Effectiveness of Mat Pilates Exercises in Individuals With Chronic Nonspecific Low Back Pain

Study Overview
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Brief Summary
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To analyze the effectiveness of mat Pilates compared to no intervention in individuals with chronic nonspecific low back pain.

Detailed Description
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There is evidence that exercises based on the Pilates method reduce pain in chronic nonspecific low back pain (CNLBP). However, is noticed the lack of studies that compare the effectiveness of mat Pilates to no intervention in the treatment of individual with CNLBP. Therefore, the main objective of the study is to analyze the effectiveness of mat Pilates compared to no intervention in patients with chronic nonspecific low back pain. It is a randomized controlled trial with two arms and double blinded (caregiver, assessor and outcome assessor), composed of 30 patients, aged between 18- 65 years (±22,47) of both sexes, diagnosed with chronic non-specific low back pain persisting for more than three months and pain intensity greater than 3 points in the Pain Numerical Rating Scale. The participants were randomly divided into two groups: Pilates Group (n = 15), intervention based on mat Pilates exercises, and Control Group (n =15) with no intervention. The mat Pilates group performed 16 sessions, twice a week in 60-minute duration each throughout eight weeks, whereas the control group participants kept usual cares until the end of the intervention. Both groups were evaluated before and after the program by a researcher who was unaware of the patients' allocation. The primary assessed outcomes: pain intensity (Pain numerical rating scale, and McGill questionnaire), quality of life (SF-36), and disability (Oswestry Low Back Pain Disability Questionnaire). In addition, the strength and muscle activation of transverse abdominal as secondary outcome assessed through the Stabilizer Pressure Biofeedback Unit test. As a result, the study infers that mat Pilates exercises have significantly improved all the evaluated outcomes. Thus, supporting clinical decisions for the treatment of chronic nonspecific low back pain.

Official Title
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Effectiveness of Mat Pilates Exercises in Individuals With Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial

Conditions
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Nonspecific Chronic Low Back Pain, Chronic Low Back Pain

Intervention / Treatment
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* Other: Pilates Group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Complaining of non-specific low back pain for more than three months without radicular symptoms for a period exceeding 12 months. Pain intensity equal to or more than 3 points evaluated by the Pain Numerical Rating Scale in the last seven days. Eligibility to practice physical activity responding to the Physical Activity Readiness Questionnaire - PAR-Q Exclusion Criteria: Degenerative or inflammatory pathologies of the spine, Acute crisis of pain in the shoulders, knees, ankles and spine Spinal tumors Recent surgery on the spine, lower and upper limbs Herniated disc Spondylolysis or spondylolisthesis Rheumatologic diseases Patients who are in labor dispute In treatment involving Pilates, physiotherapy or medication. Do not understand the writing and speaking Portuguese.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Pilates Group<br>The Pilates Group was composed by 15 participants evaluated before and after 16 sessions of intervention with mat Pilates exercises. | Other: Pilates Group<br>* The Pilates group program (PG) was composed of 16 sessions, 2x per week, 60 minute session each for 8 weeks. The intervention was based on 20 out of the 34 original mat exercises proposed by the Pilates method, classified into basic, intermediate or advanced levels divided into 4 cycles of 5 exercises each. The exercises were performed during two series of 10 repetitions respecting the patients skills.<br>|
| No Intervention: Control Group<br>The control group was composed by 15 participants that received no intervention | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Questionnaire on Pain Intensity | The pain intensity was evaluated using an 11-point pain numerical rating scale. | 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Questionnaire on Quality of Life | The quality of life assessment was measured through the SF-36 questionnaire. | 8 weeks | 
| Questionnaire on Disability | The index of disability was assessed trough the 2.0 version of the Oswestry questionnaire, which is a specific questionnaire to evaluate levels of disability in people who suffer with low back pain. | 8 weeks | 
| Questionnaire on Pain Describers | The pain describers were evaluated through the MCGill questionnaire. | 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mat Pilates, Disability, Chronic Nonspecific low back pain, Quality of life, transverse abdominal muscle