The Theoretical Framework of the Clinical Pilates Exercise Method in Managing Non-Specific Chronic Low Back Pain: A Narrative Review

Boon Chong Kwok, Justin Xuan Li Lim, Pui Wah Kong, Boon Chong Kwok, Justin Xuan Li Lim, Pui Wah Kong

Abstract

Exercise plays an important role in rehabilitating people with chronic low back pain. Aerobic exercise and resistance training are general exercise strategies to manage chronic low back pain, but these strategies require longer intervention period to achieve clinical outcomes in pain reduction and functional improvements. Directional preference is recognised as an important exercise strategy in managing low back pain. The Clinical Pilates exercise method leverages on the directional preference of an individual to achieve clinical outcomes faster. Clinical Pilates is a hybrid of two of the best exercise interventions for low back pain, which are general Pilates and the McKenzie method. Due to the scarcity of Clinical Pilates literature, a review of its theory and studies was undertaken to provide a structured guide to the technique in managing people with chronic low back pain. Hypothetical algorithms are developed to support translation into clinical practice and future research studies. These algorithms are useful in the management of complex cases involving multiple directional trauma. Although limited, current evidence suggests that the Clinical Pilates exercise method is safe and provides faster functional recovery in the early stage of rehabilitation and similar longer term outcomes as general exercises.

Keywords: exercise science; lumbago; motor control; physiotherapy; rehabilitation.

Conflict of interest statement

The authors declare no conflict of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
PRISMA flowchart of review search yield.
Figure 2
Figure 2
Axes of trunk movements.
Figure 3
Figure 3
Football tackle from the front and left of a striker.
Figure 4
Figure 4
Example of lateral flexion trauma from a rugby challenge.
Figure 5
Figure 5
(a). The diagnostic bullseye; (b). Example of charted directional trauma (red) and preference (green).
Figure 6
Figure 6
Examples of Clinical Pilates exercises for (a) Stage 2 and (b) Stage 3.

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Source: PubMed

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