Comparison Between Pilates And Home-exercises On Health-related Outcomes In Individuals With Chronic Low Back Pain

Abstract

Chronic non-specific low back pain (CNLBP) is a major cause of disability and absenteeism. Pilates is commonly adopted in the treatment of CNLBP, though the evidence is controversial. Low-cost interventions such as home-exercises are prominent and considered effective to improve disability. PURPOSE: To compare the efficacy of Pilates and home-exercises on disability and utility (health states). METHOD: Randomized controlled trial with blind assessor. Thirty-one participants with CNLBP for at least 12 weeks were randomly assigned to the Pilates (PT; n=16) or Home-Exercise (HE; n=15) groups. Allocation was concealed. The intervention lasted 6 weeks (two times/week), and 4-months follow-up. The PT was composed by fifty-minutes sessions (seven to ten exercises; two sets of 8 to 12 repetitions). The HE was composed by prescribed postural, muscle stretching and strengthening exercises (booklet, instructions to perform 2 times/week, weekly monitored by text message). Disability was measured by the Quebec Back Pain Questionnaire. The score ranges from no disability (0) to worst disability (100). Health states were measured by the EQ-5D-3L (mobility, self-care, usual activities, pain/discomfort, anxiety/depression; final utility score ranging from 0 to 1). A linear mixed-model was used to analyze the global effect over time and separate effects at baseline, post-intervention and follow-up. Significance was set at 5%. RESULTS: No significant differences were found between PT vs HE (global effects). Both groups showed a significant improvement only for disability (post-intervention and follow-up, compared to baseline). CONCLUSION: Both PT and HE were effective and improved the disability of individuals with CNLBP. However, the utility was not influenced by the interventions.Table: Effects of PT (Pilates) and HE (Home Exercises)