The effectivity of a Pilates protocol in the treatment of chronic nonspecific low-back pain: a randomized clinical trial

Low back pain is a major health and socioeconomic problem. Exercises and patient awareness are among the possible positive strategies for treating nonspecific chronic low back pain. Objective: The objective of this study was to determine the effectiveness of the Pilates Method and the "Back School" program in the treatment of nonspecific chronic low back pain. Method: A randomized controlled trial with blinded assessors. Eighty-four individuals with chronic nonspecific low back pain.Interventions: Participants were randomly allocated into two groups: Pilates Group (n= 43) or Control Group - "Back School" (n= 41). The primary outcomes were: pain (Numeric Rating Scale), quality of life (SF-36), and disability (Roland-Morris Disability Questionnaire - RMDQ). The secondary outcomes were: Flexibility (Fingertip-to-Floor Test ­ FTF) and sleep quality (Pittsburgh Sleep Quality Index - PSQI). Results: The Pilates Group was superior to the Control Group (p<0.05) in outcomes of pain intensity, disability, flexibility, and in five domains of SF-36 (physical functioning, role limitations due to physical health, pain, vitality, and general health). There was no significant difference between groups for sleep quality. Conclusion: The Pilates protocol provided significant improvements and can be considered an option for treating nonspecific chronic low back pain. The Pilates Group was superior to the "Back School" program for pain reduction, improved functional capacity, flexibility, and five quality of life domains. Due to the considerable low adhesion to both interventions, alternatives to improve adherence should be proposed in future studies.