Research: Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis

I have been making my way through the research on Pilates that has been published since 2019. (This was when we provided over 400 studies to the Federal Government for inclusion in the Natural Therapies review.)

This review claims to be the largest network meta-analysis undertaken for low back pain, looking at 217 randomised controlled trials with 20,969 participants and 507 treatment groups. In my search, I could not find any subsequent meta-analysis on low back pain, so I believe this assertion still holds true.

The conclusion for this study states, ”Pilates, McKenzie therapy and functional restoration were more effective than other types of exercise treatment for reducing pain intensity and functional limitations”.

However, on delving deeper into this article, Pilates was overwhelmingly superior. Below are some direct quotes from the full article:

• “Pilates was more effective than all other exercise types, compatible with a clinically important difference in pain intensity.”
• “There was a small to moderate difference in pain outcomes comparing Pilates to McKenzie therapy, core strengthening exercises and functional restoration, with Pilates appearing more effective.”
• “Pilates exercises were found to be more effective for pain outcomes than other comparison treatments and other types of exercise treatment. In the primary models, McKenzie therapy and Pilates were found to (be) more effective for functional limitation outcomes than other comparisons and other types of exercise treatment. McKenzie therapy was no longer better than other comparisons when adjusted for dose and additional co-interventions.”

Interestingly, high doses of a particular treatment appeared to reduce pain and functional limitation outcomes more than low doses so if your clients with low back pain can come to Pilates more often, they will see greater improvement. But we already knew that, right?

Robyn Rix, PAA President

 

Reference:

Jill A Hayden, Jenna Ellis, Rachel Ogilvie, Samuel A Stewart, Matthew K Bagg, Sanja Stanojevic, TiêP Yamato, Bruno T Saragiotto, Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis, Journal of Physiotherapy, Volume 67, Issue 4, 2021,Pages 252-262, ISSN 1836-9553, https://doi.org/10.1016/j.jphys.2021.09.004.

Link: https://www.sciencedirect.com/science/article/pii/S1836955321001028

For more research on Pilates, go to the PAA managed Pilates Science website: pilatesscience.org