Pain Perception and Stabilometric Parameters in People With Chronic Low Back Pain After a Pilates Exercise Program: A Randomized Controlled Trial

Patti, Antonino MSc; Bianco, Antonino PhD; Paoli, Antonio MD; Messina, Giuseppe MD; Montalto, Maria Alessandra MD; Bellafiore, Marianna BSc; Battaglia, Giuseppe PhD; Iovane, Angelo MD; Palma, Antonio MD

Section Editor(s): Leischik., Roman

doi: 10.1097/MD.0000000000002414
Research Article: Clinical Trial/Experimental Study

Abstract: Various exercise interventions, such as Pilates exercises and traditional physical therapy methods, are employed to decrease low back pain (LBP). Nonspecific low back pain (NSLBP) is distinct from LBP, however, as the distribution of pain is restricted to the region between the costal margin and the inferior gluteal. The aim of our randomized controlled trial was to evaluate the effects of a program of Pilates exercises on pain perception and stabilometric parameters in patients with NSLBP.

Thirty-eight participants were randomly allocated, using a 1:1 scheme, to either the experimental group (EG) or control group (CG). The EG completed a 14-week program of Pilates exercises, performed thrice per week under the supervision of an exercise specialist, while the CG was managed with a social program only. Measures of posturography and Oswestry Disability Index (ODI) for pain perception were obtained at baseline (T0) and after the 14 weeks of intervention (T1).

Posturography measures improved for patients in the EG, with both eyes open and eyes closed (P < 0.05). There were no statistical differences in posturography in the CG. ODI decreased significantly in both groups over the 14 weeks of the study protocol: EG, T0, 13.7 ± 5.0 compared with T1, 6.5 ± 4.0 (P < 0.001); and CG, T0, 10.7 ± 7.8 compared with T1, 8.4 ± 7.8 (P < 0.01). A greater extent of reduction in pain was achieved in the EG.

The Pilates exercise program yielded improvements in pain and posturography outcomes. Our study also confirms the applicability of posturography in evaluating postural instability in patients with NSLBP. Due to our relatively small study group, future studies would be necessary to confirm our findings.

From the Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy (APatti, AB, GM, MAM, MB, GB, AI, APalma); Posturalab Research Institute, Palermo, Italy (APatti, GM); and Department of Biomedical Science, University of Padua, Padua, Italy (APaoli).

Correspondence: Antonino Patti, Via Giovanni Pascoli 6, 90144 Palermo, Italy (e-mail:

Abbreviations: CE = closed eyes; CG = control group; CoP = Centre's Length of Pressure; EG = experimental group; ES = ellipse surface area; LBP = low back pain; MSCs = musculoskeletal conditions; NSLBP = nonspecific low back pain; ODI = Oswestry Disability Index; OE = open eyes; SP = sway path; X mean = pressure center coordinates on the plane frontal; Y mean = pressure center coordinates on the plane sagittal.

The authors have no funding and conflicts of interest to disclose.

This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received July 21, 2015

Received in revised form December 4, 2015

Accepted December 9, 2015

Copyright © 2016 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.