Machine-Based Pilates on Quality of Life and Low Back Pain in Older Adults (Pilates-LBP)

Feasibility and Preliminary Outcomes of a Machine-Based Pilates Program on Quality of Life and Low Back Pain in Aged Adults: A Mixed-Methods Approach

Chronic low back pain is one of the most prevalent and debilitating conditions among older adults, often compromising physical function and overall quality of life. Structured physical exercise, particularly the Pilates method, is widely recommended for managing this condition. However, existing literature primarily focuses on younger populations using mat-based group classes. This pilot study utilizes an exploratory mixed-methods design to investigate the feasibility and preliminary outcomes of a 12-week individualized, machine-based Classical Pilates program on quality of life and low back pain in active older adults (aged 55 to 75 years). Participants will complete 24 individual sessions (twice a week). The aim is to assess changes in physical domains of quality of life and perceived low back pain intensity, while gathering qualitative contextual insights on body awareness and psychosocial well-being.

Study Overview

• Status: Completed
• Conditions: Quality of Life; Low Back Pain; Aging
• Intervention / Treatment: Behavioral: Machine-Based Classical Pilates Program

Detailed Description

The study is designed as an exploratory, quasi-experimental, single-arm pilot study. Participants presenting with moderate disability caused by low back pain (Oswestry Disability Index = 21% to 40%) will undergo a structured exercise protocol utilizing the Classical Pilates method on machines in a one-on-one setting. The intervention spans 12 weeks, consisting of two individual 50-minute sessions per week.

The pedagogical structure is divided into two distinct Classical approach components: the "Skeleton" (core base exercises on the Reformer and Mat) and the "System" (adaptations and specific exercises on auxiliary equipment like the Wunda Chair, Cadillac, and Barrels). Exercise progression is individualized based on biomechanical control, absence of pain, and ability to maintain a neutral lumbopelvic position. Resistance is modified primarily via adjustable springs on the equipment. Exercise intensity is strictly monitored using the Talk Test to ensure a light-to-moderate exertion level suitable for the geriatric demographic.

Assessments are conducted at baseline and post-intervention (12 weeks) using the WHOQOL-Bref for quality of life and the Oswestry Disability Index Version 2.0 for low back pain disability. Additionally, a qualitative focus group will be conducted post-intervention with a subsample of participants to capture contextual insights regarding mobility, psychosocial benefits, and daily habit integration.

• Study Type: Interventional
• Enrollment (Actual): 16
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Portugal
  • Leiria District
    • Leiria, Leiria District, Portugal, 2411-901
      • Instituto Politécnico de Leiria

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Aged between 55 and 75 years.
• Physically active in daily routines.
• No previous experience with machine-based Pilates.
• Presenting with moderate disability (Oswestry Disability Index = 21% to 40%) caused by low back pain.

Exclusion Criteria:

• Absolute contraindications to physical exercise.
• Severe spinal pathologies (e.g., hernias requiring surgery, severe osteoporosis, idiopathic scoliosis).
• Previous or scheduled spinal surgeries.
• Severe disability (Oswestry Disability Index > 41%).
• Chronic obstructive pulmonary disease.
• Recent stroke or myocardial infarction.
• Uncontrolled hypertension.
• Active oncological treatment.
• Physical therapy treatment for low back pain within the six months prior to the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Machine-Based Pilates Group; A 12-week program consisting of two individual 50-minute sessions per week. The protocol integrates "Skeleton" exercises (Mat and Reformer) and "System" exercises (auxiliary equipment). The periodization varies the positional stimulus (starting on Mat for the first 6 weeks, and starting on Reformer for the final 6 weeks). Intensity is maintained at a light-to-moderate level, monitored continuously via the Talk Test.

Behavioral: Machine-Based Classical Pilates Program; A 12-week program consisting of two individual 50-minute sessions per week. The protocol integrates "Skeleton" exercises (Mat and Reformer) and "System" exercises (auxiliary equipment). The periodization varies the positional stimulus (starting on Mat for the first 6 weeks, and starting on Reformer for the final 6 weeks). Intensity is maintained at a light-to-moderate level, monitored continuously via the Talk Test.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Quality of Life	Assessed using the World Health Organization Quality of Life Brief (WHOQOL-Bref) questionnaire. It evaluates four domains: physical, psychological, social relationships, and environment. Responses for each item are recorded on a five-point scale ranging from 1 (minimum) to 5 (maximum), and the total domain scores are transformed to a 0 to 100 scale, where 0 is the minimum possible score and 100 is the maximum possible score. Higher scores indicate a better perceived quality of life.	Baseline (Week 0) and Post-Intervention (Week 13).

Collaborators and Investigators

• Sponsor: Instituto Politécnico de Leiria
• Investigators: Study Director: José Carlos Laranjo Marques, ESECS

Study record dates

Study Major Dates

• Study Start (Actual): October 21, 2024
• Primary Completion (Actual): January 30, 2025
• Study Completion (Actual): January 30, 2025

Study Registration Dates

• First Submitted: May 13, 2026
• First Submitted That Met QC Criteria: May 13, 2026
• First Posted (Actual): May 19, 2026

Study Record Updates

• Last Update Posted (Actual): May 22, 2026
• Last Update Submitted That Met QC Criteria: May 19, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Quality of Life; Low Back Pain; Pilates; Active Aging; Individualized Training
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Back Pain; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Low Back Pain
• Other Study ID Numbers: CE/IPLEIRIA/62/2023

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Data will be available on request from the corresponding author due to privacy and ethical restrictions.
• IPD Sharing Time Frame: Data will become available following the publication of the study results and will remain accessible for a period of 5 years.
• IPD Sharing Access Criteria: Data will be shared with researchers who provide a methodologically sound proposal for secondary analysis. To ensure privacy and ethical compliance, requesters must obtain approval from an independent Ethics Committee. All requests should be directed to the corresponding author via email.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No