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Woramontri C, Chaunchaiyakul R, Yang AL, Lin YY, Masodsai K. Effect of Mat Pilates Training on Blood Pressure, Inflammatory, and Oxidative Profiles in Hypertensive Elderly. Sports (Basel) 2024; 12:120. [PMID: 38786989 PMCID: PMC11125445 DOI: 10.3390/sports12050120] [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: 03/20/2024] [Revised: 04/20/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
To determine the effects of mat Pilates training on blood pressure, inflammatory, and antioxidative markers in hypertensive elderly people, 34 hypertensive subjects aged 60-75 years were randomly divided into a control group (CON; n = 17) and a mat Pilates training group (MP; n = 17). The CON participants conducted normal daily activities and participated in neither organized exercises nor sports training, while those in the MP group received mat Pilates training for 60 min three times/week for 12 weeks. Parameters including blood pressure, cardiovascular function, nitric oxide (NO), tumor necrotic factor-alpha (TNF-α), superoxide dismutase (SOD), and malonaldehyde (MDA) were collected at baseline and the end of 12 weeks. The MP group had significantly decreased blood pressure, improved cardiovascular variables, decreased MDA and TNF-α, and increased NO and SOD compared with the CON group and the pre-training period (p < 0.05). In conclusion, these findings demonstrate the positive effects of 12 weeks of mat Pilates training in terms of reducing blood pressure and increasing blood flow related to improvements in anti-inflammatory and antioxidative markers in hypertensive elderly people. Mat Pilates training might be integrated as an alternative therapeutic exercise modality in clinical practice for hypertensive elderly individuals.
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Affiliation(s)
- Chutima Woramontri
- Exercise Physiology in Special Population Research Unit, Faculty of Sports Science, Chulalongkorn University, Bangkok 10330, Thailand;
| | | | - Ai-Lun Yang
- Institute of Sports Sciences, University of Taipei, Taipei 11153, Taiwan;
| | - Yi-Yuan Lin
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan;
| | - Kunanya Masodsai
- Exercise Physiology in Special Population Research Unit, Faculty of Sports Science, Chulalongkorn University, Bangkok 10330, Thailand;
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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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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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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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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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Goff L. Managing the Rider. Vet Clin North Am Equine Pract 2022; 38:603-616. [DOI: 10.1016/j.cveq.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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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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Itoh N, Mishima H, Yoshida Y, Yoshida M, Oka H, Matsudaira K. Evaluation of the Effect of Patient Education and Strengthening Exercise Therapy Using a Mobile Messaging App on Work Productivity in Japanese Patients With Chronic Low Back Pain: Open-Label, Randomized, Parallel-Group Trial. JMIR Mhealth Uhealth 2022; 10:e35867. [PMID: 35576560 PMCID: PMC9152720 DOI: 10.2196/35867] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/17/2022] [Accepted: 03/22/2022] [Indexed: 12/02/2022] Open
Abstract
Background Artificial intelligence–assisted interactive health promotion systems are useful tools for the management of musculoskeletal conditions. Objective This study aimed to explore the effects of web-based video patient education and strengthening exercise therapy, using a mobile messaging app, on work productivity and pain in patients with chronic low back pain (CLBP) receiving pharmacological treatment. Methods Patients with CLBP were randomly allocated to either the exercise group, who received education and exercise therapy using a mobile messaging app, or the conventional group. For patient education, a web-based video program was used to provide evidence-based thinking regarding the importance of a cognitive behavioral approach for CLBP. The exercise therapy was developed in accordance with the recommendations for alignment, core muscles, and endogenous activation, including improvement of posture and mobility for proper alignment, stimulation and/or strengthening of deep muscles for spinal stability, and operation of intrinsic pain for the activation of endogenous substances by aerobic exercise. Both groups continued to receive the usual medical care with pharmacological treatment. The end points were changes in work productivity, pain intensity, quality of life, fear of movement, and depression. The observation period for this study was 12 weeks. An analysis adjusted for baseline values, age at the time of consent acquisition, sex, and willingness to strengthen the exercise therapy was performed. Results The exercise and conventional groups included 48 and 51 patients, with a mean age of 47.9 years (SD 10.2 years; n=27, 56.3% male patients) and 46.9 years (SD 12.3 years; n=28, 54.9% male patients) in the full analysis set, respectively. No significant impact of these interventions on work productivity was observed in the exercise group compared with the conventional group (primary end point: Quantity and Quality method; 0.062 vs 0.114; difference between groups −0.053, 95% CI −0.184 to 0.079; P=.43). However, the exercise group showed consistently better trends for the other end points than did the conventional group. Compared with the conventional group, the exercise group showed a significant improvement in the symptoms of low back pain (3.2 vs 3.8; difference between groups −0.5, 95% CI −1.1 to 0.0; P=.04), quality of life (EuroQoL 5 Dimensions 5 Level: 0.068 vs 0.006; difference between groups 0.061, 95% CI 0.008 to 0.114; P=.03), and fear of movement at week 12 (−2.3 vs 0.5; difference between groups −2.8, 95% CI −5.5 to −0.1; P=.04). Conclusions This study suggests that patient education and strengthening exercise therapy using a mobile messaging app may be useful for treating CLBP. This study does not reveal the effect of therapeutic interventions on CLBP on work productivity. Thus, further research is required to assess work productivity with therapeutic interventions. Trial Registration University Hospital Medical Information Network Clinical Trials Registry UMIN000041037; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046866
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Affiliation(s)
- Naohiro Itoh
- Medical Affairs Department, Shionogi & Co, Ltd, Osaka, Japan
| | | | - Yuki Yoshida
- Data Science Department, Shionogi & Co, Ltd, Osaka, Japan
| | - Manami Yoshida
- Medical Affairs Department, Shionogi & Co, Ltd, Osaka, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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Pilates for neck pain: A systematic review and meta-analysis of randomised controlled trials. J Bodyw Mov Ther 2022; 31:37-44. [DOI: 10.1016/j.jbmt.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/04/2022] [Accepted: 03/17/2022] [Indexed: 11/23/2022]
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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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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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12
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Bellido-Fernández L, Jiménez-Rejano JJ, Chillón-Martínez R, Lorenzo-Muñoz A, Pinero-Pinto E, Rebollo-Salas M. Clinical relevance of massage therapy and abdominal hypopressive gymnastics on chronic nonspecific low back pain: a randomized controlled trial. Disabil Rehabil 2021; 44:4233-4240. [PMID: 33587856 DOI: 10.1080/09638288.2021.1884903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To determine the clinical relevance of the effects that Massage-Therapy (MT) and Abdominal-Hypopressive-Gymnastics (AHG) and the combination of both procedures have on the disability, pain intensity, quality of life, and lumbar mobility of patients with chronic nonspecific low back pain (CNSLBP). METHODS A randomized controlled-trial with parallel-groups, concealed allocation, assessor blinding, and intention-to-treat analysis was carried out. The sample included 60 adults with CNSLBP. The participants received MT (n = 20), AHG (n = 20), or MT + AHG (n = 20). Each group received 8 interventions. RESULTS The ODI change scores were significantly higher (p < 0.05) in the MT + AHG group than in the other two groups. Significant differences were found in the results of NRS, Schober's test, and SF-12 PCS (p < 0.05) in each group. There were significant differences (p < 0.05) between the values of SF-12 MCS in AHG and MT + AHG groups. CONCLUSIONS Massage Therapy and Abdominal Hypopressive Gymnastics reduce pain levels, increase the mobility of the lumbar spine, and improve disability and quality of life (PCS) in patients with CNSLBP in the short term. Likewise, AHG and MT + AHG improve quality of life (MCS). The combination of both therapies provides more benefits in terms of lumbar disability in patients with CNSLBP in the short term. This improvement is clinically relevant. TRIAL REGISTRATION ClinicalTrials.gov (NCT02721914). IMPLICATIONS FOR REHABILITATIONMassage Therapy (MT) and Abdominal Hypopressive Gymnastics (AHG), reduce pain, improve mobility and quality of life, and reduce disability in the short term.These results are clinically relevant.The combination of manual and active therapy (MT + AHG) seems to be more effective and produces clinically relevant changes.
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13
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Hernando-Jorge A, Pérez-Del-Pozo D, Sánchez-Martín D, Beltran-Alacreu H. [Therapeutic exercise as treatment for spinal chronic pain: systematic review of randomized clinical trials]. Rehabilitacion (Madr) 2021; 55:49-66. [PMID: 32888707 DOI: 10.1016/j.rh.2020.06.005] [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: 11/11/2019] [Revised: 06/25/2020] [Accepted: 06/28/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of the present review was to analyze and compare the effectiveness of different types of therapeutic exercise in people with chronic spinal pain. METHODS Data search was conducted using the electronic database MEDLINE. Randomized clinical trials, conducted in patients between 18 and 65 years old with chronic pain in the spine region, were included. RESULTS Two independent reviewers performed the analysis of methodological quality using the PEDro scale, with 13 studies finally selected. The different types of therapeutic exercise had significant effects on pain reduction, decrease of disability and improvement of the quality of life of the patients. CONCLUSIONS The results show that there is no modality of therapeutic exercise superior to others. The combination of different therapeutic exercise modalities could be a complete tool for the management of chronic pain in the spine.
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Affiliation(s)
- A Hernando-Jorge
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - D Pérez-Del-Pozo
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - D Sánchez-Martín
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - H Beltran-Alacreu
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España; CranioSPain Research Group. Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, España.
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14
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Kinesiophobia Is Associated With Pain Intensity and Disability in Chronic Shoulder Pain: A Cross-Sectional Study. J Manipulative Physiol Ther 2020; 43:791-798. [PMID: 32829946 DOI: 10.1016/j.jmpt.2019.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 10/23/2019] [Accepted: 12/06/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Kinesiophobia is a clinically relevant factor in the management of chronic musculoskeletal pain. The aim of this study was to explore the cross-sectional association between kinesiophobia and both pain intensity and disability among individuals with chronic shoulder pain. METHODS A total of 65 participants with chronic unilateral subacromial shoulder pain were recruited from 3 primary care centers. The Shoulder Pain and Disability Index assessed pain intensity and disability. The Tampa Scale for Kinesiophobia short form assessed the presence of kinesiophobia. A linear multivariable regression analysis evaluated the potential association between kinesiophobia and range of movement free of pain with pain intensity and disability. The analysis was adjusted for sex and age. RESULTS In the linear multivariable regression analysis, only greater kinesiophobia (standardized β = 0.35, P < .01) and sex (standardized β = -0.29, P < .01) contributed to explain 19% of the variance in shoulder pain and disability scores. CONCLUSION This cross-sectional study provides preliminary evidence about the association between kinesiophobia and pain intensity and disability among individuals with chronic shoulder pain. However, our findings only contributed to explain 19% of the variance in shoulder pain and disability scores.
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15
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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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16
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Wong VL, Holahan MR. A systematic review of aerobic and resistance exercise and inflammatory markers in people with multiple sclerosis. Behav Pharmacol 2020; 30:653-660. [PMID: 31703029 DOI: 10.1097/fbp.0000000000000514] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Inflammation is a driver in the demyelination process in patients with multiple sclerosis (MS) and can influence disability levels. Both single and repeated bouts of exercise can decrease inflammatory markers in people with MS (PwMS). This systematic review evaluates whether exercise can influence inflammation and disability in individuals with MS. Experimental studies were reviewed that had to meet the following eligibility requirements: a sample of PwMS, an intervention of exercise (either aerobic, resistance, or a combination of each), and an outcome that included at least one inflammatory (cytokine) reaction. The main outcome measure was an evaluation of inflammation, as indicated by a change in any cytokine level. Other measures included muscle strength, balance, flexibility, walking ability, disability statues, and quality of life (QOL). A total of nine studies were included in the final review. Exercise interventions included predominantly cycling, although a few resistance training trials were mentioned. Small decreases were found in IL-17 and IFN-γ after exercise. Functional outcome measures and perceived disability status were improved posttraining. We conclude that while interventions such as exercise may impact QOL, they do not have a significant influence on inflammation associated with MS. Exercise is an accessible alternative that not only helps to decrease impairments but also limit the restrictions associated with participation in society. While functional outcomes after exercise improved, these improvements may not be attributable to changes in levels of cytokines or inflammatory markers.
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Affiliation(s)
- Vicki L Wong
- Department of Neuroscience, Carleton University, Ottawa, Canada
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17
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Effects of the Mat Pilates Method on Body Composition: Systematic Review With Meta-Analysis. J Phys Act Health 2020; 17:673-681. [PMID: 32396869 DOI: 10.1123/jpah.2019-0171] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 03/02/2020] [Accepted: 03/30/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The objective of this systematic review was to determine the efficacy of the mat Pilates method on body composition in healthy adult subjects compared with traditional exercise or control condition models. DESIGN Systematic review with meta-analysis. DATA SOURCES MEDLINE, EMBASE, SPORTDiscus, PEDro, SciELO, CINAHAL, and the Cochrane Library. RESULTS A total of 10 eligible studies were selected for revision. The findings of this review demonstrated that the mat Pilates method was not more effective than the traditional exercise or control condition models for the analyzed variables (body mass index, lean mass, body fat percentage, and abdominal circumference). Moreover, in the exploratory analysis with older people, adults, and overweight/obese individuals, the mat Pilates method was also not superior for the analyzed outcomes. CONCLUSION The findings of this study suggest that the mat Pilates method is no better than the control condition or other types of training to reduce body composition.
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18
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González-Gálvez N, Vaquero-Cristóbal R, Trejo-Alfaro H, Marcos-Pardo PJ. Sagittal alignment of the spine and hamstring extensibility with Pilates in adolescents: Protocol for randomized controlled trial. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Tottoli CR, van Tulder M, Silva END, Marques YA, Martins WR, Luiz Carregaro R. Effectiveness and cost-effectiveness of Pilates versus home-based exercises in individuals with chronic non-specific low back pain: randomised controlled trial protocol. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1645883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Caroline Ribeiro Tottoli
- School of Physical Therapy, Universidade de Brasília (UnB), Brasília, Brazil
- Master Program in Rehabilitation Sciences, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
| | - Maurits van Tulder
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | | | - Yara Andrade Marques
- School of Physical Therapy, Universidade de Brasília (UnB), Brasília, Brazil
- Master Program in Rehabilitation Sciences, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
| | - Wagner Rodrigues Martins
- School of Physical Therapy, Universidade de Brasília (UnB), Brasília, Brazil
- Master Program in Rehabilitation Sciences, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
| | - Rodrigo Luiz Carregaro
- School of Physical Therapy, Universidade de Brasília (UnB), Brasília, Brazil
- Master Program in Rehabilitation Sciences, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
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20
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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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21
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Nieto-García J, Suso-Martí L, La Touche R, Grande-Alonso M. Somatosensory and Motor Differences between Physically Active Patients with Chronic Low Back Pain and Asymptomatic Individuals. ACTA ACUST UNITED AC 2019; 55:medicina55090524. [PMID: 31450752 PMCID: PMC6780835 DOI: 10.3390/medicina55090524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/16/2019] [Accepted: 08/20/2019] [Indexed: 12/22/2022]
Abstract
Background and Objectives: Chronic low back pain (CLBP) is the most common occupational disorder due to its associated disability and high risk of recurrence and chronicity. However, the mechanisms underlying physical and psychological variables in patients with CLBP remain unclear. The main objective of this study was to assess whether there were differences between physically active patients with nonspecific CLBP compared with asymptomatic individuals in sensorimotor and psychological variables. Materials and Methods: This was an observational cross-sectional design with a nonprobabilistic sample. The sample was divided into two groups: individuals with nonspecific CLBP (n = 30) and asymptomatic individuals as a control (n = 30). The psychological variables assessed were low back disability, fear of movement, pain catastrophizing, and self-efficacy. The sensorimotor variables assessed were two-point discrimination, pressure pain threshold, lumbopelvic stability, lumbar flexion active range of motion, and isometric leg and back strength. Results: Statistically significant differences between the groups in terms of catastrophizing levels (p = 0.026) and fear of movement (p = 0.001) were found, but no statistically significant differences between groups were found in self-efficacy (p > 0.05). No statistically significant differences between the groups in any of the sensorimotor variables were found (p > 0.05). Conclusion: No sensorimotor differences were found between patients with asymptomatic and chronic low back pain, but differences were found in the psychological variables of catastrophizing and fear of movement.
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Affiliation(s)
- Juan Nieto-García
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Department of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, 46115 Valencia, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain.
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain.
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28023 Madrid, Spain.
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain.
| | - Mónica Grande-Alonso
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
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22
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Hornsby E, Johnston LM. Effect of Pilates Intervention on Physical Function of Children and Youth: A Systematic Review. Arch Phys Med Rehabil 2019; 101:317-328. [PMID: 31152703 DOI: 10.1016/j.apmr.2019.05.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/01/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To conduct a systematic review to evaluate the effectiveness of Pilates intervention on physical function in children and youth. DATA SOURCES Six electronic databases were searched from inception to June 2018 using the term Pilates. STUDY SELECTION Articles were included if they (1) reported original data for a Pilates-only intervention; (2) involved children or youth aged up to 22 years; (3) reported a musculoskeletal, pain, or function study outcome. Searches identified 2565 papers and 11 studies fulfilled the inclusion criteria. DATA EXTRACTION The 2 authors independently screened and assessed all studies and any discrepancies were resolved by consensus. DATA SYNTHESIS Level of evidence was classified using the Oxford Centre for Evidence Based Medicine. Study quality was assessed using the Physiotherapy Evidence Database for randomized controlled trials and Risk of Bias in N-of-1 Trials scale for single case experimental design studies. Four studies were high quality, 3 were fair quality, and 4 were of low quality. Findings showed that Pilates does appear to improve flexibility (n=6); muscle strength, power and movement speed (n=3); postural control, orientation and balance (n=3); metabolic cost (n=1); functional ability (n=1) and health related quality of life (n=1) and reduce pain (n=2) in children with musculoskeletal pathology, the majority with a large effect size. Pilates content varied from group-based mat classes to individualized programs using specialized equipment. Intervention dose and frequency varied widely. CONCLUSIONS This is the first systematic review of the effect of Pilates intervention for children and youth. Research is in the preliminary stages; however, Pilates does appear to improve flexibility, strength and postural control, and reduce pain in children with musculoskeletal pathology. Further research is warranted to determine the potential effectiveness of Pilates for children and youth for various population groups and to develop comprehensive treatment guidelines.
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Affiliation(s)
- Elizabeth Hornsby
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; Kids Care Physiotherapy, Brisbane, Australia.
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Choi W, Joo Y, Lee S. Pilates exercise focused on ankle movements for improving gait ability in older women. J Women Aging 2019; 33:30-40. [PMID: 31122161 DOI: 10.1080/08952841.2019.1618129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Pilates exercise is a structured physical activity that has been demonstrated to improve physical functions in older adults. The aim of this study was to determine whether Pilates exercise can improve gait, muscle strength, and mobility in community-dwelling older women. Twenty-two participants were recruited (mean 75.68 years old) to perform Pilates exercise for 30 minutes, twice a week for 10 weeks. After 10 weeks, significant improvements were observed in the spatial gait parameters, muscle strength, and range of motion of ankle (P < .05). Pilates exercise is beneficial exercise to improve gait, muscle strength, and mobility in community-dwelling older women.
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Affiliation(s)
- Wonjae Choi
- Institute of SMART Rehabilitation, Sahmyook University , Seoul, Korea
| | - Younglan Joo
- Department of Physical Therapy, The Graduate School of Sahmyook University , Seoul, Korea
| | - Seungwon Lee
- Institute of SMART Rehabilitation, Sahmyook University , Seoul, Korea.,Department of Physical Therapy, Sahmyook University , Seoul, Korea
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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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Franco KFM, Franco YRDS, Oliveira NTBD, Padula RS, Cabral CMN. Predictive factors for progression through the difficulty levels of Pilates exercises in patients with low back pain: a secondary analysis of a randomized controlled trial. Braz J Phys Ther 2018; 22:512-518. [PMID: 29703585 PMCID: PMC6236012 DOI: 10.1016/j.bjpt.2018.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/23/2018] [Accepted: 04/04/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The progression through the difficulty levels of Pilates exercises is a subjective criterion, that depends on the therapist's experience and ability to identify the best moment to progress to the next level. OBJECTIVE To identify the factors that interfere in the progression through the difficulty levels of the Pilates exercises in patients with chronic nonspecific low back pain. METHODS Data from 139 patients with chronic nonspecific low back pain from a randomized controlled trial were used for statistical analysis using binary logistic regression. The dependent variable was the progression through the difficulty levels, and the independent variables were age, gender, educational level, low back pain duration, pain intensity, general disability, kinesiophobia, previous physical activity, and number of absences. RESULTS The factors that interfered in the progression through the difficulty levels were previous physical inactivity (odds ratio [OR]=5.14, 95% confidence interval [CI]: 1.53-17.31), low educational level (OR=2.62, 95% CI: 1.12-6.10), more advanced age (OR=0.95, 95% CI: 0.92-0.98) and more absences (OR=0.63, 95% CI: 0.50-0.79). These variables explain 41% of the non-progression through the difficulty level of the exercises. CONCLUSION Physical inactivity, low educational level, more advanced age and greater number of absences can be interfering factors in the progression through the difficulty levels of the Pilates exercises in patients with chronic nonspecific low back pain.
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Affiliation(s)
- Katherinne Ferro Moura Franco
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil.
| | | | | | - Rosimeire Simprini Padula
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | - Cristina Maria Nunes Cabral
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
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The Consensus on Exercise Reporting Template (CERT) applied to exercise interventions in musculoskeletal trials demonstrated good rater agreement and incomplete reporting. J Clin Epidemiol 2018; 103:120-130. [PMID: 30055247 DOI: 10.1016/j.jclinepi.2018.07.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 07/03/2018] [Accepted: 07/16/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine inter-rater agreement and utility of the Consensus on Exercise Reporting Template (CERT) for evaluating reporting of musculoskeletal exercise trials. STUDY DESIGN AND SETTING Two independent reviewers applied the CERT to a random sample of 20 exercise trials published 2010 to 2015 identified from searches of PEDro, CENTRAL, and PubMed. Reviewers recorded whether each item criterion was met and detailed missing data, and appraisal time percent agreement and the Prevalence and Bias Adjusted Kappa (PABAK) statistic were used to measure inter-rater agreement. RESULTS The trials included a range of musculoskeletal conditions (back/neck pain, hip/knee osteoarthritis, tendinopathies). For percent agreement, inter-rater agreement was high (13 items ≥80%) and for PABAK substantial (nine items: 0.61-0.80) and excellent (three items: 0.81-1.0). Agreement was lower for starting level decision rule (percent agreement: 55%, PABAK 0.30); tailoring of exercise (%A: 65%, PABAK 0.40 [95% CI: 0.00 to 0.80]); exercise equipment (percent agreement: 70%, PABAK 0.30); and motivation strategies (percent agreement: 70%, PABAK 0.40). Sixty percent of descriptions were missing information for ≥50% of CERT items. Mean appraisal time was 30 minutes, and the majority of interventions required access to other published papers. CONCLUSIONS The CERT has good inter-rater agreement and can comprehensively evaluate reporting of exercise interventions. Most trials do not adequately report intervention details, and information can be difficult to obtain. Incomplete reporting of effective exercise programs may be remedied by using the CERT when constructing, submitting, reviewing, and publishing articles.
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Oliveira IS, Costa LOP, Garcia AN, Miyamoto GC, Cabral CMN, Costa LDCM. Can demographic and anthropometric characteristics predict clinical improvement in patients with chronic non-specific low back pain? Braz J Phys Ther 2018; 22:328-335. [PMID: 30017258 DOI: 10.1016/j.bjpt.2018.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/03/2018] [Accepted: 06/07/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To identify potential prognostic factors that may predict clinical improvement of patients treated with different physical therapy interventions in the short-term. METHODS This is a prospective cohort study. A total of 616 patients with chronic non-specific low back pain treated with interventions commonly used by physical therapists were included. These patients were selected from five randomized controlled trials. Multivariate linear regression models were used to verify if sociodemographic characteristics (age, gender, and marital status), anthropometric variables (height, body mass, and body mass index), or duration of low back pain, pain intensity at baseline, and disability at baseline could be associated with clinical outcomes of pain intensity and disability four weeks after baseline. RESULTS The predictive variables for pain intensity were age (β=0.01 points, 95% CI=0.00 to 0.03, p=0.03) and pain intensity at baseline (β=0.23 points, 95% CI=0.13 to 0.33, p=0.00), with an explained variability of 4.6%. Similarly, the predictive variables for disability after four weeks were age (β=0.03 points, 95% CI=0.00 to 0.06, p=0.01) and disability at baseline (β=0.71 points, 95% CI=0.65 to 0.78, p=0.00), with an explained variability of 42.1%. CONCLUSION Only age, pain at baseline and disability at baseline influenced the pain intensity and disability after four weeks of treatment. The beta coefficient for age was statistically significant, but the magnitude of this association was very small and not clinically important.
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Affiliation(s)
- Indiara Soares Oliveira
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil.
| | - Leonardo Oliveira Pena Costa
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | - Alessandra Narciso Garcia
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | - Gisela Cristiane Miyamoto
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | - Cristina Maria Nunes Cabral
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
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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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Joyce AA, Kotler DH. Core Training in Low Back Disorders: Role of the Pilates Method. Curr Sports Med Rep 2018; 16:156-161. [PMID: 28498224 DOI: 10.1249/jsr.0000000000000365] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The Pilates method is a system of exercises developed by Joseph Pilates, which emphasizes recruitment and strengthening of the core muscles, flexibility, and breathing, to promote stability and control of movement. Its focus bears similarity to current evidence-based exercise programs for low back disorders. Spinal stability is a function of three interdependent systems, osseoligamentous, muscular, and neural control; exercise addresses both the muscular and neural function. The "core" typically refers to the muscular control required to maintain functional stability. Prior research has highlighted the importance of muscular strength and recruitment, with debate over the importance of individual muscles in the wider context of core control. Though developed long before the current evidence, the Pilates method is relevant in this setting and clearly relates to current evidence-based exercise interventions. Current literature supports the Pilates method as a treatment for low back disorders, but its benefit when compared with other exercise is less clear.
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Affiliation(s)
- Andrew A Joyce
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA
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Oliveira LC, Oliveira RG, Pires-Oliveira DADA. Pilates increases the isokinetic muscular strength of the knee extensors and flexors in elderly women. J Bodyw Mov Ther 2017; 21:815-822. [DOI: 10.1016/j.jbmt.2017.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 01/03/2017] [Accepted: 01/04/2017] [Indexed: 01/17/2023]
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Roller M, Kachingwe A, Beling J, Ickes DM, Cabot A, Shrier G. Pilates Reformer exercises for fall risk reduction in older adults: A randomized controlled trial. J Bodyw Mov Ther 2017; 22:983-998. [PMID: 30368346 DOI: 10.1016/j.jbmt.2017.09.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 08/16/2017] [Accepted: 09/03/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the effects of Pilates exercises using a Reformer on measures of fall risk, balance and mobility, self-efficacy, and active range of motion in adults age 65 and over at risk for falls compared to a control group. DESIGN Randomized Controlled Trial. METHODS Fifty-five subjects (27 Pilates intervention, 28 control; 38 females, 17 males; mean age 77.6 years, range 65-95) were randomly assigned to either a Pilates Reformer intervention group or a control group (no intervention). Subjects in the intervention group attended a Pilates Reformer exercise program in a group format once a week over a 10-week period. The primary outcome measures were the Sensory Organization Test (SOT) composite scores on the NeuroCom® system, Timed Up-and-Go (TUG), and Activities-specific Balance Confidence (ABC) scale. The secondary outcome measures were the Adaptation Test (ADT), straight leg raise (SLR), hip extension, and ankle dorsiflexion active range of motion (AROM), Berg Balance Scale (BBS), and 10 Meter Walk Test (10MWT). RESULTS There was a significant interaction between group and time on the TUG, BBS, 10MWT, and SLR, hip extension, and ankle dorsiflexion AROM measurements. Over time, subjects in the Pilates intervention group improved their scores significantly on all mentioned measures, whereas subjects in the control group did not (P ≤ 0.05). Significantly improved AROM was found between groups following the Pilates intervention for hip extension, left SLR, and right ankle dorsiflexion. CONCLUSION Pilates Reformer exercises performed once per week for 10 weeks resulted in reduced fall risk and significant improvements in static and dynamic balance, functional mobility, balance self-efficacy, and lower extremity AROM in adults age 65 and older at risk for falling, whereas the control group did not significantly improve in any measures. Pilates Reformer exercises are more effective compared to no exercise intervention at improving hip and ankle AROM.
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Affiliation(s)
- Margaret Roller
- Department of Physical Therapy, California State University, Northridge, Northridge, CA, United States.
| | - Aimie Kachingwe
- Department of Physical Therapy, California State University, Northridge, Northridge, CA, United States
| | - Janna Beling
- Department of Physical Therapy, California State University, Northridge, Northridge, CA, United States
| | - Dawn-Marie Ickes
- Department of Physical Therapy, Mount Saint Mary's University, Los Angeles, CA, United States
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Marshall PWM, Schabrun S, Knox MF. Physical activity and the mediating effect of fear, depression, anxiety, and catastrophizing on pain related disability in people with chronic low back pain. PLoS One 2017; 12:e0180788. [PMID: 28686644 PMCID: PMC5501599 DOI: 10.1371/journal.pone.0180788] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 06/21/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic low back pain is a worldwide burden that is not being abated with our current knowledge and treatment of the condition. The fear-avoidance model is used to explain the relationship between pain and disability in patients with chronic low back pain. However there are gaps in empirical support for pathways proposed within this model, and no evidence exists as to whether physical activity moderates these pathways. METHODS This was a cross-sectional study of 218 people with chronic low back pain. Multiple mediation analyses were conducted to determine the role of fear, catastrophizing, depression, and anxiety in the relationship between pain and disability. Separate analyses were performed with physical activity as the moderator. Individuals were classified as performing regular structured physical activity if they described on average once per week for > 30-minutes an activity classified at least moderate intensity (≥ 4-6 METs), activity prescribed by an allied health professional for their back pain, leisure time sport or recreation, or self-directed physical activity such as resistance exercise. RESULTS Fear, catastrophizing, and depression significantly mediated the relationship between pain and disability (p<0.001). However the mediating effect of catastrophizing was conditional upon weekly physical activity. That is, the indirect effect for catastrophizing mediating the relationship between pain and disability was only significant for individuals reporting weekly physical activity (B = 1.31, 95% CI 0.44 to 2.23), compared to individuals reporting no weekly physical activity (B = 0.21, 95% CI -0.50 to 0.97). Catastrophizing also mediated the relationship between pain and fear (B = 0.37, 95% CI 0.15 to 0.62), with higher scores explaining 53% of the total effect of pain on fear. CONCLUSIONS These results support previous findings about the importance of fear and depression as factors that should be targeted in low back pain patients to reduce back pain related disability. We have also extended understanding for the mediating effect of catastrophizing on back pain related disability. Back pain patients engaged with regular physical activity may require counselling with regards to negative pain perceptions.
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Affiliation(s)
- Paul W. M. Marshall
- School of Science and Health, Western Sydney University, Penrith South, New South Wales, AUSTRALIA
| | - Siobhan Schabrun
- School of Science and Health, Western Sydney University, Penrith South, New South Wales, AUSTRALIA
| | - Michael F. Knox
- School of Science and Health, Western Sydney University, Penrith South, New South Wales, AUSTRALIA
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Comparative effects of 12 weeks of equipment based and mat Pilates in patients with Chronic Low Back Pain on pain, function and transversus abdominis activation. A randomized controlled trial. Complement Ther Med 2017; 33:72-77. [PMID: 28735829 DOI: 10.1016/j.ctim.2017.06.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/30/2017] [Accepted: 06/19/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Pilates method has been recommended for patients with chronic low back pain (CLBP) and the activation of transversus abdominis has been deemed to play an important role in the improvement of these patients. Nevertheless, the evidence of the activation of TrA in Pilates practitioners remains unclear. OBJECTIVE To assess the effectiveness of 12 weeks of Pilates practice in disability, pain, kinesiophobia and transversus abdominis activation in patients with chronic nonspecific Low Back Pain. DESIGN A randomized controlled trial was carried out. METHODS A single-blind randomized controlled trial with repeated measures at 6 and 12 weeks was carried out. A total of ninety eight patients with low back pain were included and randomly allocated to a Pilates Mat group (PMG) equipment based with apparatus Pilates (PAG) or control group (CG). Roland Morris Disability Questionnaire (RMDQ), visual analog scale (VAS) Tampa Scale of Kinesiophobia (TSK), and transversus abdominis (TrA) activation assessed by real time ultrasound measurement (US) were assessed as outcome measures. RESULTS Improvement were observed in both intervention groups in all the included variables at 6 and 12 weeks (p<0.001). Faster enhancement was observed in the equipment based Pilates group (p=0.007). CONCLUSIONS Equipment based and mat Pilates modalities are both effective in the improvement of TaA activation in patients with CLBP with associate improvement on pain, function and kinesiophobia. Significant differences were observed after 12 weeks of intervention in PMG and PAG with faster improvement in PAG suggesting that, feedback provided by equipment could help in the interiorization of Pilates principles.
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Byrnes K, Wu PJ, Whillier S. Is Pilates an effective rehabilitation tool? A systematic review. J Bodyw Mov Ther 2017; 22:192-202. [PMID: 29332746 DOI: 10.1016/j.jbmt.2017.04.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/26/2017] [Accepted: 04/04/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pilates is a system of exercise focusing upon controlled movement, stretching and breathing. Pilates is popular today not only for physical fitness but also for rehabilitation programs. This paper is a review of the literature on the effectiveness of Pilates as a rehabilitation tool in a wide range of conditions in an adult population. METHODS A systematic literature review was carried out according to the PRISMA guidelines. Electronic databases were searched for cohort studies or randomised controlled trials (RCTs), and inclusion and exclusion criteria were applied. The final RCTs were assessed using the PEDro and CONSORT 2010 checklists. RESULTS Twenty-three studies, published between 2005 and 2016, met the inclusion criteria. These papers assessed the efficacy of Pilates in the rehabilitation of low back pain, ankylosing spondylitis, multiple sclerosis, post-menopausal osteoporosis, non-structural scoliosis, hypertension and chronic neck pain. Nineteen papers found Pilates to be more effective than the control or comparator group at improving outcomes including pain and disability levels. When assessed using the CONSORT and PEDro scales, the quality of the papers varied, with more falling toward the upper end of the scale. CONCLUSION The majority of the clinical trials in the last five years into the use of Pilates as a rehabilitation tool have found it to be effective in achieving desired outcomes, particularly in the area of reducing pain and disability. It indicates the need for further research in these many areas, and especially into the benefits of particular Pilates exercises in the rehabilitation of specific conditions.
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Affiliation(s)
- Keira Byrnes
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Australia
| | - Ping-Jung Wu
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Australia
| | - Stephney Whillier
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Australia.
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Kofotolis N, Kellis E, Vlachopoulos SP, Gouitas I, Theodorakis Y. Effects of Pilates and trunk strengthening exercises on health-related quality of life in women with chronic low back pain. J Back Musculoskelet Rehabil 2016; 29:649-659. [PMID: 26922845 DOI: 10.3233/bmr-160665] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pilates programs are widely used as a form of regular exercise in a broad range of populations investigating their effectiveness for chronic low back pain (CLBP) treatment. OBJECTIVE The aim of this study was to compare the effects of a Pilates program and a trunk strengthening exercise program on functional disability and health-related quality of life (HRQOL) in women with nonspecific CLBP. METHODS A total of 101 volunteer women with CLBP provided data with a 3-month follow-up. They were randomized to either a Pilates (n= 37), trunk strengthening exercise (n= 36) or a control group (n= 28), exercising for a period of 8 weeks, three times a week. Data were collected on HRQOL using the Short-Form 36 Health Survey (SF-36v2), and functional disability using the Roland Morris Disability Questionnaire prior to program initiation, mid-intervention, immediately after program termination, and three months post-intervention. RESULTS The Pilates participants reported greater improvements on self-reported functional disability and HRQOL compared with participants in the trunk strengthening exercise and control groups (p < 0.05). The effects were retained for a period of three months after program termination for the Pilates group and to a lesser extent for the trunk strengthening exercise group. CONCLUSIONS An 8-week Pilates program improved HRQOL and reduced functional disability more than either a trunk strengthening exercise program or controls among women with CLBP.
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Affiliation(s)
- Nikolaos Kofotolis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Greece
| | - Eleftherios Kellis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Greece
| | - Symeon P Vlachopoulos
- Laboratory of Social Research on Physical Activity, Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Greece
| | - Iraklis Gouitas
- Laboratory of Neuromechanics, Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Greece
| | - Yannis Theodorakis
- Laboratory of Exercise Psychology and Quality of Life, Department of Physical Education and Sport Science, University of Thessaly, Greece
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Lin HT, Hung WC, Hung JL, Wu PS, Liaw LJ, Chang JH. Effects of pilates on patients with chronic non-specific low back pain: a systematic review. J Phys Ther Sci 2016; 28:2961-2969. [PMID: 27821970 PMCID: PMC5088161 DOI: 10.1589/jpts.28.2961] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/16/2016] [Indexed: 02/07/2023] Open
Abstract
[Purpose] To evaluate the effects of Pilates on patients with chronic low back pain
through a systematic review of high-quality articles on randomized controlled trials.
[Subjects and Methods] Keywords and synonyms for “Pilates” and “Chronic low back pain”
were used in database searches. The databases included PubMed, Physiotherapy Evidence
Database (PEDro), Medline, and the Cochrane Library. Articles involving randomized
controlled trials with higher than 5 points on the PEDro scale were reviewed for
suitability and inclusion. The methodological quality of the included randomized
controlled trials was evaluated using the PEDro scale. Relevant information was extracted
by 3 reviewers. [Results] Eight randomized controlled trial articles were included.
Patients with chronic low back pain showed statistically significant improvement in pain
relief and functional ability compared to patients who only performed usual or routine
health care. However, other forms of exercise were similar to Pilates in the improvement
of pain relief and functional capacity. [Conclusion] In patients with chronic low back
pain, Pilates showed significant improvement in pain relief and functional enhancement.
Other exercises showed effects similar to those of Pilates, if waist or torso movement was
included and the exercises were performed for 20 cumulative hours.
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Affiliation(s)
- Hui-Ting Lin
- Department of Physical Therapy, I-Shou University, Taiwan
| | - Wei-Ching Hung
- Department of Biomedical Engineering, National Cheng Kung University, Taiwan
| | - Jia-Ling Hung
- Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Taiwan
| | - Pei-Shan Wu
- Department of Physical Therapy, I-Shou University, Taiwan
| | - Li-Jin Liaw
- Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Taiwan
| | - Jia-Hao Chang
- Department of Physical Education, National Taiwan Normal University, Taiwan
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Franco KM, Franco YDS, Oliveira NBD, Miyamoto GC, Santos MO, Liebano RE, Cabral CN. Is Interferential Current Before Pilates Exercises More Effective Than Placebo in Patients With Chronic Nonspecific Low Back Pain?: A Randomized Controlled Trial. Arch Phys Med Rehabil 2016; 98:320-328. [PMID: 27771359 DOI: 10.1016/j.apmr.2016.08.485] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 08/20/2016] [Accepted: 08/26/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To determine whether interferential current (IFC) before Pilates exercises is more effective than placebo in patients with chronic nonspecific low back pain. DESIGN Two-arm randomized controlled trial, with a blinded assessor, and 6 months follow-up. SETTING Clinic of a school of physical therapy. PARTICIPANTS The random sample consisted of patients (N=148) of both sexes, with age between 18 and 80 years and chronic nonspecific low back pain. In addition, participants were recruited by disclosure of the treatment in the media. INTERVENTIONS Patients were allocated into 2 groups: active IFC + Pilates or placebo IFC + Pilates. In the first 2 weeks, patients were treated for 30 minutes with active or placebo IFC. In the following 4 weeks, 40 minutes of Pilates exercises were added after the application of the active or placebo IFC. A total of 18 sessions were offered during 6 weeks. MAIN OUTCOME MEASURES The primary outcome measures were pain intensity, pressure pain threshold, and disability measured at 6 weeks after randomization. RESULTS No significant differences were found between the groups for pain (0.1 points; 95% confidence interval, -0.9 to 1.0 points), pressure pain threshold (25.3kPa; 95% confidence interval, -4.4 to 55.0kPa), and disability (0.4 points; 95% confidence interval, -1.3 to 2.2). However, there was a significant difference between baseline and 6-week and 6-month follow-ups in the intragroup analysis for all outcomes (P<.05), except pressure pain threshold in the placebo IFC + Pilates group. CONCLUSIONS These findings suggest that active IFC before Pilates exercise is not more effective than placebo IFC with respect to the outcomes assessed in patients with chronic nonspecific low back pain.
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Affiliation(s)
- Katherinne Moura Franco
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.
| | - Yuri Dos Santos Franco
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Naiane Bastos de Oliveira
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Gisela Cristiane Miyamoto
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | | | - Richard Eloin Liebano
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Cristina Nunes Cabral
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
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Slade SC, Dionne CE, Underwood M, Buchbinder R. Consensus on Exercise Reporting Template (CERT): Explanation and Elaboration Statement. Br J Sports Med 2016; 50:1428-1437. [DOI: 10.1136/bjsports-2016-096651] [Citation(s) in RCA: 324] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 12/31/2022]
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Oliveira NTBD, Freitas SMSF, Fuhro FF, Luz MAD, Amorim CF, Cabral CMN. Muscle Activation During Pilates Exercises in Participants With Chronic Nonspecific Low Back Pain: A Cross-Sectional Case-Control Study. Arch Phys Med Rehabil 2016; 98:88-95. [PMID: 27693691 DOI: 10.1016/j.apmr.2016.09.111] [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: 06/16/2016] [Revised: 08/31/2016] [Accepted: 09/02/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the amplitude of the electromyographic activity of trunk muscles during Pilates exercises in women with and without chronic low back pain (LBP). DESIGN Case-control study. SETTING University physical therapy clinic. PARTICIPANTS Women (N=60) divided into an LBP group and a control group. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Amplitude of the electromyographic activity (root mean square values) of the gluteus maximus and external oblique muscles collected during 3 Pilates exercises: Shoulder Bridge performed on the mat, and Hip Roll and Breathing performed in equipment. Pain intensity was assessed in the LBP group. RESULTS The amplitude of the electromyographic activity was similar between groups (P≥.05). For both groups, the amplitude of the gluteus maximus was higher in the Shoulder Bridge exercise compared with the Hip Roll with 2 springs (control group: mean difference [MD]=.18; 95% confidence interval [CI], .05-.41; LBP group: MD=.29; 95% CI, .16-.31) and the Breathing exercise (control group: MD=-.40; 95% CI, -.55 to -.26; LBP group: MD=-.36; 95% CI, -.52 to -.20). The amplitude of the external oblique muscle was higher in the Shoulder Bridge compared with the Hip Roll with 2 springs (control group: MD=.13; 95% CI, .05-.21; LBP group: MD=.18; 95% CI, .03-.33). Pain intensity increased after exercises, but this increase was lower for the mat exercises. CONCLUSIONS Similar muscle activation between groups was found. The findings suggest that mat exercises caused less pain and a greater difference in the amplitude of muscle activation compared with the equipment-based exercises.
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Affiliation(s)
| | | | - Fernanda Ferreira Fuhro
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo SP, Brazil
| | | | - Cesar Ferreira Amorim
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo SP, Brazil
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Dunleavy K, Kava K, Goldberg A, Malek M, Talley S, Tutag-Lehr V, Hildreth J. Comparative effectiveness of Pilates and yoga group exercise interventions for chronic mechanical neck pain: quasi-randomised parallel controlled study. Physiotherapy 2016; 102:236-42. [DOI: 10.1016/j.physio.2015.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 06/02/2015] [Indexed: 10/23/2022]
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Valenza MC, Rodríguez-Torres J, Cabrera-Martos I, Díaz-Pelegrina A, Aguilar-Ferrándiz ME, Castellote-Caballero Y. Results of a Pilates exercise program in patients with chronic non-specific low back pain: a randomized controlled trial. Clin Rehabil 2016; 31:753-760. [PMID: 27260764 DOI: 10.1177/0269215516651978] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the effects of a Pilates exercise program on disability, pain, lumbar mobility, flexibility and balance in patients with chronic non-specific low back pain. DESIGN Randomized controlled trial. SETTING University laboratory. PARTICIPANTS A total of 54 patients with chronic non-specific low back pain. INTERVENTION Patients were randomly allocated to an experimental group ( n=27) included in a Pilates exercise program or to a control group ( n=27) receiving information in a form of a leaflet. MAIN OUTCOME MEASURES Disability (Roland-Morris Disability Questionnaire and Oswestry Disability Index), current, average and pain at it least and at its worst (Visual Analogue Scales), lumbar mobility (modified Shober test), flexibility (finger-to-floor test) and balance (single limb stance test) were measured at baseline and after the intervention. RESULTS A between-group analysis showed significant differences in the intervention group compared to the control group for both disability scores, the Rolland-Morris questionnaire (mean change±standard deviation of 5.31±3.37 and 2.40±6.78 respectively and between-groups mean difference of 3.2 ± 4.12, p=0.003) and the Oswestry Disability Index ( p<0.001), current pain ( p=0.002) and pain at it least ( p=0.033), flexibility (0.032) and balance (0.043). CONCLUSIONS An 8-week Pilates exercise program is effective in improving disability, pain, flexibility and balance in patients with chronic non-specific low back pain.
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Affiliation(s)
- M C Valenza
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, Spain
| | - J Rodríguez-Torres
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, Spain
| | - I Cabrera-Martos
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, Spain
| | - A Díaz-Pelegrina
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, Spain
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Kamioka H, Tsutani K, Katsumata Y, Yoshizaki T, Okuizumi H, Okada S, Park SJ, Kitayuguchi J, Abe T, Mutoh Y. Effectiveness of Pilates exercise: A quality evaluation and summary of systematic reviews based on randomized controlled trials. Complement Ther Med 2016; 25:1-19. [DOI: 10.1016/j.ctim.2015.12.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/10/2015] [Accepted: 12/29/2015] [Indexed: 11/28/2022] Open
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Effectiveness and Cost-Effectiveness of Different Weekly Frequencies of Pilates for Chronic Low Back Pain: Randomized Controlled Trial. Phys Ther 2016; 96:382-9. [PMID: 26294680 DOI: 10.2522/ptj.20150404] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 08/09/2015] [Indexed: 02/09/2023]
Abstract
BACKGROUND The Pilates method has been recommended to patients with low back pain, but the evidence on effectiveness is inconclusive. In addition, there is still no evidence for the cost-effectiveness of this method or for the ideal number of sessions to achieve the highest effectiveness. OBJECTIVE The aim of this study will be to investigate the effectiveness and cost-effectiveness of the Pilates method with different weekly frequencies in the treatment of patients with nonspecific low back pain. DESIGN This is a randomized controlled trial with blinded assessor. SETTING This study will be conducted at a physical therapy clinic in São Paulo, Brazil. PARTICIPANTS Two hundred ninety-six patients with nonspecific low back pain between the ages of 18 and 80 years will be assessed and randomly allocated to 4 groups (n=74 patients per group). INTERVENTION All groups will receive an educational booklet. The booklet group will not receive additional exercises. Pilates group 1 will follow a Pilates-based program once a week, Pilates group 2 will follow the same program twice a week, and Pilates group 3 will follow the same program 3 times a week. The intervention will last 6 weeks. MEASUREMENTS A blinded assessor will evaluate pain, quality-adjusted life-years, general and specific disability, kinesiophobia, pain catastrophizing, and global perceived effect 6 weeks, 6 months, and 12 months after randomization. LIMITATIONS Therapists and patients will not be blinded. CONCLUSIONS This will be the first study to investigate different weekly frequencies of treatment sessions for nonspecific low back pain. The results of this study will contribute to a better definition of treatment programs for this population.
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Equipment-based Pilates reduces work-related chronic low back pain and disability: A pilot study. J Bodyw Mov Ther 2016; 20:74-82. [DOI: 10.1016/j.jbmt.2015.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 06/02/2015] [Accepted: 06/04/2015] [Indexed: 11/20/2022]
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Geremia JM, Iskiewicz MM, Marschner RA, Lehnen TE, Lehnen AM. Effect of a physical training program using the Pilates method on flexibility in elderly subjects. AGE (DORDRECHT, NETHERLANDS) 2015; 37:119. [PMID: 26578459 PMCID: PMC5005875 DOI: 10.1007/s11357-015-9856-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 11/06/2015] [Indexed: 06/05/2023]
Abstract
The adaptations of the human body resulting from the aging process especially loss of flexibility can increase the risk of falls and the risk of developing other health conditions. Exercise training, in particular the Pilates exercise method, has become an important form of physical activity that minimizes the deleterious effects of aging on flexibility. Few studies have evaluated the effect of this training method on body flexibility among elderly. We aimed to evaluate the effects of physical training using the Pilates method on body flexibility of elderly individuals. Eighteen elderly women and two elderly men (aged 70 ± 4 years) followed a 10-week Pilates training program. Individuals were recruited from the local community via open invitations. At study entry, none of them had limited mobility (walking requiring the use of walkers or canes). Furthermore, those with neurologic, muscular, or psychiatric disorders as well as those using an assistive device for ambulation were excluded secondary to limited participation. Flexibility assessment tests (flexion, extension, right and left tilt, and right and left rotation of the cervical and thoracolumbar spine; flexion, extension, abduction, and lateral and medial right and left rotation of the glenohumeral joint; flexion, extension, abduction, adduction, and lateral and medial rotation of the right and left hip; and flexion of the right and left knee) were performed by a blinded evaluator using a flexometer before and after the training period. All assessments were carried out at the same time of day. There was an observed increase in flexion (22.86%; p < 0.001), extension (10.49%; p < 0.036), and rotation to the left side (20.45%; p < 0.019) of the cervical spine; flexion (16.45%; p < 0.001), extension (23.74%; p = 0.006), lateral bending right (39.52%; p < 0.001) and left (38.02%; p < 0.001), and right rotation (24.85%; p < 0.001) and left (24.24%; p < 0.001) of the thoracolumbar spine; flexion (right--8.80%, p = 0.034; left--7.03%, p = 0.050), abduction (right--20.69%, p < 0.001; left--16.26%, p = 0.005), and external rotation (right--116.07% and left--143%; p < 0.001 for both directions) of the glenohumeral joint; flexion (right--15.83%, p = 0.050; left--9.55%, p = 0.047) of the hips; and bending (right--14.20%, p = 0.006; left--15.20%, p = 0.017) the knees. The joint with the greatest magnitude of improvement was the thoracolumbar spine. Thus, this type of training may minimize the deleterious effects of aging and may improve the functionality of elderly individuals, which would reduce the likelihood of accidents (especially falls).
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Affiliation(s)
- Jeam Marcel Geremia
- Faculdade Sogipa de Educação Física, Av. Benjamin Constant, 80, Porto Alegre, RS, 90550-003, Brazil
| | | | - Rafael Aguiar Marschner
- Instituto de Cardiologia, Fundação Universitária de Cardiologia do RS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tatiana Ederich Lehnen
- Faculdade Sogipa de Educação Física, Av. Benjamin Constant, 80, Porto Alegre, RS, 90550-003, Brazil
| | - Alexandre Machado Lehnen
- Faculdade Sogipa de Educação Física, Av. Benjamin Constant, 80, Porto Alegre, RS, 90550-003, Brazil.
- Instituto de Cardiologia, Fundação Universitária de Cardiologia do RS, Porto Alegre, Rio Grande do Sul, Brazil.
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Effects of Nordic Walking and Pilates exercise programs on blood glucose and lipid profile in overweight and obese postmenopausal women in an experimental, nonrandomized, open-label, prospective controlled trial. Menopause 2015; 22:1215-23. [DOI: 10.1097/gme.0000000000000446] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Yamato TP, Maher CG, Saragiotto BT, Hancock MJ, Ostelo RWJG, Cabral CMN, Menezes Costa LC, Costa LOP. Pilates for low back pain. Cochrane Database Syst Rev 2015; 2015:CD010265. [PMID: 26133923 PMCID: PMC8078578 DOI: 10.1002/14651858.cd010265.pub2] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Non-specific low back pain is a major health problem worldwide. Interventions based on exercises have been the most commonly used treatments for patients with this condition. Over the past few years, the Pilates method has been one of the most popular exercise programmes used in clinical practice. OBJECTIVES To determine the effects of the Pilates method for patients with non-specific acute, subacute or chronic low back pain. SEARCH METHODS We conducted the searches in CENTRAL, MEDLINE, EMBASE, CINAHL, PEDro and SPORTDiscus from the date of their inception to March 2014. We updated the search in June 2015 but these results have not yet been incorporated. We also searched the reference lists of eligible papers as well as six trial registry websites. We placed no limitations on language or date of publication. SELECTION CRITERIA We only included randomised controlled trials that examined the effectiveness of Pilates intervention in adults with acute, subacute or chronic non-specific low back pain. The primary outcomes considered were pain, disability, global impression of recovery and quality of life. DATA COLLECTION AND ANALYSIS Two independent raters performed the assessment of risk of bias in the included studies using the 'Risk of bias' assessment tool recommended by The Cochrane Collaboration. We also assessed clinical relevance by scoring five questions related to this domain as 'yes', 'no' or 'unclear'. We evaluated the overall quality of evidence using the GRADE approach and for effect sizes we used three levels: small (mean difference (MD) < 10% of the scale), medium (MD 10% to 20% of the scale) or large (MD > 20% of the scale). We converted outcome measures to a common 0 to 100 scale when different scales were used. MAIN RESULTS The search retrieved 126 trials; 10 fulfilled the inclusion criteria and we included them in the review (a total sample of 510 participants). Seven studies were considered to have low risk of bias, and three were considered as high risk of bias.A total of six trials compared Pilates to minimal intervention. There is low quality evidence that Pilates reduces pain compared with minimal intervention, with a medium effect size at short-term follow-up (less than three months after randomisation) (MD -14.05, 95% confidence interval (CI) -18.91 to -9.19). For intermediate-term follow-up (at least three months but less than 12 months after randomisation), two trials provided moderate quality evidence that Pilates reduces pain compared to minimal intervention, with a medium effect size (MD -10.54, 95% CI -18.46 to -2.62). Based on five trials, there is low quality evidence that Pilates improves disability compared with minimal intervention, with a small effect size at short-term follow-up (MD -7.95, 95% CI -13.23 to -2.67), and moderate quality evidence for an intermediate-term effect with a medium effect size (MD -11.17, 95% CI -18.41 to -3.92). Based on one trial and low quality evidence, a significant short-term effect with a small effect size was reported for function (MD 1.10, 95% CI 0.23 to 1.97) and global impression of recovery (MD 1.50, 95% CI 0.70 to 2.30), but not at intermediate-term follow-up for either outcome.Four trials compared Pilates to other exercises. For the outcome pain, we presented the results as a narrative synthesis due to the high level of heterogeneity. At short-term follow-up, based on low quality evidence, two trials demonstrated a significant effect in favour of Pilates and one trial did not find a significant difference. At intermediate-term follow-up, based on low quality evidence, one trial reported a significant effect in favour of Pilates, and one trial reported a non-significant difference for this comparison. For disability, there is moderate quality evidence that there is no significant difference between Pilates and other exercise either in the short term (MD -3.29, 95% CI -6.82 to 0.24) or in the intermediate term (MD -0.91, 95% CI -5.02 to 3.20) based on two studies for each comparison. Based on low quality evidence and one trial, there was no significant difference in function between Pilates and other exercises at short-term follow-up (MD 0.10, 95% CI -2.44 to 2.64), but there was a significant effect in favour of other exercises for intermediate-term function, with a small effect size (MD -3.60, 95% CI -7.00 to -0.20). Global impression of recovery was not assessed in this comparison and none of the trials included quality of life outcomes. Two trials assessed adverse events in this review, one did not find any adverse events, and another reported minor events. AUTHORS' CONCLUSIONS We did not find any high quality evidence for any of the treatment comparisons, outcomes or follow-up periods investigated. However, there is low to moderate quality evidence that Pilates is more effective than minimal intervention for pain and disability. When Pilates was compared with other exercises we found a small effect for function at intermediate-term follow-up. Thus, while there is some evidence for the effectiveness of Pilates for low back pain, there is no conclusive evidence that it is superior to other forms of exercises. The decision to use Pilates for low back pain may be based on the patient's or care provider's preferences, and costs.
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Affiliation(s)
- Tiê P Yamato
- Sydney Medical School, The University of SydneyMusculoskeletal Division, The George Institute for Global HealthSydneyAustralia
| | - Christopher G Maher
- Sydney Medical School, The University of SydneyMusculoskeletal Division, The George Institute for Global HealthSydneyAustralia
| | - Bruno T Saragiotto
- Sydney Medical School, The University of SydneyMusculoskeletal Division, The George Institute for Global HealthSydneyAustralia
| | - Mark J Hancock
- Macquarie UniversityFaculty of Human SciencesGround floor, 75 Talavera Rd.Macquarie ParkSydneyAustralia
| | - Raymond WJG Ostelo
- VU UniversityDepartment of Health Sciences, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
| | - Cristina MN Cabral
- Universidade Cidade de São PauloMasters and Doctoral Programs in Physical TherapyRua Cesário Galeno,448São PauloBrazil03071‐000
| | - Luciola C Menezes Costa
- Universidade Cidade de São PauloMasters and Doctoral Programs in Physical TherapyRua Cesário Galeno,448São PauloBrazil03071‐000
| | - Leonardo OP Costa
- Universidade Cidade de São PauloMasters and Doctoral Programs in Physical TherapyRua Cesário Galeno,448São PauloBrazil03071‐000
- The George Institute for Global HealthFaculty of Medicine, The University of Sydney, AustraliaLevel 7, 341 George St.SydneyAustraliaNSW 2000
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Oliveira LCD, Oliveira DADAP, Oliveira RFD, Jassi FJ, Martini FAN, Oliveira RGD. Efeitos do método pilates no torque isocinético dos extensores e flexores do joelho: estudo piloto. REV BRAS MED ESPORTE 2015. [DOI: 10.1590/1517-86922015210102095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUÇÃO: apesar da popularização do método Pilates como forma de exercício físico, os estudos com a técnica ainda não têm explorado os seus efeitos sobre o torque isocinético dos músculos extensores e flexores do joelho.OBJETIVO: verificar os efeitos do método Pilates no torque isocinético dos extensores e flexores do joelho em mulheres jovens.MÉTODOS: 10 voluntárias foram submetidas à avaliação isocinética (60°/s e 300°/s) dos extensores e flexores do joelho, do membro inferior dominante, pré e pós-intervenção com o método Pilates, considerando-se o pico de torque (PT) e o trabalho total (TT). Oito intervenções foram realizadas ao longo de quatro semanas, constando de 28 exercícios de alongamento e fortalecimento para os principais grupos musculares. A análise estatística, utilizando os testes tde Student ou Wilcoxonpara amostras dependentes, foi utilizada (p<0,05).RESULTADOS: os resultados mostraram melhora significativa para a maioria das variáveis observadas, tanto na extensão do joelho (TT 60°/s - 8,98%, p = 0,0166; PT 300°/s - 11,80%, p = 0,0077; TT 300°/s - 19,68%, p = 0,0051), quanto na flexão (PT 60°/s - 11,44%, p = 0,0171; TT 60°/s - 11,55%, p = 0,0395; TT 300°/s - 12,86%, p = 0,0145), com exceção para duas variáveis, uma referente ao movimento de extensão do joelho (PT 60°/s - 3,04%, p = 0,4413) e outra ao movimento de flexão (PT 300°/s - 2,30%, p = 0,3873).CONCLUSÃO: foi possível verificar que oito sessões de Pilates, realizadas ao longo de quatro semanas, proporcionaram melhora significativa do torque isocinético dos músculos extensores e flexores do joelho em mulheres jovens, em relação ao PT e TT (60°/s e 300°/s) para a maioria das variáveis analisadas.
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Patti A, Bianco A, Paoli A, Messina G, Montalto MA, Bellafiore M, Battaglia G, Iovane A, Palma A. Effects of Pilates exercise programs in people with chronic low back pain: a systematic review. Medicine (Baltimore) 2015; 94:e383. [PMID: 25634166 PMCID: PMC4602949 DOI: 10.1097/md.0000000000000383] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The Pilates method has recently become a fast-growing popular way of exercise recommended for healthy individuals and those engaged in rehabilitation. Several published studies have examined the effects of Pilates method in people with chronic low back pain (LBP). The objective of this study is to describe and provide an extensive overview of the scientific literature comparing the effectiveness of the Pilates method on pain and disability in patients with chronic nonspecific LBP. The study is based on the data from the following sources: MEDLINE-NLM, MEDLINE-EBSCO, Scopus Elsevier, Cochrane, DOAJ, SciELO, and PLOSONE. Original articles and systematic reviews of adults with chronic nonspecific LBP that evaluated pain and/or disability were included in this study; studies in which the primary treatment was based on Pilates method exercises compared with no treatment, minimal intervention, other types of intervention, or other types of exercises. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adopted. The literature search included 7 electronic databases and the reference list of relevant systematic reviews and original articles to July 2014. Two independent investigators conducted the literature search and performed the synthesis as follows: Study Design; Sample (n); Disability measure; Intervention; and Main results. The searches identified a total of 128 articles. From these, 29 were considered eligible and were included in the analysis. The items were stratified as follows: Pilates method versus other kind of exercises (n = 6 trials) and Pilates method versus no treatment group or minimal intervention for short-term pain (n = 9 trials); the therapeutic effect of the Pilates method in randomized cohorts (n = 5); and analysis of reviews (n = 9). We found that there is a dearth of studies that clearly demonstrates the efficacy of a specific Pilates exercise program over another in the treatment of chronic pain. However, the consensus in the field suggests that Pilates method is more effective than minimal physical exercise intervention in reducing pain. These conclusions need to be supported by other proper investigations.
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Affiliation(s)
- Antonino Patti
- Sport and Exercise Sciences Research Unit (A Patti, AB, GM, MAM, MB, GB, AI, A Palma), University of Palermo; Posturalab (A Patti, GM), Italy; and Department of Biomedical Science (A Paoli), University of Padua, Padua, Italy
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