Effects of Pilates and trunk strengthening exercises on health-related quality of life in women with chronic low back pain

Abstract

BACKGROUND:

Pilates programs are widely used as a form of regular exercise in a broad range of populations investigating their effectiveness for chronic low back pain (CLBP) treatment.

OBJECTIVE:

The aim of this study was to compare the effects of a Pilates program and a trunk strengthening exercise program on functional disability and health-related quality of life (HRQOL) in women with nonspecific CLBP.

METHODS:

A total of 101 volunteer women with CLBP provided data with a 3-month follow-up. They were randomized to either a Pilates (n= 37), trunk strengthening exercise (n= 36) or a control group (n= 28), exercising for a period of 8 weeks, three times a week. Data were collected on HRQOL using the Short-Form 36 Health Survey (SF-36v2), and functional disability using the Roland Morris Disability Questionnaire prior to program initiation, mid-intervention, immediately after program termination, and three months post-intervention.

RESULTS:

The Pilates participants reported greater improvements on self-reported functional disability and HRQOL compared with participants in the trunk strengthening exercise and control groups (p < 0.05). The effects were retained for a period of three months after program termination for the Pilates group and to a lesser extent for the trunk strengthening exercise group.

CONCLUSIONS:

An 8-week Pilates program improved HRQOL and reduced functional disability more than either a trunk strengthening exercise program or controls among women with CLBP.

Keywords

Exercise rehabilitation lumbar spine muscle recruitment stabilization exercises back pain

References

Kloubec

. Pilates: how does it work and who needs it? Muscles Ligaments Tendons J. 2011 Apr; 1(2): 61-6. doi: 12701.

Muscolino

, Cipriani

. Pilates and the ``powerhouse''. Journal of Bodywork and Movement Therapies. 2004; 8: 15-24. doi: 12620.

Herrington

, Wrapson

, Matthews

. Anterior Cruciate Ligament reconstruction, hamstring versus bone-patella tendon-bone grafts: A systematic literature review of outcome from surgery. Knee. 2005; 12(1): 41-50. doi: 10487.

McNeill

. Pilates: Ranging beyond neutral. J Bodyw Mov Ther. 2014 Jan; 18(1): 119-23. doi: 12623S1360-8592(13) 00194-0 [pii]. 10.1016/j.jbmt.2013.11.012.

Notarnicola

, Fischetti

, Maccagnano

, Comes

, Tafuri

, Moretti

. Daily pilates exercise or inactivity for patients with low back pain: A clinical prospective observational study. Eur J Phys Rehabil Med. 2013 Oct 9. doi: 12636R33 Y9999N00A0260[pii]

Gladwell

, Head

, Haggar

, Beneke

. Does a program of pilates improve chronic non-Specific low back pain? J Sport Rehabil. 2006; 15: 338-50. doi: 13033.

Rydeard

, Leger

, Smith

. 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 Jul; 36(7): 472-84. doi: 1290310.2519/jospt.2006.2144.

Marshall

, Kennedy

, Brooks

, Lonsdale

. Pilates exercise or stationary cycling for chronic nonspecific low back pain: does it matter? a randomized controlled trial with 6-month follow-up. Spine (Phila Pa 1976). 2013 Jul 1; 38(15): E952-9. doi: 1264910.1097/BRS.0b013e318297c1e5.

Wajswelner

, Metcalf

, Bennell

. Clinical pilates versus general exercise for chronic low back pain: randomized trial. Med Sci Sports Exerc. 2012 Jul; 44(7): 1197-205. doi: 1267410.1249/MSS.0b013e318248f665.

10.

Donzelli

, Di Domenica

, Cova

, Galletti

, Giunta

. Two different techniques in the rehabilitation treatment of low back pain: A randomized controlled trial. Eura Medicophys. 2006; 42(3): 205-10. doi: 13034.

11.

da Luz

, Costa

, Fuhro

, Manzoni

, Oliveira

, Cabral

. Effectiveness of Mat Pilates or Equipment-Based Pilates Exercises in Patients With Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial. Phys Ther. 2014 Jan 16. doi: 12621ptj.20130277 [pii] 10.2522/ptj.20130277.

12.

Miyamoto

, Costa

, Cabral

. 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 Nov-Dec; 17(6): 517-32. doi: 12632S1413-35552013000600517 [pii] 10.1590/S1413-35552012005000127.

13.

Wells

, Kolt

, Marshall

, Hill

, Bialocerkowski

. Effectiveness of Pilates exercise in treating people with chronic low back pain: A systematic review of systematic reviews. BMC Med Res Methodol. 2013; 13: 7. doi: 126531471-2288-13-7 [pii] 10.1186/1471-2288-13-7.

14.

van Middelkoop

, Rubinstein

, Kuijpers

, Verhagen

, Ostelo

, Koes

, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J. 2011 Jan; 20(1): 19-39. doi: 1246110.1007/s00586-010-1518-3.

15.

Ferreira

, Ferreira

, Maher

, Herbert

, Refshauge

. Specific stabilisation exercise for spinal and pelvic pain: A systematic review. Aust J Physiother. 2006; 52(2): 79-88. doi: 9988.

16.

May

, Johnson

. Stabilisation exercises for low back pain: A systematic review. Physiotherapy. 2008 Sep; 94(3): 179-89. doi: 997210.1016/j.physio.2007.08.010.

17.

Schneider

, Randoll

, Buchner

. Why do women have back pain more than men? A representative prevalence study in the federal republic of Germany. Clin J Pain. 2006 Oct; 22(8): 738-47. doi: 1453010.1097/01.ajp.0000210920.03289.93.00002508-200610000-00011 [pii].

18.

Koumantakis

, Watson

, Oldham

. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther. 2005 Mar; 85(3): 209-25. doi: 9639.

19.

Koumantakis

, Watson

, Oldham

. Supplementation of general endurance exercise with stabilisation training versus general exercise only. Physiological and functional outcomes of a randomised controlled trial of patients with recurrent low back pain. Clin Biomech (Bristol, Avon). 2005 Jun; 20(5): 474-82. doi: 9638S0268-0033(05)00005-7 [pii] 10.1016/j.clinbiomech.2004.12.006.

20.

Ware

JEJ

, Kosinski

, Bjorner

, Turner-Bowker

, Gandek

, Maruish

. User's Manual for the SF-36v2 Health Survey (2nd ed.): Lincoln, RI: QualityMetric Incorporated, 2007.

21.

Roland

, Morris

. A study of the natural-history of back pain. 1. Development of a reliable and sensitive measure of disability in low-back-pain. Spine. 1983; 8(2): 141-4. doi: 10.01410.1097/00007632-198303000-00004.

22.

Noordzij

, Tripepi

, Dekker

, Zoccali

, Tanck

, Jager

. Sample size calculations: Basic principles and common pitfalls. Nephrol Dial Transplant. 2010 May; 25(5): 1388-93. doi: 10.860gfp732 [pii] 10.1093/ndt/gfp732.

23.

Cronbach

. Coefficient alpha and the internal structure of tests. Psychometrika. 1951; 16: 297-334. doi: 12724.

24.

O'Sullivan

, Twomey

, Allison

. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997 Dec 15; 22(24): 2959-67. doi: 993010.1097/00007632-199712150-00020.

25.

Miyamoto

, Costa

, Galvanin

, Cabral

. 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 Mar; 93(3): 310-20. doi: 12657ptj.20120190 [pii] 10.2522/ptj.20120190.

26.

Roelofs

, Deyo

, Koes

, Scholten

, van Tulder

. Non-steroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev. 2008 (1): CD000396. doi: 1345810.1002/14651858.CD000396.pub3.

27.

Crow

, Gage

, Hampson

, Hart

, Kimber

, Thomas

. The role of expectancies in the placebo effect and their use in the delivery of health care: A systematic review. Health Technol Assess. 1999; 3(3): 1-96. doi: 13477.

28.

Biering-Sorensen

, Bendix

. Working off low back pain. Lancet. 2000 Jun 3; 355(9219): 1929-30. doi: 10.08010.1016/s0140-6736(00)02321-7.