Abstract
BackgroundChronic low back pain is an expensive and difficult condition to treat. One of the interventions widely used by physiotherapists in the treatment of chronic non-specific low back pain is exercise therapy based upon the Pilates principles. Pilates exercises can be performed with or without specific equipment. These two types of Pilates exercises have never been compared on a high-quality randomised controlled trial.Methods/designThis randomised controlled trial with a blinded assessor will evaluate eighty six patients of both genders with chronic low back pain, aged between 18 and 60 years, from one Brazilian private physiotherapy clinic. The patients will be randomly allocated into two groups: Mat Group will perform the exercises on the ground while the Equipment-based Group will perform the Pilates method exercises on the following equipment: Cadillac, Reformer, Ladder Barrel, and Step Chair. The general and specific disability of the patient, kinesiophobia, pain intensity and global perceived effect will be evaluated by a blinded assessor before randomisation and at six weeks and six months after randomisation. In addition, the expectation of the participants and their confidence with the treatment will be evaluated before randomisation and after the first treatment session, respectively.DiscussionThis will be the first study aiming to compare the effectiveness of Mat and Equipment-based Pilates exercises in patients with chronic non-specific low back pain. The results may help health-care professionals in clinical decision-making and could potentially reduce the treatment costs of this condition.Trial registrationBrazilian Registry of Clinical Trials RBR-7tyg5j
Highlights
Chronic low back pain is an expensive and difficult condition to treat
This will be the first study aiming to compare the effectiveness of Mat and Equipment-based Pilates exercises in patients with chronic non-specific low back pain
Discussion the use of Pilates exercises in the treatment of chronic low back pain has steadily increased, the current evidence of its effectiveness is still supported by a low number of studies with suboptimal methodological quality [5,17,18,21,34,35,36], being only one study achieving a high score on the PEDro scale [18], this reinforces the need for new high quality studies [13,14,15]
Summary
The use of Pilates exercises in the treatment of chronic low back pain has steadily increased, the current evidence of its effectiveness is still supported by a low number of studies with suboptimal methodological quality [5,17,18,21,34,35,36], being only one study achieving a high score on the PEDro scale [18], this reinforces the need for new high quality studies [13,14,15]. Our study can provide a better understanding about possible differences in the treatment effectiveness of these two Pilates approaches in patients with chronic low back pain. The results of this study can help physiotherapists on their clinical decision-making as well could help to guide possible investments in physiotherapy clinics as the Equipment-based Pilates is more expensive than the Mat Pilates. To our knowledge, this is the largest randomised controlled trial that used Pilates interventions in patients with chronic low back pain and the first to compared Mat and Equipment-based Pilates in this population. Author’s contributions Authors MALJ, LOPC, FFF, ACTM, NTBO and CMNC have all contributed to conception and design of this trial, have been involved in drafting the manuscript and revised it critically and have given final approval of this version to be published
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