The effectivity of a Pilates protocol in the treatment of chronic nonspecific low-back pain: a randomized clinical trial
DOI:
https://doi.org/10.11606/issn.2317-0190.v28i4a190072Keywords:
Low Back Pain, Exercise Movement Techniques, Health Education, Physical Therapy Modalities, Quality of LifeAbstract
Low back pain is a major health and socioeconomic problem. Exercises and patient awareness are among the possible positive strategies for treating nonspecific chronic low back pain. Objective: The objective of this study was to determine the effectiveness of the Pilates Method and the "Back School" program in the treatment of nonspecific chronic low back pain. Method: A randomized controlled trial with blinded assessors. Eighty-four individuals with chronic nonspecific low back pain.Interventions: Participants were randomly allocated into two groups: Pilates Group (n= 43) or Control Group - “Back School” (n= 41). The primary outcomes were: pain (Numeric Rating Scale), quality of life (SF-36), and disability (Roland-Morris Disability Questionnaire - RMDQ). The secondary outcomes were: Flexibility (Fingertip-to-Floor Test – FTF) and sleep quality (Pittsburgh Sleep Quality Index - PSQI). Results: The Pilates Group was superior to the Control Group (p<0.05) in outcomes of pain intensity, disability, flexibility, and in five domains of SF-36 (physical functioning, role limitations due to physical health, pain, vitality, and general health). There was no significant difference between groups for sleep quality. Conclusion: The Pilates protocol provided significant improvements and can be considered an option for treating nonspecific chronic low back pain. The Pilates Group was superior to the "Back School" program for pain reduction, improved functional capacity, flexibility, and five quality of life domains. Due to the considerable low adhesion to both interventions, alternatives to improve adherence should be proposed in future studies.
Downloads
References
Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028-37. Doi: http://dx.doi.org/10.1002/art.34347
Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ. 2003;81(9):646-56.
Henschke N, Maher CG, Refshauge KM, Herbert RD, Cumming RG, Bleasel J, et al. Prognosis in patients with recent onset low back pain in Australian primary care: Inception cohort study. BMJ. 2008;337(7662):154-7. Doi: http://dx.doi.org/10.1136/bmj.a171
Miyamoto GC, Costa LOP, Galvanin T, Cabral CMN. Efficacy of the addition of modified pilates exercises to a minimal intervention in patients with chronic low back pain: a randomized controlled trial. Phys Ther. 2013;93(3):310-20. Doi: http://dx.doi.org/10.2522/ptj.20120190
van Tulder M, Becker A, Bekkering T, Breen A, Del Real MTG, Hutchinson A, et al. Chapter 3: European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J. 2006;15(Suppl 2):169-91. Doi: http://dx.doi.org/10.1007/s00586-006-1071-2
Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000;84(1):95-103. Doi: http://dx.doi.org/10.1016/S0304-3959(99)00187-6
Walker BF, Muller R, Grant WD. Low back pain in Australian adults: the economic burden. Asia-Pacific J Public Health. 2003;15(2):79-87. Doi: http://dx.doi.org/10.1177/101053950301500202
Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J. 2008;8(1):8-20. Doi: http://dx.doi.org/10.1016/j.spinee.2007.10.005
Bevan S. Economic impact of musculoskeletal disorders (MSDs) on work in Europe. Best Pract Res Clin Rheumatol. 2015;29(3):356-73. Doi: http://dx.doi.org/:10.1016/j.berh.2015.08.002
Delitto A, George SZ, Van Dillen L, Whitman JM, Sowa G, Shekelle P, et al. Low Back Pain. J Orthop Sports Phys Ther. 2012;42(4):A1-57. Doi: http://dx.doi.org/10.2519/jospt.2012.42.4.A1
Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-30. Doi: http://dx.doi.org/10.7326/M16-2367
Hayden J, van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. Cochrane Database Syst Rev. 2005;10(2):164-5. Doi: http://dx.doi.org/10.1002/14651858.CD000335.pub2
Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15 (Suppl 2):S192-300. Doi: http://dx.doi.org/10.1007/s00586-006-1072-1
Wajswelner H, Metcalf B, Bennell K. Clinical Pilates versus General Exercise for Chronic Low Back Pain. Med Sci Sports Exerc. 2012;44(7):1197-205. Doi: http://dx.doi.org/10.1249/MSS.0b013e318248f665
Bryan M, Hawson S. The benefits of pilates exercise in orthopaedic rehabilitation. Tech Orthop. 2003;18(1):126-9. Doi: http://dx.doi.org/10.1097/00013611-200303000-00018
Gladwell V, Head S, Haggar M, Beneke R. Does a program of pilates improve chronic non-specific low back pain? J Sport Rehabil. 2006;15(4):338-50. Doi: http://dx.doi.org/10.1123/jsr.15.4.338
Forssell MZ. The Back School. Spine (Phila Pa 1976). 1981;6(1):104-6. Doi: http://dx.doi.org/10.1097/00007632-198101000-00022
Yamato T, Maher C, Saragiotto B, Hancock M, Ostelo R, Cabral C, et al. Pilates for low back pain. Cochrane Collab. 2015;(7):CD010265. Doi: http://dx.doi.org/10.1002/14651858.CD010265.pub2
Schulz KF, Altman DG, Moher D. CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340(7748):698–702. Doi: http://dx.doi.org/10.1136/bmj.c332
Costa L, Maher C, Latimer J, Ferreira P, Ferreira M, Pozzi G, et al. Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: Which one is the best? Spine (Phila Pa 1976). 2008;33(22):2459-63. Doi: http://dx.doi.org/10.1097/BRS.0b013e3181849dbe
Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR. Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Rev Bras Reumatol. 1999;39(3):143-50.
Lins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med. 2016;4:2050312116671725. Doi: http://dx.doi.org/10.1177/2050312116671725
Nusbaum L, Natour J, Ferraz MB, Goldenberg J. Translation, adaptation and validation of the Roland-Morris questionnaire - Brazil Roland-Morris. Brazilian J Med Biol Res. 2001;34(2):203-10. Doi: http://dx.doi.org/10.1590/S0100-879X2001000200007
Perret C, Poiraudeau S, Fermanian J, Colau MM, Mayoux Benhamou MA, Revel M. Validity, reliability, and responsiveness of the fingertip-to-floor test. Arch Phys Med Rehabil. 2001;82(11):1566-70. Doi: http://dx.doi.org/10.1053/apmr.2001.26064
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. Doi: http://dx.doi.org/10.1016/0165-1781(89)90047-4
Bertolazi AN, Fagondes SC, Hoff LS, Dartora EG, Silva Miozzo IC, Barba MEF, et al. Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index. Sleep Med. 2011;12(1):70-5. Doi: http://dx.doi.org/10.1016/j.sleep.2010.04.020
Natour J, Cazotti LDA, Ribeiro LH, Baptista AS, Jones A. Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial. Clin Rehabil. 2015;29(1):59-68. Doi: http://dx.doi.org/10.1177/0269215514538981
Nectoux VZ, Fiamoncini R. Método pilates como recurso analgésico em pessoas com diagnóstico de lombalgia/lombociatalgia. Rev Bras Prescr Fisiol Exerc. 2010;4(20):196-202.
Quinn K, Barry S, Barry L. Do patients with chronic low back pain benefit from attending Pilates classes after completing conventional physiotherapy treatment? Physiother Pract Res. 2011;32(1):5-12. Doi: http://dx.doi.org/10.3233/ppr-2011-32102
Rydeard R, Leger A, Smith D. Pilates-based therapeutic exercise: Effect on subjects with nonspecific chronic low back pain and functional disability: A randomized controlled trial. J Orthop Sports Phys Ther. 2006;36(7):472-84. Doi: http://dx.doi.org/10.2519/jospt.2006.2144
Miyamoto GC, Costa LOP, Cabral CMN. Efficacy of the Pilates method for pain and disability in patients with chronic nonspecific low back pain: a systematic review with meta-analysis. Braz J Phys Ther. 2013;17(6):517-32. Doi: http://dx.doi.org/10.1590/S1413-35552012005000127
Pereira LM, Obara K, Dias JM, Menacho MO, Guariglia DA, Schiavoni D, et al. Comparing the Pilates method with no exercise or lumbar stabilization for pain and functionality in patients with chronic low back pain: systematic review and meta-analysis. Clin Rehabil. 2012;26(1):10-20. Doi: http://dx.doi.org/10.1177/0269215511411113
Garcia AN, Gondo FLB, Costa RA, Cyrillo FN, Costa LOP. Effects of two physical therapy interventions in patients with chronic non-specific low back pain: feasibility of a randomized controlled trial. Rev Bras Fisioter. 2011;15(5):420-7. Doi: http://dx.doi.org/10.1590/S1413-35552011005000019
Nogueira HC, Navega MT. Influência da Escola de Postura na qualidade de vida, capacidade funcional, intensidade de dor e flexibilidade de trabalhadores administrativos. Fisioter Pesq. 2011;18(4):353-8. Doi: https://doi.org/10.1590/S1809-29502011000400010
Parreira P, Heymans MW, van Tulder MW, Esmail R, Koes BW, Poquet N, et al. Back Schools for chronic non-specific low back pain. Cochrane Database Syst Rev. 2017;8(8):CD011674. Doi: http://dx.doi.org/10.1002/14651858.CD011674.pub2
Helfenstein Junior M, Goldenfum MA, Siena C. Occupational low back pain. Rev Assoc Med Bras. 2010;56(5):583-9. Doi: http://dx.doi.org/10.1590/S0104-42302010000500022
Kurita GP, Pimenta CAM. Adesão ao tratamento da dor crônica e o locus de controle da saúde. Rev Esc Enferm USP. 2004;38(3):254-61. Doi: http://dx.doi.org/10.1590/s0080-62342004000300003
Gonçalves PS, Lima POP. Percepção de saúde e qualidade de vida: um inquérito com praticantes de Pilates. Rev Fisioter S Func. 2014;3(1):11-7.
Verbunt JA, Westerterp KR, van Der Heijden GJ, Seelen HA, Vlaeyen JW, Knottnerus JA. Physical activity in daily life in patients with chronic low back pain. Arch Phys Med Rehabil. 2001;82(6):726-30. Doi: http://dx.doi.org/10.1053/apmr.2001.23182
Al-Obaidi SM, Beattie P, Al-Zoabi B, Al-Wekeel S. The relationship of anticipated pain and fear avoidance beliefs to outcome in patients with chronic low back pain who are not receiving workers’ compensation. Spine (Phila Pa 1976). 2005;30(9):1051-7. Doi: http://dx.doi.org/10.1097/01.brs.0000160848.94706.83
Dhondt E, van Oosterwijck J, Cagnie B, Adnan R, Schouppe S, van Akeleyen J, et al. Predicting treatment adherence and outcome to outpatient multimodal rehabilitation in chronic low back pain. J Back Musculoskelet Rehabil. 2020;33(2):277-93. Doi: http://dx.doi.org/10.3233/BMR-181125
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Acta Fisiátrica
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
