Efficacy of Pilates on Pain, Functional Disorders and Quality of Life in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis

Abstract

Background: Chronic low back pain (CLBP) is a common health problem. Pilates is a unique exercise therapy. This meta-analysis aims to evaluate the efficacy of Pilates on pain, functional disorders, and quality of life in patients with chronic low back pain (CLBP). Methods: PubMed, Web of Science, CNKI, VIP, Wanfang Data, CBM, EBSCO, and Embase were searched. Randomized controlled trials of Pilates in the treatment of CLBP were collected based on the inclusion and exclusion criteria. The meta-analysis was performed using RevMan 5.4 and Stata 12.2. Results: 19 randomized controlled trials with a total of 1108 patients were included. Compared with the controls, the results showed the following values: Pain Scale [standard mean difference; SMD = −1.31, 95%CI (−1.80, −0.83), p < 0.00001], Oswestry Disability Index (ODI) [mean difference; MD = −4.35, 95%CI (−5.77, −2.94), p < 0.00001], Roland–Morris Disability Questionnaire (RMDQ) [MD = −2.26, 95%CI (-4.45, −0.08), p = 0.04], 36-item Short-Form (SF-36) (Physical Function (PF) [MD = 5.09, 95%CI (0.20, 9.99), p = 0.04], Role Physical (RP) [MD = 5.02, 95%CI (−1.03, 11.06), p = 0.10], Bodily Pain (BP) [MD = 8.79, 95%CI (−1.57, 19.16), p = 0.10], General Health (GH) [MD = 8.45, 95%CI (−5.61, 22.51), p = 0.24], Vitality (VT) [MD = 8.20, 95%CI(−2.30, 18.71), p = 0.13], Social Functioning (SF) [MD = −1.11, 95%CI (−7.70, 5.48), p = 0.74], Role Emotional (RE) [MD = 0.86, 95%CI (−5.53, 7.25), p = 0.79], Mental Health (MH) [MD = 11.04, 95%CI (−12.51, 34.59), p = 0.36]), Quebec Back in Disability Scale (QBPDS) [MD = −5.51, 95%CI (−23.84, 12.81), p = 0.56], and the sit-and-reach test [MD = 1.81, 95%CI (−0.25, 3.88), p = 0.09]. Conclusions: This meta-analysis reveals that Pilates may have positive efficacy for pain relief and the improvement of functional disorders in CLBP patients, but the improvement in quality of life seems to be less obvious. Registration: PROSPERO CRD42022348173.

Unlocking the Potential: Increasing Muscle Strength in Lower Limbs of Youth Soccer Players over Five Weeks through Mat Pilates Training—A Pilot Study

“…In essence, the mat Pilates method does not primarily aim to induce hypertrophy, a characteristic observed in other methods utilizing load to recruit and increase muscle fiber volume [ 47 ]. The method is characterized as a complement to hypertrophy’s role in augmenting muscle mass, with mat Pilates exercises emphasizing the quality of movement over the quantity of repetitions performed [ 22 , 48 ]. Therefore, as anticipated, the intervention did not exert a substantial influence in instigating new muscle trophism.…”

“…This process facilitates the activation of muscle satellite cells, promoting protein synthesis through molecular pathways, ultimately resulting in an increase in muscle volume, commonly referred to as hypertrophy [ 37 ]. Notably, exercises within the mat Pilates method involve motor activity, indicating the presence of mechanical stimulation at the myotendinous junction [ 22 , 49 ].…”

“…The synchronization of breathing with movements is a distinctive feature of Pilates [ 12 , 19 , 20 , 21 ]. This component contributes not only to biomechanical efficacy but also to trunk stabilization, enhancing movement efficiency and promoting body awareness [ 10 , 22 , 23 , 24 , 25 ]. Such an approach contributes to the proportional development of muscle strength and improved body awareness, positively affecting proprioception and postural control.…”

Isometric vs Isotonic Core Stabilization Exercises to Improve Pain and Disability in Patients with Non-specific Chronic Low Back Pain: A Randomized Controlled Trial

“…However, pharmacotherapy may lead to side effects such as constipation, nausea, and fatigue, and prolonged use of these drugs may result in a resurgence of pain upon discontinuation ( 7 ). On the other hand, physiotherapy without the incorporation of therapeutic exercise is not suitable for alleviating long-term pain and enhancing performance because it is relatively expensive and lacks active muscle contraction ( 8 ). Therefore, exercise therapy emerges as a more effective and affordable option for therapists and specialists in treating patients with NSCLBP, given its minimal harm and ease of implementation ( 5 ).…”

The Effects of an 8-Week Dynamic Neuromuscular Stabilization Exercise on Pain, Functional Disability, and Quality of Life in Individuals with Non-specific Chronic Low Back Pain: A Two-Month Follow-up Study

“…They reported that Pilates may be bene cial in relieving pain and improving functional impairments in individuals with CLBP. However, its impact on improving quality of life may be less pronounced (10). In another study aiming to investigate the short-term and midterm effects of Pain Neuroscience Education (PNE) combined with Manual Therapy (MT) and Home Exercise Program (HEP) on pain intensity, lumbar functional performance, disability, and movement fear in patients with CLBP, a multidimensional treatment program combining PNE, MT, and HEP was found to be more effective in improving lumbar function and reducing pain, disability, and movement fear in the short-term (4 weeks) and midterm (12 weeks) (11).…”