the primary treatment was based on Pilates exercise compared with no exercise, or non-specific exercise. RESULTS The search returned 1566 records of which 36 articles were included in the systematic review and 19 in the meta-analysis. Twenty-two studies compared the effects of Pilates exercise vs no exercise and 13 studies examined the effects of Pilates exercise vs non-specific exercise. Analysis showed that Pilates had a positive effect on the perception of LBP vs no exercise. A similar trend occurred with non-specific exercise. CONCLUSIONS Pilates exercise can decrease LBP compared to no exercise and non-specific exercise. General practitioners should consider Pilates exercise as an effective strategy to manage LBP and counteract the growing health. TRIAL REGISTRATION PROSPERO registration number: CRD42022308387.IMPLICATIONS FOR REHABILITATIONPilates is a good strategy for improving low back pain and is more effective than other exercise programs or no exercise.Pilates is a safe tool to apply to most of the population with low back pain.Pilates is a non-pharmacological strategy useful for counteracting low back pain.
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Affiliation(s)
- Antonino Patti
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Jane S Thornton
- Western Centre for Public Health and Family Medicine, University of Western Ontario Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Valerio Giustino
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Jenna M Schulz
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Canada
- Bone and Joint Institute, University of Western Ontario, London, Canada
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
- Regional Sports School of Italian National Olympic Committee (CONI) Sicilia, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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11
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Jadhakhan F, Sobeih R, Falla D. Effects of exercise/physical activity on fear of movement in people with spine-related pain: a systematic review. Front Psychol 2023; 14:1213199. [PMID: 37575449 PMCID: PMC10415102 DOI: 10.3389/fpsyg.2023.1213199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Background Kinesiophobia (i.e., fear of movement) can be an important contributor for ongoing pain and disability in people with spine-related pain. It remains unclear whether physical activity interventions/exercise influence kinesiophobia in this population. A systematic review was therefore conducted to synthesize the available evidence on whether physical activity interventions/exercise influence kinesiophobia in people with chronic non-specific spine-related pain. Methods The study protocol was registered prospectively with PROSPERO (CRD42021295755). The following databases were systematically searched from inception to 31 January 2022 and updated on 22 June 2023: PubMed, MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, ZETOC, PROSPERO and Google Scholar. Inclusion criteria were randomized or non-randomized controlled studies investigating adults aged ≥18 years, reporting the effect of exercise or physical activity on kinesiophobia in individuals with chronic non-specific spine-related pain. Two reviewers independently extracted data and assessed the quality of the included studies. Bias was assessed using the Cochrane ROB2 tool and evidence certainty via Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results Seventeen studies from seven countries involving a total of 1,354 individuals were selected for inclusion. The majority of studies (n = 13) involved participants with chronic low back pain (LBP), and Pilates was the most common form of exercise evaluated. Most of the studies reported a positive direction of effect in favor of exercise reducing kinesiophobia when compared to a control group. There was moderate to high risk of bias among the studies and the overall certainty of the evidence was very low. Conclusion This review supports the use of exercise for reducing kinesiophobia in people with chronic LBP albeit with very low certainty of evidence; Pilates (especially equipment-based) was shown to be effective as were strengthening training programmes. There was limited evidence available on the effects of exercise on kinesiophobia for people with chronic neck or thoracic pain and further research is required. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=295755.
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Affiliation(s)
| | | | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
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12
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Franks J, Thwaites C, Morris ME. Pilates to Improve Core Muscle Activation in Chronic Low Back Pain: A Systematic Review. Healthcare (Basel) 2023; 11:healthcare11101404. [PMID: 37239690 DOI: 10.3390/healthcare11101404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/26/2023] [Accepted: 05/07/2023] [Indexed: 05/28/2023] Open
Abstract
Low back pain is prevalent in the community and associated with deficits in core muscle strength and activation. Pilates is argued to improve movement and reduce pain, yet there is a limited understanding of the specific effects of Pilates training on core muscle strength or activity. A systematic search of databases (CINAHL, Embase, Ovid MEDLINE) used Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methods to evaluate randomised controlled trials (RCTs) on the effects of Pilates to improve core muscle activation. Methodological quality was assessed using the Physiotherapy Evidence Database scale (PEDro). The certainty of findings was determined using the Grading of Recommendations Assessment, Development and Evaluation tool. Of the initial yield of 563 articles, eight RCTs met the inclusion criteria. A diverse range of Pilates interventions and outcome measures were utilised to assess effects on core muscle activation and strength. The main finding was that Pilates is not inferior to equivalently dosed exercises, and can be superior to non-equivalent or no exercise, for improving core muscle strength as indicated by muscle thickness. There was emerging evidence that Pilates positively impacts core muscle strength and can be an effective intervention for people living with chronic low back pain.
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Affiliation(s)
- Jennifer Franks
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, VIC 3086, Australia
| | - Claire Thwaites
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, VIC 3086, Australia
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, VIC 3150, Australia
| | - Meg E Morris
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, VIC 3086, Australia
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, VIC 3150, Australia
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Marchand F, Laudner K, Delank KS, Schwesig R, Steinmetz A. Effects of Sensorimotor Training on Transversus Abdominis Activation in Chronic Low Back Pain Patients. J Pers Med 2023; 13:jpm13050817. [PMID: 37240987 DOI: 10.3390/jpm13050817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: The aim of this study was to investigate and compare the effect of sensorimotor training on transversus abdominis activation. (2) Methods: Seventy-five patients with chronic low back pain were randomly assigned to one of three groups (whole body vibration training using Galileo®, coordination training using Posturomed®, or physiotherapy (control)). Transversus abdominis activation was measured by using sonography pre- and post-intervention. Second, changes in clinical function tests and their correlation with the sonographic measurements were determined. (3) Results: All three groups showed an improvement in activation of the transversus abdominis post-intervention, with the Galileo® demonstrating the largest improvement. There were no relevant (r > 0.5) correlations between activation of the transversus abdominis muscle and any clinical tests. (4) Conclusions: The present study provides evidence that sensorimotor training on the Galileo® significantly improves the activation of the transversus abdominis muscle.
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Affiliation(s)
- Felix Marchand
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, 06120 Halle, Germany
- Department of Orthopedic and Trauma Surgery, Josephs-Hospital Warendorf, 48231 Warendorf, Germany
| | - Kevin Laudner
- Department of Health Sciences, Hybl Sports Medicine and Performance Center, University of Colorado, Colorado Springs, CO 80918, USA
| | - Karl-Stefan Delank
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, 06120 Halle, Germany
| | - René Schwesig
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, 06120 Halle, Germany
| | - Anke Steinmetz
- Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Physical and Rehabilitation Medicine, 17475 Greifswald, Germany
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14
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Gilliam JR, George SZ, Norman KS, Hendren S, Sahu PK, Silfies SP. Mind-Body Exercise Performed by Physical Therapists for Reducing Pain and Disability in Low Back Pain: A Systematic Review With Meta-analysis. Arch Phys Med Rehabil 2023; 104:776-789. [PMID: 36535419 PMCID: PMC10546903 DOI: 10.1016/j.apmr.2022.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the effectiveness of mind-body (MB) exercise interventions provided by physical therapists for reducing pain and disability in people with low back pain (LBP). DATA SOURCES MEDLINE, Embase, CINAHL, and the Cochrane Library were searched for articles published in English between December 2010 and June 2020. STUDY SELECTION Randomized controlled trials evaluating the effects of Pilates, yoga, and tai chi interventions performed by physical therapists on pain or disability outcomes in adults with musculoskeletal LBP were included. DATA EXTRACTION Data were extracted by 2 independent reviewers. Quality of evidence and risk of bias were assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework and Cochrane risk of bias tools, respectively. DATA SYNTHESIS 21,230 exercise trials were identified; 161 progressed to full-text review. Eight trials, 7 reporting on Pilates and 1 reporting on yoga, were included. Short-term outcomes for pain (SMD: -0.93; 95% confidence interval [CI]: -1.65 to -0.021) and disability (SMD: -0.74 95% CI: -1.36 to -0.012) indicated MB exercise was more effective than control intervention. Tests for subgroup differences between studies with exercise vs non-exercise control groups revealed a moderating effect on short-term outcomes where larger effects were observed in studies with non-exercise comparators. Long-term outcomes for pain (SMD: -0.60; 95% CI:-1.43 to 0.23) and disability (SMD: -1.05; 95% CI:-3.51 to 1.41) suggested that MB exercise is not more effective than control interventions for pain or disability. Quality of the evidence ranged from very low to low. CONCLUSIONS Physical therapist-delivered MB exercise interventions, which overwhelmingly consisted of Pilates, were more effective than control in the short and long-term for pain and in the short-term for disability, with differences in the short-term effects lessened when compared with an active intervention. Pilates interventions delivered by physical therapists represent a viable tool for the clinical management of chronic LBP.
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Affiliation(s)
- John R Gilliam
- Department of Exercise Science, University of South Carolina, Columbia, SC.
| | - Steven Z George
- Department of Orthopaedic Surgery and Duke Clinical Research Institute, Duke University, Durham, NC
| | - Katherine S Norman
- Departments of Orthopaedic Surgery and Population Health Sciences, Duke University, Durham, NC
| | | | - Pradeep K Sahu
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Sheri P Silfies
- Department of Exercise Science, University of South Carolina, Columbia, SC
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Yu Z, Yin Y, Wang J, Zhang X, Cai H, Peng F. Efficacy of Pilates on Pain, Functional Disorders and Quality of Life in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2850. [PMID: 36833545 PMCID: PMC9956295 DOI: 10.3390/ijerph20042850] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Chronic low back pain (CLBP) is a common health problem. Pilates is a unique exercise therapy. This meta-analysis aims to evaluate the efficacy of Pilates on pain, functional disorders, and quality of life in patients with chronic low back pain (CLBP). METHODS PubMed, Web of Science, CNKI, VIP, Wanfang Data, CBM, EBSCO, and Embase were searched. Randomized controlled trials of Pilates in the treatment of CLBP were collected based on the inclusion and exclusion criteria. The meta-analysis was performed using RevMan 5.4 and Stata 12.2. RESULTS 19 randomized controlled trials with a total of 1108 patients were included. Compared with the controls, the results showed the following values: Pain Scale [standard mean difference; SMD = -1.31, 95%CI (-1.80, -0.83), p < 0.00001], Oswestry Disability Index (ODI) [mean difference; MD = -4.35, 95%CI (-5.77, -2.94), p < 0.00001], Roland-Morris Disability Questionnaire (RMDQ) [MD = -2.26, 95%CI (-4.45, -0.08), p = 0.04], 36-item Short-Form (SF-36) (Physical Function (PF) [MD = 5.09, 95%CI (0.20, 9.99), p = 0.04], Role Physical (RP) [MD = 5.02, 95%CI (-1.03, 11.06), p = 0.10], Bodily Pain (BP) [MD = 8.79, 95%CI (-1.57, 19.16), p = 0.10], General Health (GH) [MD = 8.45, 95%CI (-5.61, 22.51), p = 0.24], Vitality (VT) [MD = 8.20, 95%CI(-2.30, 18.71), p = 0.13], Social Functioning (SF) [MD = -1.11, 95%CI (-7.70, 5.48), p = 0.74], Role Emotional (RE) [MD = 0.86, 95%CI (-5.53, 7.25), p = 0.79], Mental Health (MH) [MD = 11.04, 95%CI (-12.51, 34.59), p = 0.36]), Quebec Back in Disability Scale (QBPDS) [MD = -5.51, 95%CI (-23.84, 12.81), p = 0.56], and the sit-and-reach test [MD = 1.81, 95%CI (-0.25, 3.88), p = 0.09]. CONCLUSIONS This meta-analysis reveals that Pilates may have positive efficacy for pain relief and the improvement of functional disorders in CLBP patients, but the improvement in quality of life seems to be less obvious. REGISTRATION PROSPERO CRD42022348173.
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Affiliation(s)
- Zhengze Yu
- College of Physical Education and Health, Guangxi Normal University, Guilin 541006, China
| | - Yikun Yin
- College of Physical Education and Health, Guangxi Normal University, Guilin 541006, China
| | - Jialin Wang
- College of Physical Education and Health, Geely University of China, Chengdu 641432, China
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Xingxing Zhang
- College of Physical Education and Health, Guangxi Normal University, Guilin 541006, China
| | - Hejia Cai
- College of Physical Education and Health, Guangxi Normal University, Guilin 541006, China
| | - Fenglin Peng
- College of Physical Education and Health, Guangxi Normal University, Guilin 541006, China
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16
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Caglayan BC, Basakci Calik B, Gur Kabul E, Karasu U. Investigation of effectiveness of reformer pilates in individuals with fibromyalgia: A randomized controlled trial. REUMATOLOGIA CLINICA 2023; 19:18-25. [PMID: 36603963 DOI: 10.1016/j.reumae.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/13/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION AND OBJECTIVES Fibromyalgia (FM) is a chronic condition characterized by widespread pain, sleep disorder, fatigue, other somatic symptoms. Clinical pilates method is therapeutic modality that can be used in improving the symptoms. The aim of this study was to investigate the effectiveness of reformer pilates exercises in individuals with FM and to compare with home mat pilates. MATERIAL AND METHODS Twenty-eight women (age mean=45.61±10.31) diagnosed with FM were included in this study. Participants were randomly divided into two groups as reformer pilates group (n=14) and home mat pilates group (n=14). Reformer and home mat pilates exercises were given 2 times a week for 6 weeks. The number of painful regions with Pain Location Inventory (PLI), clinical status with Fibromyalgia Impact Questionnaire (FIQ), lower extremity muscle strength with Chair Stand Test, functional mobility with The Timed Up and Go Test (TUG), biopsychosocial status with Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) and quality of life with Short Form-36 (SF-36) were evaluated. All evaluations were assessed before and after treatment. RESULTS There was a significant difference in FIQ and chair stand test in reformer pilates group, while in PLI, FIQ, BETY-BQ vs. SF-36 Physical Component in home group (p<0.05) compared with baseline. There were no statistical differences between the groups in terms of delta value (p>0.05). CONCLUSIONS Reformer pilates exercises had positive effects on clinical status and muscle strength while home mat pilates exercises had positive effects on the number of painful regions, clinical status, biopsychosocial status and physical component quality of life. Clinical trial registration number NCT04218630.
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Affiliation(s)
- Berna Cagla Caglayan
- Faculty of Health Sciences, Physiotherapy and Rehabilitation, Okan Universit, Istanbul, Turkey.
| | - Bilge Basakci Calik
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Elif Gur Kabul
- Institute of Health Sciences, Physiotherapy and Rehabilitation, Usak University, Uzak, Turkey
| | - Ugur Karasu
- Department of Rheumatology, Medical Faculty of Pamukkale University, Denizli, Turkey
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Kim JH, Park HY. Effects of combined hip exercise and passive stretching on muscle stiffness, pain perception and painrelated disability, and physical function in older adults with low back pain. Phys Act Nutr 2022; 26:16-24. [DOI: 10.20463/pan.2022.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/14/2022] [Indexed: 11/07/2022] Open
Abstract
[Purpose] This study aimed to examine the effects of combined hip exercise and passive stretching as a novel treatment method for low back pain (LBP) in older adults.[Methods] Altogether, 20 Koreans with LBP aged 60–79 years (67.3 ± 5.92 years) were randomly assigned to undertake combined exercise (CE; n = 10) or lumbar stabilization exercise (LSE; n = 10). All participants performed their respective exercise program for 25–30 min with an OMNI scale of 6–8 for 8 weeks, three times a week. Body composition, muscle stiffness, pain-visual analog scale (P-VAS), Oswestry disability index, and physical function were evaluated before and after the exercise intervention.[Results] The CE group demonstrated greater improvements in lean body mass (<i>η<sup>2</sup></i> = 0.402, <i>p</i> = 0.003) and percent body fat (<i>η<sup>2</sup></i> = 0.222, <i>p</i> = 0.036) than the LSE group. Both groups demonstrated significant improvements in muscle stiffness, P-VAS scores, and Oswestry disability index scores, although no significant differences were observed between the interventions. All physical function parameters demonstrated a significant improvement in both groups, and the CE group demonstrated greater improvement in the YMCA sit-and-reach (<i>η<sup>2</sup></i> = 0.338, <i>p</i> = 0.007) and straight leg raise tests (<i>η<sup>2</sup></i> = 0.283, p = 0.016) than the LSE group.[Conclusion] CE is comparable to LSE as an effective and successful exercise intervention that reduces muscle stiffness and P-VAS scores. Moreover, CE is more effective than LSE in enhancing the physical function of older adults with LBP.
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Chang XQ, Chen XP, Shen YX, Wang K, Huang SJ, Qi Y, Niu WX. The deer play in Wuqinxi and four-point hand−knee kneeling positions for training core muscle function and spinal mobility. Front Bioeng Biotechnol 2022; 10:965295. [PMID: 36237219 PMCID: PMC9551037 DOI: 10.3389/fbioe.2022.965295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/07/2022] [Indexed: 12/03/2022] Open
Abstract
The four-point kneeling exercise is a core stabilization exercise that provides the spine with dynamic stability and neuromuscular control. In the traditional Chinese exercise Wuqinxi, deer play is performed in a hand−foot kneeling (HFK) position, which is remarkably similar to the four-point hand−knee kneeling (HKK) position. However, the differences in spinal function promotion between these two positions are poorly understood. The aim of this study was to investigate muscle activation patterns and spinal kinematics during specific core stabilization training to provide evidence for selecting specific exercises. A total of 19 healthy adults were recruited to perform HFK and HKK. The rotation angle of the C7–T4 vertebra and the surface EMG signals of abdominal and lumbar muscles on both sides were collected. The paired t-test showed that the vertebral rotation angles were significantly higher during HKK than HFK, and the intra-group differences mainly occurred at the level of the thoracic vertebra. The muscle activation of both sides of the rectus abdominis and external oblique in HFK was significantly higher than in HKK when the upper limb was lifted (p < 0.05). The activation of the ipsilateral lumbar multifidus and erector spinae muscles was significantly higher during the HKK position than during HFK when the lower limb was lifted (p < 0.05). HFK provided more training for strengthening abdominal muscles, while HKK could be recommended for strengthening lumbar muscles and increasing spine mobility. These findings can be used to help physiotherapists, fitness coaches, and others to select specific core exercises and develop individualized training programs.
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Affiliation(s)
- Xiao-Qian Chang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Xin-Peng Chen
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Yi-Xin Shen
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Kuan Wang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Shang-Jun Huang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Yan Qi
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Yan Qi,
| | - Wen-Xin Niu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
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Best Exercise Options for Reducing Pain and Disability in Adults With Chronic Low Back Pain: Pilates, Strength, Core-Based, and Mind-Body. A Network Meta-analysis. J Orthop Sports Phys Ther 2022; 52:505-521. [PMID: 35722759 DOI: 10.2519/jospt.2022.10671] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine which type of exercise is best for reducing pain and disability in adults with chronic low back pain (LBP). DESIGN Systematic review with a network meta-analysis (NMA) of randomized controlled trials (RCTs). LITERATURE SEARCH Six electronic databases were systematically searched from inception to July 2021. STUDY SELECTION CRITERIA RCTs testing the effects of exercise on reducing self-perceived pain or disability in adults (aged 18-65 years) with chronic LBP. DATA SYNTHESIS We followed the PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, incorporating NMAs of health care interventions) statement when reporting our NMA. A frequentist NMA was conducted. The probability of each intervention being the most effective was conducted according to surface under the cumulative ranking curve (SUCRA) values. RESULTS We included 118 trials (9710 participants). There were 28 head-to-head comparisons, 7 indirect comparisons for pain, and 8 indirect comparisons for disability. Compared with control, all types of physical exercises were effective for improving pain and disability, except for stretching exercises (for reducing pain) and the McKenzie method (for reducing disability). The most effective interventions for reducing pain were Pilates, mind-body, and core-based exercises. The most effective interventions for reducing disability were Pilates, strength, and core-based exercises. On SUCRA analysis, Pilates had the highest likelihood for reducing pain (93%) and disability (98%). CONCLUSION Although most exercise interventions had benefits for managing pain and disability in chronic LBP, the most beneficial programs were those that included (1) at least 1 to 2 sessions per week of Pilates or strength exercises; (2) sessions of less than 60 minutes of core-based, strength, or mind-body exercises; and (3) training programs from 3 to 9 weeks of Pilates and core-based exercises. J Orthop Sports Phys Ther 2022;52(8):505-521. Epub: 19 June 2022. doi:10.2519/jospt.2022.10671.
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Shanbehzadeh S, ShahAli S, Hides J, Ebrahimi-Takamjani I, Rasouli O. Effect of Motor Control Training on Trunk Muscle Morphometry, Pain, and Disability in People With Chronic Low Back Pain: A Systematic Review and Meta-Analysis. J Manipulative Physiol Ther 2022; 45:202-215. [PMID: 35879124 DOI: 10.1016/j.jmpt.2022.06.003] [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: 03/01/2022] [Revised: 05/12/2022] [Accepted: 06/09/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis was to study the effects of motor control training (MCT) on trunk muscle morphometry measured by ultrasound imaging and pain and disability in individuals with chronic low back pain. METHODS PubMed, Web of Science, Scopus, and Cochrane Library databases were searched from study inception until January 2021. Randomized control trials evaluating both muscle morphometry and pain or disability in individuals with chronic low back pain were included. Study selection, data extraction, and quality assessment were performed by 2 reviewers independently. Modified Downs and Black tool and the Grading of Recommendations Assessment, Development and Evaluation approach were used to assess the risk of bias and quality of evidence, respectively. A meta-analysis was performed using a random effects model with mean difference or standardized mean difference (SMD). RESULTS Of 3459 studies initially identified, 15 studies were included, and 13 studies were selected for meta-analysis. The results revealed no differences in the resting thickness of the transversus abdominis, internal and external oblique, and lumbar multifidus muscles in studies that compared MCT with other interventions. The transversus abdominis muscles contraction ratio was greater (SMD = 0.93; 95% confidence interval [CI], -0.0 to 1.85) and lower pain (weighted mean difference: -1.07 cm; 95% CI, -1.91 to -0.22 cm; P = .01) and disability (SMD = -0.86; 95% CI, -1.42 to -0. 29; P < .01) scores were found in the groups who underwent MCT compared with other interventions. CONCLUSION This systematic review and meta-analysis found that motor control exercise training increased the transverse abdominis contraction ratio (muscle activation) and improved the level of pain and disability compared to other interventions in people with chronic low back pain. However, motor control exercise training was not superior to other interventions in increasing the resting thickness of deep abdominal and lumbar multifidus muscles in intervention times less than 12 weeks.
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Affiliation(s)
- Sanaz Shanbehzadeh
- Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran; Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam ShahAli
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Julie Hides
- School of Health Sciences and Social Work, Griffith University, Nathan Campus, Brisbane, Queensland, Australia
| | - Ismail Ebrahimi-Takamjani
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Omid Rasouli
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Huang J, Xu Y, Xuan R, Baker JS, Gu Y. A Mixed Comparison of Interventions for Kinesiophobia in Individuals With Musculoskeletal Pain: Systematic Review and Network Meta-Analysis. Front Psychol 2022; 13:886015. [PMID: 35846681 PMCID: PMC9277051 DOI: 10.3389/fpsyg.2022.886015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022] Open
Abstract
Objective This systematic review aims to make a mixed comparison of interventions for kinesiophobia and individuals with musculoskeletal pain. Methods A comprehensive search strategy was conducted in the database of PubMed, MEDLINE, and Web of Science with the inclusion criteria: (1) randomized controlled design; (2) patients with musculoskeletal pain as participants; (3) treatments protocols of kinesiophobia as interventions or comparisons; (4) the score of Tampa Scale Kinesiophobia (TSK) as outcome measures. A network meta-analysis was used to synthesize the data after checking the model consistency. The risk of bias was assessed by the Cochrane Collaboration Risk of Bias Assessment Tool. Results Thirty-one studies were included in this review after a comprehensive search strategy with a low risk of bias and good consistency. According to the results of the network meta-analysis, a multi-modal treatment protocol had the highest probability to become the best choice in dealing with kinesiophobia caused by musculoskeletal pain, whereas psychological treatment protocols also showed a potentially positive effect on musculoskeletal pain-induced kinesiophobia. Conclusion Multi-modal protocols could be recommended as the preferred option when dealing with kinesiophobia caused by musculoskeletal pain. However, it is still worth mentioning that there are also potentially positive therapeutic effects of psychological interventions. Since the concept of kinesiophobia is based on the fear-avoidance model, the psychological mechanism should be paid enough attention to during treatment. Registration Number CRD42021286450.
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Affiliation(s)
- Jialu Huang
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Yining Xu
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Rongrong Xuan
- The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Julien S. Baker
- Department of Sport and Physical Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
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Feital AMBDF, Gonçalves BM, de Souza TR, Christo PP, Scalzo PL. Pilates method for low back pain in individuals with Parkinson’s disease: A feasibility study. J Bodyw Mov Ther 2022; 32:19-28. [DOI: 10.1016/j.jbmt.2022.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 05/02/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
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Pereira MJ, Mendes R, Mendes RS, Martins F, Gomes R, Gama J, Dias G, Castro MA. Benefits of Pilates in the Elderly Population: A Systematic Review and Meta-Analysis. Eur J Investig Health Psychol Educ 2022; 12:236-268. [PMID: 35323204 PMCID: PMC8947639 DOI: 10.3390/ejihpe12030018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/10/2022] [Accepted: 02/16/2022] [Indexed: 01/25/2023] Open
Abstract
The aim of this systematic review is to collect and summarize the benefits of Pilates in the elderly population (>60 years old), within the current scientific production, assessing its contribution to Healthy Ageing (HA). We used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) to select, collect, and analyse this thematic. The methodological procedures were registered in the PROSPERO database. The main results of the studies analysed (n = 30) point to significant differences between the intervention and the control groups in dynamic balance, strength, mobility, functional capacity, risk of falling reduction, and mental and psychological health. Thus, the results showed that Pilates may be beneficial for the health of the elderly. The meta-analysis found statistical differences between means on the dynamic balance (mean difference (MD) = −0.0, 95% CI [−0.71, −0.50]; I2: 0%) and the aerobic capacity and aerobic resistance [(MD) = 38.29, 95% CI [6.82, 69.77]; I2: 0%). Thus, it is concluded that the efficacy of Pilates has been shown in various areas of HA and has proven to be affordable and safe for the majority of people, using just a mat on the floor. Future studies should focus on the analysis of the relationship between the cost and the benefit of a Pilates intervention in the elderly population, to better understand how health costs can be minimized and to contribute to a multidisciplinary and generalized HA. Pilates has practical application for the clinicians, therapists, and health professionals that work with the elderly population.
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Affiliation(s)
- Mário José Pereira
- Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra, 3040-248 Coimbra, Portugal
- Correspondence: ; Tel.: +35-191-846-6976
| | - Rodrigo Mendes
- ESEC-UNICID-ASSERT, Instituto Politécnico de Coimbra, 3030-329 Coimbra, Portugal; (R.M.); (R.S.M.) (F.M.); (R.G.); (G.D.)
| | - Rui Sousa Mendes
- ESEC-UNICID-ASSERT, Instituto Politécnico de Coimbra, 3030-329 Coimbra, Portugal; (R.M.); (R.S.M.) (F.M.); (R.G.); (G.D.)
- ROBOCORP, IIA, Instituto Politécnico de Coimbra, 3030-329 Coimbra, Portugal;
- Research Unit for Sport and Physical Activity (CIDAF) (UID/DTP/04213/2020), Universidade de Coimbra, 3040-248 Coimbra, Portugal;
| | - Fernando Martins
- ESEC-UNICID-ASSERT, Instituto Politécnico de Coimbra, 3030-329 Coimbra, Portugal; (R.M.); (R.S.M.) (F.M.); (R.G.); (G.D.)
- ROBOCORP, IIA, Instituto Politécnico de Coimbra, 3030-329 Coimbra, Portugal;
- Instituto de Telecomunicações (IT), 6201-001 Covilhã, Portugal
| | - Ricardo Gomes
- ESEC-UNICID-ASSERT, Instituto Politécnico de Coimbra, 3030-329 Coimbra, Portugal; (R.M.); (R.S.M.) (F.M.); (R.G.); (G.D.)
- ROBOCORP, IIA, Instituto Politécnico de Coimbra, 3030-329 Coimbra, Portugal;
- Research Unit for Sport and Physical Activity (CIDAF) (UID/DTP/04213/2020), Universidade de Coimbra, 3040-248 Coimbra, Portugal;
| | - José Gama
- Research Unit for Sport and Physical Activity (CIDAF) (UID/DTP/04213/2020), Universidade de Coimbra, 3040-248 Coimbra, Portugal;
| | - Gonçalo Dias
- ESEC-UNICID-ASSERT, Instituto Politécnico de Coimbra, 3030-329 Coimbra, Portugal; (R.M.); (R.S.M.) (F.M.); (R.G.); (G.D.)
- ROBOCORP, IIA, Instituto Politécnico de Coimbra, 3030-329 Coimbra, Portugal;
- Research Unit for Sport and Physical Activity (CIDAF) (UID/DTP/04213/2020), Universidade de Coimbra, 3040-248 Coimbra, Portugal;
| | - Maria António Castro
- ROBOCORP, IIA, Instituto Politécnico de Coimbra, 3030-329 Coimbra, Portugal;
- CEMMPRE (UIDB/00285/2020), Universidade de Coimbra, 3030-788 Coimbra, Portugal
- Escola Superior de Saúde, Instituto Politécnico de Leiria, 2411-901 Leiria, Portugal
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Batıbay S, Külcü DG, Kaleoğlu Ö, Mesci N. Effect of Pilates mat exercise and home exercise programs on pain, functional level, and core muscle thickness in women with chronic low back pain. J Orthop Sci 2021; 26:979-985. [PMID: 33386201 DOI: 10.1016/j.jos.2020.10.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/13/2020] [Accepted: 10/15/2020] [Indexed: 02/09/2023]
Abstract
BACKGROUND To investigate the effects of Pilates exercise in patients with chronic non-specific low back pain (CNLBP) by training core stabilization muscles in aspects such as: pain, functional level, depression, quality of life, and muscle thickness measured by Ultrasound Imaging (UI) and to compare it with home based exercise. METHODS A prospective, randomized-single blinded study included 60 female patients with CNLBP. Patients were randomized into Pilates (group 1) or home exercise group (group 2) three times/week for eight weeks. The evaluations were made at the beginning and end of the treatment. Outcome parameters were VAS, Oswestry Disability Index, Qubec Disability Scale, Short Form-36, Beck Depression Questionnaire, sit and reach, Modified Schöber and sit up tests. Multifidus and abdominal muscle thickness were measured by UI. RESULTS Significant improvement has been observed in all parameters in both groups. It was found that Group 1 was more effective in terms of all parameters (p < 0.05). CONCLUSIONS Both Pilates and home exercises are effective in treating patients with chronic low back pain. UI can be useful for evaluating the core muscle thickness progression of chronic low back pain patients who are undergoing exercise therapy.
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Affiliation(s)
- Sevilay Batıbay
- Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Division of Rheumatology, Gazi University, Ankara, Turkey.
| | - Duygu Geler Külcü
- Haydarpaşa Numune Education and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - Özlem Kaleoğlu
- Haydarpaşa Numune Education and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - Nilgün Mesci
- Haydarpaşa Numune Education and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
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Abstract
BACKGROUND Low back pain has been the leading cause of disability globally for at least the past three decades and results in enormous direct healthcare and lost productivity costs. OBJECTIVES The primary objective of this systematic review is to assess the impact of exercise treatment on pain and functional limitations in adults with chronic non-specific low back pain compared to no treatment, usual care, placebo and other conservative treatments. SEARCH METHODS We searched CENTRAL (which includes the Cochrane Back and Neck trials register), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, SPORTDiscus, and trials registries (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform), and conducted citation searching of relevant systematic reviews to identify additional studies. The review includes data for trials identified in searches up to 27 April 2018. All eligible trials have been identified through searches to 7 December 2020, but have not yet been extracted; these trials will be integrated in the next update. SELECTION CRITERIA We included randomised controlled trials that assessed exercise treatment compared to no treatment, usual care, placebo or other conservative treatment on the outcomes of pain or functional limitations for a population of adult participants with chronic non-specific low back pain of more than 12 weeks' duration. DATA COLLECTION AND ANALYSIS Two authors screened and assessed studies independently, with consensus. We extracted outcome data using electronic databases; pain and functional limitations outcomes were re-scaled to 0 to 100 points for meta-analyses where 0 is no pain or functional limitations. We assessed risk of bias using the Cochrane risk of bias (RoB) tool and used GRADE to evaluate the overall certainty of the evidence. When required, we contacted study authors to obtain missing data. To interpret meta-analysis results, we considered a 15-point difference in pain and a 10-point difference in functional limitations outcomes to be clinically important for the primary comparison of exercise versus no treatment, usual care or placebo. MAIN RESULTS We included 249 trials of exercise treatment, including studies conducted in Europe (122 studies), Asia (38 studies), North America (33 studies), and the Middle East (24 studies). Sixty-one per cent of studies (151 trials) examined the effectiveness of two or more different types of exercise treatment, and 57% (142 trials) compared exercise treatment to a non-exercise comparison treatment. Study participants had a mean age of 43.7 years and, on average, 59% of study populations were female. Most of the trials were judged to be at risk of bias, including 79% at risk of performance bias due to difficulty blinding exercise treatments. We found moderate-certainty evidence that exercise treatment is more effective for treatment of chronic low back pain compared to no treatment, usual care or placebo comparisons for pain outcomes at earliest follow-up (MD -15.2, 95% CI -18.3 to -12.2), a clinically important difference. Certainty of evidence was downgraded mainly due to heterogeneity. For the same comparison, there was moderate-certainty evidence for functional limitations outcomes (MD -6.8 (95% CI -8.3 to -5.3); this finding did not meet our prespecified threshold for minimal clinically important difference. Certainty of evidence was downgraded mainly due to some evidence of publication bias. Compared to all other investigated conservative treatments, exercise treatment was found to have improved pain (MD -9.1, 95% CI -12.6 to -5.6) and functional limitations outcomes (MD -4.1, 95% CI -6.0 to -2.2). These effects did not meet our prespecified threshold for clinically important difference. Subgroup analysis of pain outcomes suggested that exercise treatment is probably more effective than education alone (MD -12.2, 95% CI -19.4 to -5.0) or non-exercise physical therapy (MD -10.4, 95% CI -15.2 to -5.6), but with no differences observed for manual therapy (MD 1.0, 95% CI -3.1 to 5.1). In studies that reported adverse effects (86 studies), one or more adverse effects were reported in 37 of 112 exercise groups (33%) and 12 of 42 comparison groups (29%). Twelve included studies reported measuring adverse effects in a systematic way, with a median of 0.14 (IQR 0.01 to 0.57) per participant in the exercise groups (mostly minor harms, e.g. muscle soreness), and 0.12 (IQR 0.02 to 0.32) in comparison groups. AUTHORS' CONCLUSIONS We found moderate-certainty evidence that exercise is probably effective for treatment of chronic low back pain compared to no treatment, usual care or placebo for pain. The observed treatment effect for the exercise compared to no treatment, usual care or placebo comparisons is small for functional limitations, not meeting our threshold for minimal clinically important difference. We also found exercise to have improved pain (low-certainty evidence) and functional limitations outcomes (moderate-certainty evidence) compared to other conservative treatments; however, these effects were small and not clinically important when considering all comparisons together. Subgroup analysis suggested that exercise treatment is probably more effective than advice or education alone, or electrotherapy, but with no differences observed for manual therapy treatments.
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Affiliation(s)
- Jill A Hayden
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Jenna Ellis
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Rachel Ogilvie
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Antti Malmivaara
- Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, Netherlands
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Song O, Seo KE, O’Sullivan DM, Park JJ. A Biomechanical Analysis of the Effect of Pilates Exercise on Female College Students with Knee Joint Deformity. THE ASIAN JOURNAL OF KINESIOLOGY 2021. [DOI: 10.15758/ajk.2021.23.3.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Current research on genu varum shows the favorable influence of exercise on the biomechanics of the knee joint by reducing the static malalignment and mechanical imbalances, however the transference to a more optimum gait has not been investigated.OBJECTIVES To investigate the effects of Pilates exercise on the changes of gait and lower limb malalignment in female students with genu varum.METHODS A total of 23 female college students with verified genu varum participated in this study. The participants were randomly assigned to two groups a Pilates exercise group (n=15) and a control group (n=8). The Pilates exercise group participated in 1 hour Pilates exercise 3 times per week for a total of 10 weeks. Each of the participants had an X-ray and performed gait 5 times before and after the exercise treatment. The participants kinetic and kinematic data were gathered using an eight Vicon Motion camera system and two force platforms.RESULTS For the Pilates group gait their maximum extension and internal rotation knee moment, and maximum adduction and internal rotation hip moment significantly increased, while the maximum knee moment flexion decreased. For the control group gait their maximum hip extension and hip adduction moment significantly decreased. For the Pilates group there was a significant reduction in the distance from the anatomical axis to the weight bearing line in the left leg, but there was no significant change for the control group.CONCLUSIONS The results suggest that Pilates exercise may be beneficial for females with genu varum by helping to improve both their static alignment and helping their gait to become more balanced.
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Altug Z. Lifestyle Medicine for Chronic Lower Back Pain: An Evidence-Based Approach. Am J Lifestyle Med 2021; 15:425-433. [PMID: 34366741 PMCID: PMC8299916 DOI: 10.1177/1559827620971547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022] Open
Abstract
Lower back pain is a leading cause of work absence and activity limitations globally, with a 60% to 85% lifetime chance of occurrence. This article highlights the role that lifestyle medicine plays in managing lower back pain as a cost-effective intervention strategy. It is suggested that lifestyle medicine strategies, such as incorporating whole foods and a plant-based diet, sustainable physical activity and mind-body exercises, restorative sleep, stress resiliency, awareness and mitigation of substance abuse and addiction, and establishing meaningful social networks and self-care strategies, be a part of managing chronic lower back pain.
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Affiliation(s)
- Ziya Altug
- IntegrativeDPT.com, Los Angeles, California
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The effect of aquatic exercise on functional disability, flexibility and function of trunk muscles in postmenopausal women with chronic non-specific low back pain: Randomized controlled trial. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Moreno-Muñoz MDM, Hita-Contreras F, Estudillo-Martínez MD, Aibar-Almazán A, Castellote-Caballero Y, Bergamin M, Gobbo S, Cruz-Díaz D. The Effects of Abdominal Hypopressive Training on Postural Control and Deep Trunk Muscle Activation: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2741. [PMID: 33800428 PMCID: PMC7967465 DOI: 10.3390/ijerph18052741] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/24/2021] [Accepted: 03/05/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Abdominal Hypopressive Training (AHT) provides postural improvement, and enhances deep trunk muscle activation. However, until recently, there was a lack of scientific literature supporting these statements. The major purpose of this study was to investigate the effect of AHT on posture control and deep trunk muscle function. METHODS 125 female participants aged 18-60 were randomly allocated to the Experimental Group (EG), consisting of two sessions of 30 min per week for 8 weeks of AHT, or the Control Group (CG), who did not receive any treatment. Postural control was measured with a stabilometric platform to assess the static balance and the activation of deep trunk muscles (specifically the Transverse Abdominal muscle (TrA)), which was measured by real-time ultrasound imaging. RESULTS The groups were homogeneous at baseline. Statistical differences were identified between both groups after intervention in the Surface of the Center of Pressure (CoP) Open-Eyes (S-OE) (p = 0.001, Cohen's d = 0.60) and the Velocity of CoP under both conditions; Open-Eyes (V-OE) (p = 0.001, Cohen´s d = 0.63) and Close-Eyes (V-CE) (p = 0.016, Cohen´s d = 0.016), with the EG achieving substantial improvements. Likewise, there were statistically significant differences between measurements over time for the EG on S-OE (p < 0.001, Cohen´s d = 0.99); V-OE (p = 0.038, Cohen´s d = 0.27); V-CE (p = 0.006, Cohen´s d = 0.39), anteroposterior movements of CoP with Open-Eyes (RMSY-OE) (p = 0.038, Cohen´s d = 0.60) and activity of TrA under contraction conditions (p < 0.001, Cohen´s d = 0.53). CONCLUSIONS The application of eight weeks of AHT leads to positive outcomes in posture control, as well as an improvement in the deep trunk muscle contraction in the female population.
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Affiliation(s)
- María del Mar Moreno-Muñoz
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, E-23071 Jaén, Spain; (M.d.M.M.-M.); (F.H.-C.); (A.A.-A.); (D.C.-D.)
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, E-23071 Jaén, Spain; (M.d.M.M.-M.); (F.H.-C.); (A.A.-A.); (D.C.-D.)
| | | | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, E-23071 Jaén, Spain; (M.d.M.M.-M.); (F.H.-C.); (A.A.-A.); (D.C.-D.)
| | - Yolanda Castellote-Caballero
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, E-23071 Jaén, Spain; (M.d.M.M.-M.); (F.H.-C.); (A.A.-A.); (D.C.-D.)
| | - Marco Bergamin
- Department of Medicine, University of Padova Palazzina ex SemeioticaMedica-Via Ospedale Civile, 105 35128 Padova, Italy; (M.B.); (S.G.)
| | - Stefano Gobbo
- Department of Medicine, University of Padova Palazzina ex SemeioticaMedica-Via Ospedale Civile, 105 35128 Padova, Italy; (M.B.); (S.G.)
| | - David Cruz-Díaz
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, E-23071 Jaén, Spain; (M.d.M.M.-M.); (F.H.-C.); (A.A.-A.); (D.C.-D.)
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de Souza Andrade L, da Silva Almeida I, Mochizuki L, Sousa CV, Falk Neto JH, Kennedy MD, Quagliotti Durigan JL, Mota YL. What is the exercise intensity of Pilates? An analysis of the energy expenditure, blood lactate, and intensity of apparatus and mat Pilates sessions. J Bodyw Mov Ther 2020; 26:36-42. [PMID: 33992270 DOI: 10.1016/j.jbmt.2020.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 11/08/2020] [Accepted: 12/05/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Pilates is a form of exercise commonly used in rehabilitation settings that improves muscular fitness and flexibility. However, it is unknown whether the energy expenditure (EE) from Pilates sessions could also lead to the intensity suggested by health organizations to improve physical fitness. This study aimed to quantify and compare the intensity and the EE of two different Pilates sessions (mat and apparatus). METHODS 18 healthy females (age: 22 ± 3 years; height: 1.6 ± 0.1m; body mass: 61.0 ± 10.0 kg; body mass index: 21 ± 3 kg/m2) performed two different sessions. Each session involved the performance of 15 exercises. Oxygen consumption (V˙O2) was measured continuously and then converted to EE in Kcal/min. Blood lactate, heart rate (HR), and blood pressure (BP) were also measured. A repeated measures two-way ANOVA (time X group) determined differences between sessions. Bonferroni's post hoc analysis was used to identify significant differences between measures. RESULTS The Reformer apparatus and Mat sessions presented an EE of 2.59 ± 0.53 and 1.93 ± 0.26 kcal/min, respectively. V˙O2 was higher for the Reformer session (8.67 ± 1.15 ml/kg/min) when compared to Mat (6.44 ± 0.73 ml/kg/min). There was no significant increase in blood lactate, HR, and BP for either session above resting values. CONCLUSION The Pilates sessions analyzed in this study elicit low cardiovascular stress, leading to low EE levels. However, a typical session performed on the Reformer apparatus presented a higher EE, V˙O2, and HR compared to the Mat Pilates session.
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Affiliation(s)
| | - Isabella da Silva Almeida
- Physiotherapy Department, Universidade Católica de Brasília, Distrito Federal, Brazil; Postgraduate Program in Rehabilitation Science, Faculdade de Ceilândia, Universidade de Brasília, Brasília, Distrito Federal, Brazil.
| | - Luís Mochizuki
- School of Arts, Sciences and Humanities, Faculty of Physical Education and Health, Universidade de São Paulo, São Paulo, Brazil
| | - Caio Victor Sousa
- Physical Education Department, Universidade Católica de Brasília, Distrito Federal, Brazil
| | - João Henrique Falk Neto
- Athlete Health Lab, Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Michael David Kennedy
- Athlete Health Lab, Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - João Luiz Quagliotti Durigan
- Postgraduate Program in Rehabilitation Science, Faculdade de Ceilândia, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | - Yomara Lima Mota
- Physiotherapy Department, Universidade Católica de Brasília, Distrito Federal, Brazil
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Barros BSD, Imoto AM, O'Neil J, Duquette-Laplante F, Perrier MF, Dorion M, Franco ESB, Brosseau L, Peccin MS. The management of lower back pain using pilates method: assessment of content exercise reporting in RCTs. Disabil Rehabil 2020; 44:2428-2436. [PMID: 33096012 DOI: 10.1080/09638288.2020.1836269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the quality of the reporting of exercise interventions with Pilates method for the treatment of lower back pain (LBP) in adults. MATERIALS AND METHODS Two independent evaluators selected randomized controlled trials (RCTs) of moderate and high methodological quality included in a Cochrane Systematic Review (SR) and from an additional updated search in the following databases: CENTRAL, MEDLINE, EMBASE, CINAHL, PEDro and SPORTDiscus. Three assessment tools (Consensus on Therapeutic Exercise Training (CONTENT) scale, Template for Intervention Description and Replication (TIDieR) checklist and Consensus on Exercise Reporting Template (CERT) checklist) were utilized by three pairs of two independent researchers trained. The scales' concordance was measured using the Kappa coefficient. RESULTS Ten RCTs were included. The CONTENT scale score was 5.3 (± 1.33) out of 9 points; the TIDieR checklist was 8.5 (± 1.71) out of 12 points and the CERT checklist was 9.5 (± 3.62) out of 19 points. The CONTENT and CERT had moderate concordance, while there was fair concordance between the other tools. CONCLUSIONS The overall reporting quality for the Pilates exercises in ten moderate-to-high quality RTCs for the management of LBP was low according to CONTENT scale and CERT checklist and high according to TIDieR checklist.Implications for RehabilitationReporting of Pilates exercise program in moderate-to-high quality RCTs for the management of lower back pain remains incomplete.Pilates exercise program should be personalized and contextualized to individual participants.There may be a need to consider adding to or combining the information available from various trials.
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Affiliation(s)
- Brenison Souza de Barros
- Programa de Pós Graduação Interdisciplinar em Ciências da Saúde, Universidade Federal de São Paulo, Santos, Brazil
| | - Aline Mizusaki Imoto
- Mestrado Profissional e Acadêmico em Ciências da Saúde, Escola Superior em Ciências da Saúde, Brasilia, Brazil
| | - Jennifer O'Neil
- School of Rehabilitation Sciences, Faculty of Health Sciences, Bruyere Research Institute, University of Ottawa, Ottawa, Canada
| | - Fauve Duquette-Laplante
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Marie-France Perrier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Michelle Dorion
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Lucie Brosseau
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Maria Stella Peccin
- Programa de Pós Graduação Interdisciplinar em Ciências da Saúde, Universidade Federal de São Paulo, Santos, Brazil
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Hanel J, Owen PJ, Held S, Tagliaferri SD, Miller CT, Donath L, Belavy DL. Effects of Exercise Training on Fear-Avoidance in Pain and Pain-Free Populations: Systematic Review and Meta-analysis. Sports Med 2020; 50:2193-2207. [PMID: 32946074 DOI: 10.1007/s40279-020-01345-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Fear of pain and movement is an important factor in the development of hypervigilance and avoidance behaviours. OBJECTIVE We examined the effectiveness of exercise training on improving fear-avoidance beliefs. METHODS A systematic review (data sources: MEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL) and metaanalysis of randomised controlled/clinical trials of exercise training in adults versus relevant nonexercise comparators that quantified fear-avoidance was conducted. RESULTS After screening 4603 identified records, 17 (2014 participants) and 13 (1152 participants) studies were eligible for qualitative and quantitative synthesis, respectively. Pairwise meta-analysis showed exercise training was more effective than all non-exercise comparators (standardised mean difference (SMD) [95% CI] - 0.378 [- 0.623, - 0.133], P = 0.002, Grading of Recommendations Assessment, Development and Evaluation [GRADE]: very low) for reducing fear-avoidance. Exercise training was more effective than true control for reducing fear avoidance (- 0.407 [- 0.750, - 0.065], P = 0.020, GRADE: very low), however it was not more effective than other interventions (- 0.243 [- 0.614, 0.128], P = 0.199, GRADE: very low). In people with low back pain, exercise training was more effective than non-exercise comparator groups for reducing fear-avoidance (- 0.530 [- 0.755, - 0.304], P < 0.001, GRADE: very low). For individuals with neck pain, exercise training was not more effective than non-exercise comparator groups for reducing fear-avoidance (0.061 [- 0.360, 0.482], P = 0.777, GRADE: very low). CONCLUSION There is very low to low-quality evidence that exercise training is effective for reducing fear-avoidance, including in people with low back pain. Exercise training may be more effective than no intervention for reducing fear avoidance, but there is very low-quality evidence that non-exercise interventions are as effective as exercise for fear avoidance. Few studies with low risk of bias is a limitation. TRAIL REGISTRATION PROSPERO Registration Number: CRD42019139678.
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Affiliation(s)
- Joshua Hanel
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, VIC, 3125, Australia
| | - Patrick J Owen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, VIC, 3125, Australia
| | - Steffen Held
- German Sports University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Scott D Tagliaferri
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, VIC, 3125, Australia
| | - Clint T Miller
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, VIC, 3125, Australia
| | - Lars Donath
- German Sports University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Daniel L Belavy
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, VIC, 3125, Australia.
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Gulsen C, Soke F, Eldemir K, Apaydin Y, Ozkul C, Guclu-Gunduz A, Akcali DT. Effect of fully immersive virtual reality treatment combined with exercise in fibromyalgia patients: a randomized controlled trial. Assist Technol 2020; 34:256-263. [DOI: 10.1080/10400435.2020.1772900] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- C. Gulsen
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - F. Soke
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - K. Eldemir
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Y. Apaydin
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - C. Ozkul
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - A. Guclu-Gunduz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - D. T. Akcali
- Faculty of Medicine, Department of Algology, Gazi University, Ankara, Turkey
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Domingues de Freitas C, Costa DA, Junior NC, Civile VT. Effects of the pilates method on kinesiophobia associated with chronic non-specific low back pain: Systematic review and meta-analysis. J Bodyw Mov Ther 2020; 24:300-306. [PMID: 32826004 DOI: 10.1016/j.jbmt.2020.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 12/11/2019] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Patients with chronic low back pain with higher levels of kinesiophobia have a 41% greater risk of developing a physical disability. The kinesiophobia model suggests that patients fear movements because of pain, associating movement with worsening of their state. Studies that apply the Pilates method for chronic low back pain achieve positive results in reducing pain and disability, and moderate results regarding kinesiophobia. OBJECTIVE The purpose of this review is to evaluate the effects of the Pilates method on kinesiophobia associated with chronic non-specific low back pain. SEARCH METHODS The following databases were searched from August to October 2018: MEDLINE, PEDro, SciELO, LILACS and the Cochrane Database of Systematic Reviews (CENTRAL), without restriction of language and year of publication. SELECTION CRITERIA Randomized clinical trials assessing the effectiveness of the Pilates method in the treatment of kinesiophobia in patients with chronic non-specific low back pain. DATA COLLECTION AND ANALYSIS Two authors independently selected the studies, assessed the risk of bias and extracted data. A third author was consulted in case of disagreements. The primary outcome was kinesiophobia as evaluated by the Tampa scale. RESULTS Our electronic searches resulted in 314 studies; 288 studies were excluded and 27 were selected for reading in full-text. Five articles were included in this review and four in the meta-analysis. CONCLUSION There is a favorable effect of the Pilates method compared to minimal intervention or no treatment in reducing kinesiophobia associated with chronic non-specific low back pain, with a moderate quality of evidence. DESCRIPTORS Low Back Pain, Exercise Movement Techniques, Exercises, Pilates-Based.
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Affiliation(s)
| | | | - Nelson Carvas Junior
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Universidade Paulista (UNIP), Brazil
| | - Vinicius Tassoni Civile
- Universidade Metodista de São Paulo for Universidade Federal de São Paulo (UNIFESP), Universidade Paulista (UNIP), Brazil
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Owen PJ, Miller CT, Mundell NL, Verswijveren SJJM, Tagliaferri SD, Brisby H, Bowe SJ, Belavy DL. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med 2019; 54:1279-1287. [PMID: 31666220 PMCID: PMC7588406 DOI: 10.1136/bjsports-2019-100886] [Citation(s) in RCA: 205] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2019] [Indexed: 12/29/2022]
Abstract
Objective Examine the effectiveness of specific modes of exercise training in non-specific chronic low back pain (NSCLBP). Design Network meta-analysis (NMA). Data sources MEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL. Eligibility criteria Exercise training randomised controlled/clinical trials in adults with NSCLBP. Results Among 9543 records, 89 studies (patients=5578) were eligible for qualitative synthesis and 70 (pain), 63 (physical function), 16 (mental health) and 4 (trunk muscle strength) for NMA. The NMA consistency model revealed that the following exercise training modalities had the highest probability (surface under the cumulative ranking (SUCRA)) of being best when compared with true control: Pilates for pain (SUCRA=100%; pooled standardised mean difference (95% CI): −1.86 (–2.54 to –1.19)), resistance (SUCRA=80%; −1.14 (–1.71 to –0.56)) and stabilisation/motor control (SUCRA=80%; −1.13 (–1.53 to –0.74)) for physical function and resistance (SUCRA=80%; −1.26 (–2.10 to –0.41)) and aerobic (SUCRA=80%; −1.18 (–2.20 to –0.15)) for mental health. True control was most likely (SUCRA≤10%) to be the worst treatment for all outcomes, followed by therapist hands-off control for pain (SUCRA=10%; 0.09 (–0.71 to 0.89)) and physical function (SUCRA=20%; −0.31 (–0.94 to 0.32)) and therapist hands-on control for mental health (SUCRA=20%; −0.31 (–1.31 to 0.70)). Stretching and McKenzie exercise effect sizes did not differ to true control for pain or function (p>0.095; SUCRA<40%). NMA was not possible for trunk muscle endurance or analgesic medication. The quality of the synthesised evidence was low according to Grading of Recommendations Assessment, Development and Evaluation criteria. Summary/conclusion There is low quality evidence that Pilates, stabilisation/motor control, resistance training and aerobic exercise training are the most effective treatments, pending outcome of interest, for adults with NSCLBP. Exercise training may also be more effective than therapist hands-on treatment. Heterogeneity among studies and the fact that there are few studies with low risk of bias are both limitations.
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Affiliation(s)
- Patrick J Owen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Clint T Miller
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Niamh L Mundell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Simone J J M Verswijveren
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Scott D Tagliaferri
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Helena Brisby
- Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Steven J Bowe
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, Victoria, Australia
| | - Daniel L Belavy
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Conservative Interventions Reduce Fear in Individuals With Chronic Low Back Pain: A Systematic Review. Arch Phys Med Rehabil 2019; 101:329-358. [PMID: 31473206 DOI: 10.1016/j.apmr.2019.08.470] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To systematically review and critically appraise the effectiveness of conservative and surgical interventions to reduce fear in studies of people with chronic low back pain, based on the analysis of randomized controlled trials for which fear was a primary or secondary outcome. DATA SOURCES Electronic databases PubMed, CINAHL, PsycINFO, PEDro, and CENTRAL, as well as manual searches and grey literature were searched from inception until May 2019. STUDY SELECTION Randomized controlled trials analyzing the effectiveness of conservative and surgical interventions to reduce fear were included. DATA EXTRACTION Two reviewers independently conducted the search strategy, study selection, data extraction, risk of bias assessment, and quality of the evidence judgment. DATA SYNTHESIS Sixty-one studies (n=7201) were included. A large number of fear-related search terms were used but only 3 fear constructs (kinesiophobia, fear-avoidance beliefs, fear of falling) were measured in the included studies. Multidisciplinary and psychological interventions as well as exercise reduced kinesiophobia. Fear-avoidance beliefs were reduced by the aforementioned interventions, manual therapy, and electrotherapy. A multidisciplinary intervention reduced the fear of falling. There was moderate evidence of multidisciplinary interventions and exercise to reduce kinesiophobia. There was moderate evidence of manual therapy and electrotherapy to reduce fear-avoidance beliefs. CONCLUSIONS The present systematic review highlights the potential effectiveness of conservative interventions to reduce kinesiophobia and fear-avoidance beliefs in individuals with chronic low back pain. This information can help health professionals to reduce fear when treating patients with this condition.
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King KM, Estill O. Exercise as a Treatment for Chronic Pain. ACSM'S HEALTH & FITNESS JOURNAL 2019. [DOI: 10.1249/fit.0000000000000461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Eliks M, Zgorzalewicz-Stachowiak M, Zeńczak-Praga K. Application of Pilates-based exercises in the treatment of chronic non-specific low back pain: state of the art. Postgrad Med J 2019; 95:41-45. [PMID: 30636192 PMCID: PMC6581086 DOI: 10.1136/postgradmedj-2018-135920] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 11/23/2018] [Accepted: 12/10/2018] [Indexed: 12/19/2022]
Abstract
According to the current recommendations on the management of chronic non-specific low back pain (CNLBP), the intervention in this group of patients should include a programme of exercises. Pilates is a system of exercises widely used in patients with low back pain. The practices based on this method have promoted the restoration of the function of muscles involved in lumbopelvic stabilisation, that is, transversus abdominis, multifidus, diaphragm and pelvic floor muscles. During each exercise, specific principles of this method should be followed to restore or sustain the motor control of the lumbar spine and proper body posture. The aim of this study is to present the current state of knowledge concerning the application of Pilates method in the management of CNLBP as well as to define factors (eg, duration, frequency, exercises performed on a mat or specific equipment) influencing the effectiveness of Pilates in these individuals.
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Affiliation(s)
- Małgorzata Eliks
- Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, Heliodor Swiecicki Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland
| | - Małgorzata Zgorzalewicz-Stachowiak
- Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, Heliodor Swiecicki Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland
| | - Krystyna Zeńczak-Praga
- Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, Heliodor Swiecicki Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland
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Paolucci T, Attanasi C, Cecchini W, Marazzi A, Capobianco SV, Santilli V. Chronic low back pain and postural rehabilitation exercise: a literature review. J Pain Res 2018; 12:95-107. [PMID: 30588084 PMCID: PMC6305160 DOI: 10.2147/jpr.s171729] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Chronic low back represents one of the major causes of disability worldwide. Our narrative review has the purpose of highlighting the evidence supporting the different rehabilitative techniques described for its management. In total, 26 studies were found suitable to be included in the review (14 articles about pilates, six about McKenzie (MK), one article about Feldenkrais, three about Global Postural Rehabilitation (GPR) and two about Proprioceptive Neuromuscular Facilitation). The effect of exercise therapy was examined for each single study through changes in the main clinical outcomes (pain, disability,) quality of life (QoL) and psychological aspects and the targeted aspects of physical function (muscle strength, mobility, muscular activity and flexibility). All the techniques are effective for the study groups with respect to the control groups in reducing pain and disability and improving the QoL and maintaining benefits at follow-up; pilates, Back School, MK and Feldenkrais methods reduce pain and are more efficient than a pharmacological or instrumental approach in reducing disability and improving all psychological aspects also. GPR shows long lasting results for the last outcome. To date, it is difficult to affirm the superiority of one approach over another. Further high quality research is needed to confirm the effect of these techniques, together with the use of more appropriate evaluation measures.
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Affiliation(s)
- Teresa Paolucci
- Department of Physical Medicine and Rehabilitation, Policlinico Universitario Umberto I, Sapienza University, Rome, Italy,
| | - Carmine Attanasi
- Department of Physical Medicine and Rehabilitation, Policlinico Universitario Umberto I, Sapienza University, Rome, Italy,
| | - Walter Cecchini
- Physical Medicine and Rehabilitation Unit, S. Filippo Neri Hospital, Rome, Italy
| | - Alessandra Marazzi
- Physical Medicine and Rehabilitation Unit, S. Filippo Neri Hospital, Rome, Italy
| | - Serena V Capobianco
- Department of Physical Medicine and Rehabilitation, Policlinico Universitario Umberto I, Sapienza University, Rome, Italy,
| | - Valter Santilli
- Department of Physical Medicine and Rehabilitation, Policlinico Universitario Umberto I, Sapienza University, Rome, Italy,
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Miranda S, Marques A. Pilates in noncommunicable diseases: A systematic review of its effects. Complement Ther Med 2018; 39:114-130. [PMID: 30012382 DOI: 10.1016/j.ctim.2018.05.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/31/2018] [Accepted: 05/31/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES Chronic cardiovascular diseases, cancer, chronic respiratory diseases and diabetes are the four major groups of non-communicable diseases (NCDs) and the main cause of mortality worldwide. Pilates has been described as an effective intervention to promote healthy behaviors and physical activity in people with chronic diseases. However, the evidence of its effects in NCDs have not been systematized. We investigated the effects of Pilates in the four major groups of NCDs. DESIGN A systematic review was performed. Searches were conducted on Cochrane Library, EBSCO, PubMed, Science Direct, Scopus and Web of Science databases. Studies were rated with the quality assessment tool for quantitative studies. As a meta-analysis was not possible to conduct, a best-evidence synthesis was used. RESULTS Twelve studies, mostly of moderate quality, were included with 491 participants (78.6% females; age range 13-70 years old) with breast cancer (n = 3), diabetes (n = 3), chronic stroke (2 years post stroke) (n = 2), chronic obstructive pulmonary disease (n = 1), cystic fibrosis (n = 1), heart failure (n = 1) and arterial hypertension (n = 1). The best-evidence synthesis revealed strong evidence for improving exercise tolerance; moderate evidence for improving symptoms, muscle strength and health-related quality of life and limited or conflicting evidence on vital signs, metabolic parameters, body composition, respiratory function, functional status, balance, flexibility and social support. CONCLUSIONS Pilates should be considered for patients with NCDs, as it improves exercise tolerance. Future studies with robust methodologies are still needed to clarify its effectiveness on outcomes with moderate, limited or conflicting evidence and to establish the most suitable intervention protocol.
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Affiliation(s)
- Sara Miranda
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute for Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.
| | - Alda Marques
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute for Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.
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Cruz-Díaz D, Romeu M, Velasco-González C, Martínez-Amat A, Hita-Contreras F. The effectiveness of 12 weeks of Pilates intervention on disability, pain and kinesiophobia in patients with chronic low back pain: a randomized controlled trial. Clin Rehabil 2018; 32:1249-1257. [PMID: 29651872 DOI: 10.1177/0269215518768393] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the effectiveness of 12 weeks of Pilates practice on disability, pain and kinesiophobia in patients with chronic non-specific low back pain. DESIGN This is a randomized controlled trial. SETTING This study was conducted in the university laboratory. SUBJECTS A total of 64 participants with chronic non-specific low back pain were included. INTERVENTIONS Participants were randomly allocated to intervention group consisted in Pilates intervention during 12 weeks ( n = 32) or control group who received no treatment ( n = 32). MAIN MEASURES Disability, pain and kinesiophobia were assessed by Roland Morris Disability Questionnaire, visual analogue scale and Tampa Scale of Kinesiophobia, respectively. Measurements were performed at baseline, at 6 and 12 weeks after study completion. RESULTS There were significant differences between groups with observed improvement in Pilates intervention group in all variables after treatment ( P < 0.001). Major changes on disability and kinesiophobia were observed at six weeks of intervention with no significant difference after 12 weeks ( P < 0.001). Mean changes of the intervention group compared with the control group were 4.00 (0.45) on the Roland Morris Disability Questionnaire and 5.50 (0.67) in the Tampa Scale of Kinesiophobia. Pain showed better results at six weeks with a slightly but statistically significant improvement at 12 weeks with Visual Analogue Scale scores of 2.40 (0.26) ( P < 0.001). CONCLUSION Pilates intervention in patients with chronic non-specific low back pain is effective in the management of disability, pain and kinesiophobia.
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Affiliation(s)
- David Cruz-Díaz
- 1 Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Marta Romeu
- 2 Unit of Pharmacology, Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, NFOC Group, Universitat Rovira i Virgili, Reus, Spain
| | - Carmen Velasco-González
- 1 Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Antonio Martínez-Amat
- 1 Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Fidel Hita-Contreras
- 1 Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
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