Effectiveness of Mat Pilates or Equipment-Based Pilates Exercises in Patients With Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial

Background. The Pilates method has been widely used to treat patients with chronic low back pain. Pilates exercises can be performed in 2 ways: by using specific equipment or without it (also known as mat Plates). There are no studies, however, that have compared the effectiveness of mat Pilates with that of equipment-based Pilates. Objective. The aim of this study was to compare the effectiveness of mat Pilates and equipment-based Pilates in patients with chronic nonspecific low back pain. Design. A 2-arm randomized controlled trial with a blinded assessor was conducted. Setting. The study was conducted at a private physical therapy clinic in Brazil. Patients. Eighty-six patients with chronic nonspecific low back pain participated. Intervention. The patients were randomly allocated to 1 of 2 groups: a mat Pilates group (n = 43) and an equipment-based Pilates group (n = 43). The participants in both groups attended 12 Pilates sessions over a period of 6 weeks. Measurements. The primary outcomes were pain intensity and disability. The secondary outcomes were global perceived effect, patient's specific disability, and kinesiophobia. A blinded assessor evaluated the outcomes at baseline and 6 weeks and 6 months after randomization. Results. After 6 months, there was a statistically significant difference for disability (mean difference=3.0 points, 95% confidence interval [CI] = 0.6 to 5.4), specific disability (mean difference = -1.1 points, 95% CI = -2.0 to 0.1), and kinesiophobia (mean difference = 4.9 points, 95% CI = 1.6 to 8.2) in favor of equipment-based Pilates. No differences were found for the remaining outcomes. Conclusions. Equipment-based Pilates was superior to mat Pilates in the 6-month follow-up for the outcomes of disability and kinesiophobia. These benefits were not observed for pain intensity and global perceived effect in patients with chronic nonspecific low back pain.