Efficacy of the Pilates method for pain and disability in patients with chronic nonspecific low back pain: a systematic review with meta-analysis

Gisela C Miyamoto, Leonardo O P Costa, Cristina M N Cabral, Gisela C Miyamoto, Leonardo O P Costa, Cristina M N Cabral

Abstract

Objective: To systematically review the available evidence on the efficacy of the Pilates method in patients with chronic nonspecific low back pain.

Method: Searches were performed in MEDLINE, EMBASE, PEDro, SciELO, LILACS, CINAHL and CENTRAL in March 2013. Randomized controlled trials that tested the effectiveness of the Pilates method (against a nontreatment group, minimal intervention or other types of interventions) in adults with chronic low back pain were included regardless the language of publication. The outcome data were extracted from the eligible studies and were combined using a meta-analysis approach.

Results: The searches identified a total of 1,545 articles. From these, eight trials were considered eligible, and seven trials were combined in the meta-analysis. The comparison groups were as follows: Pilates versus other types of exercises (n=2 trials), and Pilates versus no treatment group or minimal intervention (n=4 trials) for short term pain; Pilates versus minimal intervention for short-term disability (n=4).We determined that Pilates was not better than other types of exercises for reducing pain intensity. However, Pilates was better than a minimal intervention for reducing short-term pain and disability (pain: pooled mean difference=1.6 points; 95% CI 1.4 to 1.8; disability: pooled mean difference=5.2 points; 95% CI 4.3 to 6.1).

Conclusions: Pilates was better than a minimal intervention for reducing pain and disability in patients with chronic low back pain. Pilates was not better than other types of exercise for short-term pain reduction.

Figures

Figure 1
Figure 1
Selection process for studies included in the analysis.
Figure 2
Figure 2
Forest plot of the results of the meta-analysis. A) Comparison of the Pilates method with minimal intervention for pain. The values shown are the average effects (difference between means) and the 95% confidence interval. The average effect was calculated using a fixed-effects model for short-term pain relief. B) Comparison of the Pilates method with other types of exercises for pain. The values shown are the average effects (difference between means) and the 95% confidence interval. The average effect was calculated using a fixed-effects model for short-term pain relief. C) Comparison of the Pilates method with minimal intervention for disability. The values shown are the average effects (difference between means) and the 95% confidence interval. The average effect was calculated using a random-effects model for short-term changes in disability.

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Source: PubMed

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