Derivation of a Preliminary Clinical Prediction Rule for Identifying a Subgroup of Patients With Low Back Pain Likely to Benefit From Pilates-Based Exercise

Stolze, Lise R.; Allison, Stephen; Childs, John D.

doi:10.2519/jospt.2012.3826

Cited by 32 publications

(28 citation statements)

References 68 publications

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“…Future RCTs should also investigate the long term efficacy of Pilates exercise to other treatments, such as massage, and confirm if there is any difference in effectiveness between Pilates exercise and various forms of exercise, such as aerobic exercise versus lumbar stabilisation [15]. Research into whether some people with CLBP may benefit from Pilates exercise more than others may also assist in clinical decision-making on whether Pilates exercise is suitable for individual clients [63], [64].…”

Section: Resultsmentioning

confidence: 99%

The Effectiveness of Pilates Exercise in People with Chronic Low Back Pain: A Systematic Review

et al. 2014

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ObjectiveTo evaluate the effectiveness of Pilates exercise in people with chronic low back pain (CLBP) through a systematic review of randomised controlled trials (RCTs).Data SourcesA search for RCTs was undertaken using Medical Search Terms and synonyms for “Pilates” and “low back pain” within the maximal date range of 10 databases. Databases included the Cumulative Index to Nursing and Allied Health Literature; Cochrane Library; Medline; Physiotherapy Evidence Database; ProQuest: Health and Medical Complete, Nursing and Allied Health Source, Dissertation and Theses; Scopus; Sport Discus; Web of Science.Study SelectionTwo independent reviewers were involved in the selection of evidence. To be included, relevant RCTs needed to be published in the English language. From 152 studies, 14 RCTs were included.Data ExtractionTwo independent reviewers appraised the methodological quality of RCTs using the McMaster Critical Review Form for Quantitative Studies. The author(s), year of publication, and details regarding participants, Pilates exercise, comparison treatments, and outcome measures, and findings, were then extracted.Data SynthesisThe methodological quality of RCTs ranged from “poor” to “excellent”. A meta-analysis of RCTs was not undertaken due to the heterogeneity of RCTs. Pilates exercise provided statistically significant improvements in pain and functional ability compared to usual care and physical activity between 4 and 15 weeks, but not at 24 weeks. There were no consistent statistically significant differences in improvements in pain and functional ability with Pilates exercise, massage therapy, or other forms of exercise at any time period.ConclusionsPilates exercise offers greater improvements in pain and functional ability compared to usual care and physical activity in the short term. Pilates exercise offers equivalent improvements to massage therapy and other forms of exercise. Future research should explore optimal Pilates exercise designs, and whether some people with CLBP may benefit from Pilates exercise more than others.

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Section: Resultsmentioning

confidence: 99%

The Effectiveness of Pilates Exercise in People with Chronic Low Back Pain: A Systematic Review

et al. 2014

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“…Subgrouping of patients who share similar clinical characteristics has been recommended to achieve improved patient outcomes (Long et al, 2004;McKenzie and May, 2003;Stolze et al, 2012). A number of movement-based classification systems have been proposed within the past two decades for subgrouping patients (Dettori et al, 1995;Karayannis et al, 2012).…”

Section: Introductionmentioning

confidence: 98%

Interrater reliability of a Pilates movement-based classification system

Tulloch

Hendrick

2015

Journal of Bodywork and Movement Therapies

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“…Previous CPR developed for rehabilitation programs in LBP populations [ 15 , 22 , 23 ] included 5 predictors or fewer in their final model. According to the formula suggested by Green [ 24 ] for regression analysis (50 + [8 x number of prognostic factors]), and considering the expected 5 variables in the final model, as well as an estimated 20% dropout rate, the ideal sample size was 108.…”

Section: Methodsmentioning

confidence: 99%

Prognostic factors of a favorable outcome following a supervised exercise program for soldiers with sub-acute and chronic low back pain

Perron

Gendron

Langevin

et al. 2018

BMC Musculoskelet Disord

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BackgroundLow back pain (LBP) encompasses heterogeneous patients unlikely to respond to a unique treatment. Identifying sub-groups of LBP may help to improve treatment outcomes. This is a hypothesis-setting study designed to create a clinical prediction rule (CPR) that will predict favorable outcomes in soldiers with sub-acute and chronic LBP participating in a multi-station exercise program.MethodsMilitary members with LBP participated in a supervised program comprising 7 stations each consisting of exercises of increasing difficulty. Demographic, impairment and disability data were collected at baseline. The modified Oswestry Disability Index (ODI) was administered at baseline and following the 6-week program. An improvement of 50% in the initial ODI score was considered the reference standard to determine a favorable outcome. Univariate associations with favorable outcome were tested using chi-square or paired t-tests. Variables that showed between-group (favorable/unfavorable) differences were entered into a logistic regression after determining the sampling adequacy. Finally, continuous variables were dichotomized and the sensitivity, specificity and positive and negative likelihood ratios were determined for the model and for each variable.ResultsA sample of 85 participants was included in analyses. Five variables contributed to prediction of a favorable outcome: no pain in lying down (p = 0.017), no use of antidepressants (p = 0.061), FABQ work score < 22.5 (p = 0.061), fewer than 5 physiotherapy sessions before entering the program (p = 0.144) and less than 6 months’ work restriction (p = 0.161). This model yielded a sensitivity of 0.78, specificity of 0.80, LR+ of 3.88, and LR- of 0.28. A 77.5% probability of favorable outcome can be predicted by the presence of more than three of the five variables, while an 80% probability of unfavorable outcome can be expected if only three or fewer variables are present.ConclusionThe use of prognostic factors may guide clinicians in identifying soldiers with LBP most likely to have a favorable outcome. Further validation studies are needed to determine if the variables identified in our study are treatment effect modifiers that can predict success following participation in the multi-station exercise program.Trial registrationClinicalTrials.gov Identifier: NCT03464877 registered retrospectively on 14 March 2018.Electronic supplementary materialThe online version of this article (10.1186/s12891-018-2022-x) contains supplementary material, which is available to authorized users.

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Derivation of a Preliminary Clinical Prediction Rule for Identifying a Subgroup of Patients With Low Back Pain Likely to Benefit From Pilates-Based Exercise

Cited by 32 publications

References 68 publications

The Effectiveness of Pilates Exercise in People with Chronic Low Back Pain: A Systematic Review

The Effectiveness of Pilates Exercise in People with Chronic Low Back Pain: A Systematic Review

Interrater reliability of a Pilates movement-based classification system

Prognostic factors of a favorable outcome following a supervised exercise program for soldiers with sub-acute and chronic low back pain

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