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Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews
Wells Cherie,Kolt Gregory S,Marshall Paul,Hill Bridget
BMC Medical Research Methodology , 2013, DOI: 10.1186/1471-2288-13-7
Abstract: Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words)
Effectiveness of mat Pilates or equipment-based Pilates in patients with chronic non-specific low back pain: a protocol of a randomised controlled trial  [cached]
da Luz Maurício Ant?nio,Costa Leonardo Oliveira Pena,Fuhro Fernanda Ferreira,Manzoni Ana Carolina Taccolini
BMC Musculoskeletal Disorders , 2013, DOI: 10.1186/1471-2474-14-16
Abstract: Background Chronic low back pain is an expensive and difficult condition to treat. One of the interventions widely used by physiotherapists in the treatment of chronic non-specific low back pain is exercise therapy based upon the Pilates principles. Pilates exercises can be performed with or without specific equipment. These two types of Pilates exercises have never been compared on a high-quality randomised controlled trial. Methods/design This randomised controlled trial with a blinded assessor will evaluate eighty six patients of both genders with chronic low back pain, aged between 18 and 60 years, from one Brazilian private physiotherapy clinic. The patients will be randomly allocated into two groups: Mat Group will perform the exercises on the ground while the Equipment-based Group will perform the Pilates method exercises on the following equipment: Cadillac, Reformer, Ladder Barrel, and Step Chair. The general and specific disability of the patient, kinesiophobia, pain intensity and global perceived effect will be evaluated by a blinded assessor before randomisation and at six weeks and six months after randomisation. In addition, the expectation of the participants and their confidence with the treatment will be evaluated before randomisation and after the first treatment session, respectively. Discussion This will be the first study aiming to compare the effectiveness of Mat and Equipment-based Pilates exercises in patients with chronic non-specific low back pain. The results may help health-care professionals in clinical decision-making and could potentially reduce the treatment costs of this condition. Trial registration Brazilian Registry of Clinical Trials RBR-7tyg5j
Effects of Pilates Exercises on the Social Physical Concern of Patients with Fibromyalgia Syndrome: A Pilot Study  [cached]
Nimet Korkmaz
Turkish Journal of Rheumatology , 2010,
Abstract: Objective: The goal of this study was to investigate the effect of Pilates exercises on the social physical concern (SPC) of patients with fibromyalgia syndrome (FMS). We also aimed to determine the effect of Pilates exercises on strength, body mass index (BMI), pain, and depression.Materials and Methods: Twenty-five female patients with an age range of 33 to 63 years (mean: 49.16±7.51) were evaluated. All patients had been diagnosed with FMS according to the American College of Rheumatology (ACR) criteria. Patients underwent a Pilates exercise program consisting of one hour of exercise performed three times per week for 12 weeks. Prior to exercise and at the end of the 12th week, the patient’s weight, grip strength of the hands, back strength, body fat ratio, and BMI were measured. Before- and after-exercise measurements were compared. The patient pain level was determined using the visual analog scale (VAS). Beck Depression Inventory (BDI) was used to define the depression level of patients. SPC level of patients was obtained by Social Physique Anxiety Scale (SPAS). The correlations between SPC scores and anthropometric values and pain and depression levels were evaluated.Results: Pilates exercises significantly improved the weight, BMI, body fat ratio and SPC and pain level of the patients. No statistically significant change was found for grip strength of either hand or back strength. A statistically significant correlation was found between SPC scores and the body fat ratio, weight, BMI, and pain and depression scores of patients before and after the exercise program.Conclusion: A 12-week Pilates program had positive effects on anthropometric parameters, SPC, and pain and depression levels of FMS patients. Patients with FMS can safely perform Pilates exercises to control weight, improve physical appearance, and reduce SPC and pain and depression levels, and no adverse side effects were observed. To obtain further evidence regarding the effectiveness of Pilates exercises, additional studies involving different patient groups are required.
Eficácia do método Pilates no solo em pacientes com lombalgia cr?nica: relato de casos
Concei??o, Josilene Souza;Mergener, Cristian Robert;
Revista Dor , 2012, DOI: 10.1590/S1806-00132012000400015
Abstract: background and objectives: the inability to stabilize the spine due to the unbalance between trunk extensor and flexor muscles is a strong indication of the development of lumbar spine disorders. the exercise commonly referred to as pilates? advocates improvement of muscle agonist and antagonist relations favoring the work of stabilizing muscles and preventing several lumbar spine disorders. this study aimed at evaluating the effectiveness of pilates to treat chronic low back pain. case reports: we have evaluated seven female patients aged between 18 and 50 years, with clinical diagnosis of chronic low back pain and able to perform basic and intermediate pilates exercises. evaluation tools were the pain visual analog scale (vas) and oswestry's low back pain questionnaire, in addition to an identification questionnaire. data were analyzed by simple arithmetic average. there has been significant pain improvement by vas which initially had a mean of 7 and after 3 months of treatment has decreased to 1.7. there has been improvement in quality of life, with owestry's index decreasing from 36.8% to 8% after 3 months of treatment. conclusion: pilates was effective to treat chronic low back pain, having improved pain and incapacities.
Análise comparativa da atividade elétrica do músculo multífido durante exercícios do Pilates, série de Williams e Spine Stabilization
Silva, M?nica Angélica Cardoso;Dias, Josilainne Marcelino;Silva, Mariana Felipe;Mazuquin, Bruno Fles;Abr?o, Taufik;Cardoso, Jefferson Rosa;
Fisioterapia em Movimento , 2013, DOI: 10.1590/S0103-51502013000100010
Abstract: introduction: the back muscle weakness is related with the etiology of low back pain. nowadays, there are several methods the focus is on back muscle strengthening. objectives: the purpose of this study was to compare and analyze the multifidus muscle bilaterally during exercises of the pilates method, spine stabilization and williams' flexion. materials and methods: ten healthy female volunteers participated in the study. they performed the leg pull front support exercise from the pilates method, the quadruped exercise from the spine stabilization and the fourth exercise from the additional williams' flexion. the signal was normalized by the electromyographic peak of the dynamic activity and was adjusted to 2000 samples/s and filter with a frequency band from 20 to 450 hz. anova was used to verify differences between the exercises, the paired-sample t test was used to compare activation between the right and left multifidus for each exercise. results and conclusion: when the exercises where compared, statistically significant differences were observed in the concentric and eccentric phases for the pilates exercise, showing that this exercise is the one who activates the musculature the most between the exercises evaluated.
The Effectiveness of Functional Back School Concurrently Applied with Exercise and Physical Therapy Modalities in Patients with Chronic Mechanical Low Back Pain-Short Term Results  [cached]
?lknur Tu?cu,Mustafa Erkut ?nder,Kamil Yaz?c?o?lu,Haydar M?hür
Türkiye Fiziksel Tip ve Rehabilitasyon Dergisi , 2008,
Abstract: Objective: To evaluate the effectiveness of functional back school programme concurrently applied with an exercise and physical therapy modalities in patients with chronic mechanical low back pain (LBP) for a short time. Materials and Methods: Thirty seven patients diagnosed as chronic mechanical LBP were included in this study. A functional back schoolprogramme combined with physical therapy modalities and exercise programme was applied to patients for a period of 10 days. Lumbar Schober and finger-toe distance were used for the assessment of lumbar mobility. Lumbar flexion-extension and lateral lumbar flexions were measured by an inclinometer. Pain was assessed using the Visual Analogue Scale. For the assessment of functional disability; Modified Oswestry Disability Questionnaire, Rolland-Morris Functional Activities Questionnaire and Istanbul LBP Functional Scale were applied to the patients. Assessments were made before and after the treatment. Results: Only finger-toe distance of the mobility assessed parameters was determined to show a statistically significant difference (p=0.004). Furthermore, the pain score was decreased significantly (p=0.001) and all of the functional parameters showed significant improvement (Modified Oswestry Disability Questionnaire p=0.001, Rolland-Morris Functional Activities Questionnaire p=0.016 and Istanbul LBP Functional Scale p=0.014). Conclusion: In our study, we obtained a statistically significant decrease in pain sensation and functional disability in patients for a short time. Consequently, we believe that effective results can be obtained through the functional back school programme combined with other treatment modalities for patients with chronic mechanical LBP. Turk J Phys Med Rehab 2008;54:63-8
Effects of preferred-exercise prescription compared to usual exercise prescription on outcomes for people with non-specific low back pain: a randomized controlled trial [ACTRN12608000524392]
Susan C Slade, Jennifer L Keating
BMC Musculoskeletal Disorders , 2009, DOI: 10.1186/1471-2474-10-14
Abstract: The study will be a randomised controlled trial comparing an exercise rehabilitation program informed by a participant preferences questionnaire compared to a program without this guideline for patients with chronic low back pain. A sample of 150 patients will be recruited in Melbourne, Australia through community-based healthcare clinics that provide supervised exercise rehabilitation programs for people with non-specific chronic low back pain. Clinicians will be randomly assigned to exercise preferences questionnaire or no questionnaire and participants will be allocated in a concealed manner. A qualitative focus group study of exercise instructor feedback about the exercise preferences instrument will be embedded in the research design. Two qualitative focus group studies will also be conducted for participants in the intervention and the control groups to obtain feedback about participants' experiences of the two types of exercise programs. The primary outcomes will be functional ability, pain, fear avoidance, exercise adherence.This trial will evaluate the effectiveness of individualised exercise prescription compared to usual exercise prescription for NSCLP and, using feedback following the trial, refine the exercise preferences questionnaire.Non-specific chronic low back pain (NSCLBP) has become a significant problem due to high healthcare utilization, rising costs of care and perceived limitations of effectiveness of many current treatments. It is a significant source of long-term disability and absence from work and a substantial burden in industrialized societies [1-9]. NSCLBP is not a diagnosis but rather a description of back pain for which a cause cannot be definitively identified and a precise patho-anatomical diagnosis cannot be given. This accounts for approximately 85% of all low back pain and does presume that specific pathologies, such as nerve root compression or tumour, have been ruled out by appropriate tests and imaging [10]. The condition man
EFFECTIVENESS OF KATIVASTHI AND EXERCISE IN CHRONIC LOW BACK PAIN: A RANDOMIZED CONTROL STUDY
Panda Ashok Kumar,Debnath Saroj Kumar
International Journal of Research in Ayurveda and Pharmacy , 2011,
Abstract: Chronic low back pain is very common and comprises of 2 .21% in US population and 15% in working groups over the age of 30. In this study there were two groups, one was Kativasthi therapy group and another was Exercise therapy group. Both groups were continued for 10 days. Kativasthi is process specially prepared warm medicated oil kept over low back area with Masa churna (Black gram powder) paste boundary over a period of 45 minutes. An open prospective study was conducted to evaluate the effectiveness of Kativasthi (warm oil stagnation procedure) in patients of chronic low back pain. Mahanarayan taila is used in Kativasthi for 10 days after Sarvanga Snehana with Mahanarayan taila (oil massage) and Sarvanga Baspa Svedana (steam bath). 40 patients, aged 40±10.4 years were divided into two groups by a computer generated random number table. X ray of lumbo-sacral spine (antero-posterior & lateral view) was reviewed. Differences of lumbar and ridiculer pains on an analog visual scale, Modified Oswestry Disability score and distance finger ground test were assessed at 0-day & 10th -day. There is significant improvement in all above parameters on 10th day. It was found that Kativasthi was more effective than the conventional exercise practices.
A Meta-Analysis of Core Stability Exercise versus General Exercise for Chronic Low Back Pain  [PDF]
Xue-Qiang Wang, Jie-Jiao Zheng, Zhuo-Wei Yu, Xia Bi, Shu-Jie Lou, Jing Liu, Bin Cai, Ying-Hui Hua, Mark Wu, Mao-Ling Wei, Hai-Min Shen, Yi Chen, Yu-Jian Pan, Guo-Hui Xu, Pei-Jie Chen
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0052082
Abstract: Objective To review the effects of core stability exercise or general exercise for patients with chronic low back pain (LBP). Summary of Background Data Exercise therapy appears to be effective at decreasing pain and improving function for patients with chronic LBP in practice guidelines. Core stability exercise is becoming increasingly popular for LBP. However, it is currently unknown whether core stability exercise produces more beneficial effects than general exercise in patients with chronic LBP. Methods Published articles from 1970 to October 2011 were identified using electronic searches. For this meta-analysis, two reviewers independently selected relevant randomized controlled trials (RCTs) investigating core stability exercise versus general exercise for the treatment of patients with chronic LBP. Data were extracted independently by the same two individuals who selected the studies. Results From the 28 potentially relevant trials, a total of 5 trials involving 414 participants were included in the current analysis. The pooling revealed that core stability exercise was better than general exercise for reducing pain [mean difference (?1.29); 95% confidence interval (?2.47, ?0.11); P = 0.003] and disability [mean difference (?7.14); 95% confidence interval (?11.64, ?2.65); P = 0.002] at the time of the short-term follow-up. However, no significant differences were observed between core stability exercise and general exercise in reducing pain at 6 months [mean difference (?0.50); 95% confidence interval (?1.36, 0.36); P = 0.26] and 12 months [mean difference (?0.32); 95% confidence interval (?0.87, 0.23); P = 0.25]. Conclusions Compared to general exercise, core stability exercise is more effective in decreasing pain and may improve physical function in patients with chronic LBP in the short term. However, no significant long-term differences in pain severity were observed between patients who engaged in core stability exercise versus those who engaged in general exercise. Systematic Review Registration http://www.crd.york.ac.uk/PROSPERO PROSPERO registration number: CRD42011001717.
How do care-provider and home exercise program characteristics affect patient adherence in chronic neck and back pain: a qualitative study
Pilar Escolar-Reina, Francesc Medina-Mirapeix, Juan J Gascón-Cánovas, Joaquina Montilla-Herrador, Francisco J Jimeno-Serrano, Silvana L de Oliveira Sousa, M Elena del Ba?o-Aledo, Rafael Lomas-Vega
BMC Health Services Research , 2010, DOI: 10.1186/1472-6963-10-60
Abstract: This is a qualitative study consisting of seven focus groups, with a total of 34 participants presenting chronic neck or low back pain. The subjects were included if they were receiving physiotherapy treatment and were prescribed home-based exercises.Two themes emerged: home-based exercise programme conditions and care provider's style. In the first theme, the participants described their positive and negative experiences regarding time consumption, complexity and effects of prescribed exercises. In the second theme, participants perceived more bonding to prescribed exercises when their care provider presented knowledge about the disease, promoted feedback and motivation during exercise instruction, gave them reminders to exercise, or monitored their results and adherence to exercises.Our experiential findings indicate that patient's adherence to home-based exercise is more likely to happen when care providers' style and the content of exercise programme are positively experienced. These findings provide additional information to health care providers, by showing which issues should be considered when delivering health care to patients presenting chronic neck or back pain.Neck and low back pain are prevalent and they are the major cause of work disability, being responsible for high costs to society [1,2]. Recurrence of neck and low back pain are common and their course is variable [3-5], with 10-15% of cases leading to chronic pain [6,7]. Exercise therapy commonly forms part of the treatment prescribed by care providers to patients presenting low back or neck pain. Systematic reviews have concluded that exercise appears to be effective in decreasing pain and improving function [8-11]. Exercises are often instructed individually and prescribed to be performed at home [12]. Although home-based exercises vary greatly in the method of delivery and content [7,13,14], different programmes appear to have similar effects on patients [15,16].Scientific evidence suggests tha
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