Please select the eligibility criteria that correspond to the clinical trial below.
Title: Cost Effectiveness and Effectiveness of the Addition of Different Weekly Frequency of Modified Pilates Method Exercises to a Minimal Intervention in the Treatment of Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial
Brief Summary: Low back pain is a major cause of disability and absenteeism and the supervised exercise is a recommended treatment by the guidelines and has been cost-effective. Currently, the Pilates method has shown to be effective in improving pain and disability in patients with chronic low back pain (CLBP). However, there is still no evidence about the ideal number of sessions for the treatment and the interval between sessions to achieve better efficacy of this method for these patients. Thus, the aim of this study is to investigate the effectiveness of the Pilates method with different weekly frequency of sessions in the treatment of patients with nonspecific CLBP. Investigators will assess 296 patients of both genders, with nonspecific CLBP lasting more than three months and aged between 18 and 80 years. Participants will be randomly divided into four groups (n = 74 patients per group): Control Group will receive an educational booklet and no additional exercise, Pilates 1 Group will receive a program of exercises based on Pilates method once a week for six weeks, Pilates 2 Group will receive the same program of exercises twice a week for six weeks and Pilates 3 Group will receive the same program of exercises three times a week for six weeks. The outcomes overall disability (Roland Morris Disability questionnaire), specific disability (Patient-Specific Functional scale), kinesiophobia (Tampa scale for kinesiophobia), pain intensity (Pain Numerical Rating scale) and global perceived effect (Global Perceived Effect scale) will be assessed by a blinded assessor before, six weeks, six and 12 months after randomization. Investigators expect that the largest number of weekly sessions of Pilates method may influence the results in all analyzes (short, medium and long term), since there is a relationship between frequency of exercises and effect size of the treatment.


Options:
A: Inclusion Criteria: patients seeking care for chronic non-specific low back pain (defined as pain or discomfort between the costal margins and the inferior gluteal folds, with or without referred symptoms in the lower limbs, for at least 3 months), with a pain intensity of at least 3 points measured by a 0-10 points pain numerical rating scale, aged between 18 and 80 years and able to read in Portuguese.

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Exclusion Criteria: patients will be excluded if they have any contraindication to physical exercise or ultrasound or short wave therapy, evidence of nerve root compromise (i.e one or more of motor, reflex or sensation deficit), serious spinal pathology (such as fracture, tumor, inflammatory and infectious diseases), serious cardiovascular and metabolic diseases, previous back surgery and pregnancy.

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B: Inclusion Criteria:

* Veterans receiving care at the VA Ann Arbor Healthcare System
* Have back pain that has persisted for more than 3 months
* Have a sedentary lifestyle (less than 150 minutes of physical activity per week)
* Have access to a computer (with Windows XP or Vista) on at least a weekly basis with an available USB port and Internet access
* Have a working e-mail address
* Are competent to provide written informed consent
* Are able to communicate in English
* Are not institutionalized
* Can identify a health care provider who can provide medical clearance.

Exclusion Criteria:

* Currently pregnant
* Cannot walk at least one block
* Cannot obtain written clearance to start a walking program from a treating healthcare provider
C: Inclusion Criteria:

* Patients with chronic nonspecific low back pain longer 12 weeks

Exclusion Criteria:

* Contra indications to physical exercise
* Serious spinal pathologies (e. g. tumors, fractures and inflammatory diseases)
* Nerve root compromise
* Pregnancy
* Previous surgery on spine
* Pilates treatment for low back pain in the last three months
D: Inclusion Criteria:

* diagnosed with nonspecific low back pain by the primary care physician
* more than or equal to 18 and less than or equal to 65 years of age

Exclusion Criteria:

* not signing the informed consent form
* pregnancy
* diagnosis of inflammatory rheumatologic disease, cancer, or fibromyalgia
* signs for suspicion of fibromyalgia
* having red flags for systemic disease
* presenting criteria for urgent referral to surgery
* presenting criteria for non-urgent referral to surgery
* inability to read, understand, or follow verbal orders (dementia,blindness, doesn´t know how to read)
* bedridden
* having received physiotherapy in last 12 months

Answer: C