Effectiveness of Pilates Exercise in Chronic Nonspecific Low Back Pain: A Systematic Synthesis of Randomized Controlled Trial Results Comparing Dose, Form, and Comparative Therapies
| Authors | |
|---|---|
| Year of publication | 2025 |
| Type | Appeared in Conference without Proceedings |
| Citation | |
| Description | The aim of this systematic review was to evaluate the effectiveness, optimal dosage, and cost-utility of Pilates exercises for adults suffering from chronic non-specific low back pain (CNLBP), defined as pain lasting 12 weeks or longer. The review focused exclusively on randomized controlled trials (RCTs) identified through searches in databases covering the publication period from 2014 to 2024. Key outcomes analyzed included pain intensity, functional disability, and health-related quality of life (QoL), alongside psychological factors such as kinesiophobia (fear of movement) and pain catastrophizing. The synthesis of data revealed that adding Pilates to minimal intervention provides small to moderate benefits for reducing pain and disability. Regarding the frequency of treatment, a dose of twice a week (12 sessions) was generally found to be more effective for clinical results (pain and disability) than once a week. From an economic perspective, attending three times a week was the preferred option in terms of cost-utility for gaining Quality-Adjusted Life-Years (QALYs). When comparing specific modalities, equipment-based Pilates was superior to Mat Pilates for improving disability and kinesiophobia in the 6-month follow-up. However, programs focusing on either low back mobility or stability were found to be equally effective in improving pain, disability, and movement functionality. When directly compared with home-based exercises, Pilates resulted in significantly lower pain and disability immediately after the intervention. However, these differences were generally not considered clinically relevant for pain and disability, though the improvement observed in quality of life was statistically significant and did reach a clinically relevant difference. Furthermore, adding Photobiomodulation Therapy (PBMT) to a Mat Pilates program did not provide any additional effect for reducing peak pain intensity, perceived disability, or pain catastrophizing, nor did it improve postural balance. In conclusion, Pilates therapy is an effective option for treating CNLBP, with a frequency of twice a week generally providing the best balance of clinical results, and therapeutic recommendations should ultimately be guided by the preference of the practitioner or the patient. |