AB0128 EVALUATION OF THE METHODOLOGICAL QUALITY OF RANDOMIZED CONTROLLED TRIALS INVESTIGATING THE PILATES METHOD FOR FIBROMYALGIA
Authors: K. O. Aksel, B. Unver
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Fibromyalgia (FM) is characterized by continuous, extensive pain, sleep-related issues, including poor sleep quality, physical exhaustion, and cognitive dysfunction. The nature, causative factors, and treatment approaches for FM are subjects of ongoing debate, and there's even skepticism regarding its existence. In 1990, the American College of Rheumatology (ACR) initially set forth classification criteria which encompassed multiple tender points and ongoing extensive pain. The 2010 revision of the ACR's diagnostic criteria, however, eliminated the need for identifying tender points, accepted less intense pain, and placed greater emphasis on self-reported physical and cognitive symptoms by patients. Current guidelines based on evidence underscore the necessity of holistic treatment approaches, combining non-pharmacological and targeted drug therapies, tailored to individual symptoms like pain, exhaustion, sleep issues, and emotional disturbances. A variety of exercise regimes are recommended for FM management. Pilates is an exercise system that merges mental and physical wellness, emphasizing core stability, muscular strength, and flexibility. It focuses on muscle control, correct posture, and efficient breathing techniques. While numerous Pilates exercises are conducted on the floor, the method also utilizes specialized apparatus to offer a more varied exercise routine. Pilates is increasingly being integrated into rehabilitation programs due to its noted beneficial impact on musculoskeletal disorders and other health-related issues such as FM. <h3>Objectives:</h3> To assess the methodological quality of randomized controlled trials (RCTs) focusing on Pilates-based rehabilitation for FM was conducted. This evaluation employed the Physiotherapy Evidence Database (PEDro) scale in conjunction with the eight defined methodological criteria outlined in the Consolidated Standards of Reporting Trials (CONSORT) 2010 guidelines. <h3>Methods:</h3> The study entailed a comprehensive search of three electronic databases (Pubmed, Google Scholar and Web of Science) up until January 9, 2024. Utilizing a dual-reviewer system, the articles were appraised based on two key inclusion criteria: firstly, the incorporation of a study cohort participating in a Pilates-based rehabilitation program for FM, and secondly, the existence of a comparative group receiving either an alternate therapeutic intervention or no treatment at all. The methodological rigor of the eight selected studies was meticulously assessed using the PEDro scale, in conjunction with eight elements derived from the CONSORT 2010 guidelines. <h3>Results:</h3> The mean PEDro scale and CONSORT checklist score was 5.9 (±1.4) and 5.1 (±1.4). Blinding of subjects (0; 0.0%), and therapists (0; 0.0%) were not reported in any study, random allocation (8; 100.0 %) baseline comparability (8; 100.0%), between-group comparisons (8; 100.0 %) and point estimates and variability (8; 100.0%) PEDro scale items were reported in all studies. Locations where the data were collected (0; 0.0%) and how the sample size was determined (2; 25.0%) were not reported in most studies. Number of primary outcomes (8; 100.0%), number of randomized participants (8; 100.0%) CONSORT checklist items were reported in most studies. <h3>Conclusion:</h3> The predominant portion of RCTs that evaluate the Pilates method in FM, as examined in our study, demonstrated a moderate level of methodological quality. RCTs are highly esteemed within the hierarchy of evidence because of their structure, which inherently reduces bias and thereby offers a more robust level of evidence in research findings. The future quality of published studies could be significantly improved if both journals and researchers consistently adhere to the guidelines of the PEDro scale and the CONSORT checklists in their reporting. This adherence would not only enhance the methodological rigor of the studies but also ensure a more reliable and valid representation of research outcomes, ultimately leading to better-informed clinical practices and decisions. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>