The effects of selective Pilates versus extension-based exercises on rehabilitation of low back pain

Abstract

Introduction: Chronic non-specific low back pain (LBP) may lead to functional impairment and physical disability. The aim of this study was to compare the effects of selective Pilates (SP) and extension-based (EB) exercises on pain, lumbar spine curvature, lumbar forward flexion range of motion (ROM), and physical disability in such individuals.

Materials and methods: In this randomized clinical trial, Forty-seven patients with chronic non-specific LBP (Mean of age: 39.7 years) were randomly allocated into either SP (N = 16), EB (N = 15), or control (N = 16) groups. The measurements included pain intensity, physical disability, lumbar forward bending ROM, and lumbar spine curvature at the baseline, after receiving the 6-week interventions, and also following one month of cessation of the exercises The analysis of co-variance (ANCOVA) and Post-hoc Bonferroni tests were administered to compare the three groups after the interventions and one month later (P < 0.05).

Results: More significant improvement was observed in SP group compared to the subjects receiving EB exercises in terms of pain, ROM, and physical disability (P < 0.001), however, there was no significant difference between the two experimental groups for lumbar curvature (P > 0.05). Furthermore; in follow-up, the patients in SP group significantly achieved a higher level of pain intensity improvement and lumbar flexion ROM than the EB exercises (P < 0.001).

Conclusions: It is estimated that core muscles activation and improving lumbopelvic rhythm in SP training may play a role in decreasing pain and physical disability in chronic LBP patients. Further high-quality studies are required to investigate the details of this mechanism.

Keywords: Exercise therapy; Low back pain; Pilates; Range of motion.