Abstract
Introduction The Pilates® method incorporates a number of the guidelines recommended for therapeutic exercises considered to be effective in the treatment of chronic lower back pain, such as the contraction of the transversus abdominis and multifidus muscles, associated with breathing, while taking into account the individual characteristics of patients. Objective To assess the effects of the Pilates® method on the treatment of lower back pain. Method This systematic review includes papers published from 2000 to 2010 in the BIREME, LILACS, MEDLINE and SciELO databases. The keywords used were spinal stabilization, Pilates®, and back pain and their equivalents in Portuguese. Results Imbalance among the trunk’s agonist-antagonist muscles and the ineffective activation of the transversus abdominis are risk factors for the onset of lower back pain that can be mitigated with the practice of Pilates®-based exercises. Conclusion The method has clinical effects similar to those obtained with traditional stabilization exercises and Back School exercises in the treatment of chronic lower back pain and are considered more satisfactory than conservative treatments.
Highlights
The Pilates® method incorporates a number of the guidelines recommended for therapeutic exercises considered to be effective in the treatment of chronic lower back pain, such as the contraction of the transversus abdominis and multifidus muscles, associated with breathing, while taking into account the individual characteristics of patients
Electromyographic studies show that individuals with chronic lower back pain experience little activation of the transversus abdominis and that after an episode of acute lower back pain, the multifidus are inhibited and weakened, unable to return to their physiological standards without therapeutic interventions [21, 22, 12]
Sensorial experiences of the proprioceptive system go to the Central Nervous System (CNS) that promotes muscle contraction responses to control stability
Summary
The Pilates® method incorporates a number of the guidelines recommended for therapeutic exercises considered to be effective in the treatment of chronic lower back pain, such as the contraction of the transversus abdominis and multifidus muscles, associated with breathing, while taking into account the individual characteristics of patients. As for any pain condition, back pain can be defined as pain with or without stiffness, located in the lower regions of the back between the last coastal arc and the gluteal fold [4] It is classified as acute pain when symptoms last less than 12 weeks, chronic when they last more than 12 weeks, and specific when there is a well-defined etiology, or nonspecific or mechanical/ postural, which indicates musculoskeletal disorders [5]. Lower back pain is triggered by various etiological factors, such as: inflammatory, degenerative or neoplastic disorders; congenital malformations; muscle weakness; rheumatic predisposition; and signs of degeneration in the spine or intervertebral discs [6]
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