The effects of supervised versus non-supervised Pilates mat exercises on non-specific chronic low back pain

Includes bibliographical references.Chronic non-specific low back pain (NSCLBP) is a common low back condition affecting a large proportion of the population suffering from low back pain (LBP). Exercise therapy is recommended as the first line treatment for NSCLBP but no type of exercise has been found to be more effective than another in improving pain and function outcomes. Low back pain trials have compared heterogeneous exercise types to date. Pilates mat classes are a popular form of exercise taught by therapists. The aim of this study was to compare outcomes of an eight-week supervised Pilates mat programme with those of a similar non-supervised home exercise programme with regard to pain intensity, function, medication use, health related quality of life, adherence, and participant satisfaction with such exercise programmes in treating NSCLBP. A randomised control trial was done to compare the effect of a supervised Pilates at programme with a non-supervised home programme of similar exercises. The programmes were comparable for both the type of exercise and the participation duration of programmes (per week) and included the same fourteen exercises with gradual progressions. The Pilates classes were held twice a week for a 45 minute class and the home programme required doing the exercises for 30 minutes, three times a week, for an eight-week period. All participants were women who had been suffering from NSCLBP for longer than six weeks and who had volunteered to participate, or were referred by a therapist. The participants were screened and randomly allocated to the respective groups: a supervised exercise group (SEG) and a home exercise group (HEG). All the individual sessions and the supervised classes were held at a multi-disciplinary centre, which housed both a private physiotherapy practice and a Pilates studio. Outcome measures were measured at baseline, four weeks, eight weeks and 12 weeks by an assessor who was blinded to group allocation. The primary outcomes of pain and function were measured using the Pain Intensity Numeric Rating Scale (PINRS) and the Roland Morris Disability Questionnaire (RMDQ) respectively. Change in medication was measured as a percentage change in medication; mobility of the pelvis and lumbar spine was measured using the fingertip-to-floor (FTF) test; health-related quality of life was assessed using the EQ-5D questionnaire, and the confidence to perform certain tasks was measured using the pain self-efficacy questionnaire (PSEQ). Additionally, patient satisfaction was measured at eight weeks using the Better Backs Patient Satisfaction Questionnaire, and adherence was measured by calculating a percentage of the maximum adherence