Efficacy and Influence of Pilates Based Physical Therapy Exercises for Low Back Pain

Study Overview
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Brief Summary
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An assessment of the effectiveness of Pilates based physical therapy exercises for patients with low back pain (LBP) and its influence on spinal movement and patient reported functional disability.

Detailed Description
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Low back pain (LBP) is becoming a major public health problem associated with enormous economic burden on the modern society. Despite conservative interventions such as Pilates back exercises are routinely prescribed in clinical practice, most studies to date have only assessed its efficacy based on subjective patient reported outcomes with limited objective data available to clearly demonstrate the benefit of Pilates exercise on spinal alignment and mobility. Furthermore, patient adherence has been well identified to be an obstacle for effective home exercise program and the most cost-effective strategy to improve patient compliance remain unknown. Current study therefore aims to fulfil this gap in our knowledge by assessing the change of spinal alignment and kinematics utilizing dynamic radiographs performed pre- and post- a 6-week Pilates based physical therapy exercise program compare to a more generic hospital based back care exercise program. Furthermore, the effectiveness of conducing weekly phone reminders for 6 weeks on improving short (6-month) and long (12-month) term functional outcomes and patient compliance will also be assessed.

Official Title
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Efficacy and Influence of Pilates Based Physical Therapy Exercises on Spinal Radiographic Kinematics and Functional Status in Patients With Low Back Pain

Conditions
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Mechanical Low Back Pain

Intervention / Treatment
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* Other: Pilates Exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. Predominant LBP for a minimum of three consecutive months as diagnosed by a rehabilitation physician Exclusion Criteria: . Radicular neurological signs, . Trauma induced LBP, . Diagnosis of spinal deformity such as scoliosis or spondylolisthesis, . Spinal infection or tumor, . Rheumatologic conditions, . Previous spinal surgery, . History of hip or pelvic disorder that required treatment, . Contradiction for radiographic exposure such as pregnancy.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Controls<br>Age-matched Healthy Controls | |
| General Exercises<br>Low Back Pain Participants Receiving General Exercises | |
| Pilates Exercises<br>Low Back Pain Participants Receiving Pilates Exercises | Other: Pilates Exercises<br>* Pilates method based stability exercise intervention<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Radiographic Spino-pelvic Alignment Parameters | Thoroaco-lumbo-pelvic dynamic radiographs taken for both maximum flexion and extension will be analysed to determine parameters such as 1. Pelvic incidence angle, 2. Pelvic tilt angle, 3. Sacral slope angle, 4. Lumbosacral angle, 5. Lumbar lordosis angle and 6. | 12-month | 
| Radiographic Lumbar Spine Segmental and Global Range of Motion | Thoroaco-lumbo-pelvic dynamic radiographs taken for both maximum flexion and extension will be analysed to determine the lumbar spine segmental and its contribution to the global range of motion | 12-month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Modified Oswestry Disability Index | Questionnaires to determine patients' self-reported pain and functional disabilities | 12-month | 
| Roland Morris Disability Questionnaire | Questionnaires to determine patients' self-reported pain and functional disabilities | 12-month | 
| Short Form-36 | Questionnaires to determine patients' self-reported pain and functional disabilities | 12-month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Spinal alignment, Kinematics, Pilates, Physical Therapy