Pilates for chronic low back pain: methodological analysis of systematic reviews
DOI:
https://doi.org/10.12820/rbafs.31e0462Keywords:
Low back pain, Physical therapy modalities, Rehabilitation, Exercise movement techniquesAbstract
Introduction: Recent studies suggest that Pilates is a promising intervention for chronic low back pain (CLBP); however, it is important to jointly summarize intervention characteristics as well as reporting and methodological transparency. Objective: To synthesize systematic reviews that evaluated interventions using Pilates for the treatment of CLBP to identify the types and characteristics of exercises most frequently reported. Methods: This is an evidence synthesis conducted through a systematic review, retrieving publications from SciELO, MEDLINE/PubMed, Cochrane Library, and Google Scholar databases. Systematic reviews published between 2013 and 2023 were included, with no language restrictions. The study followed the PRISMA 2020 guidelines. The interventions were analyzed based on the primary studies included in the systematic reviews, whereas the methodological quality of the systematic reviews was assessed using the AMSTAR-2 instrument. Results: A total of 1,939 studies were retrieved, and 9 met the eligibility criteria. Despite methodological variability, a pattern emerged: most studies adopted 60-minute sessions, conducted with heterogeneous weekly frequencies ranging from one to seven sessions per week, over 4–12 weeks, using mixed mat Studio Pilates. Conclusion: While Pilates demonstrates clinical efficacy for CLBP consistent with evidence-based guidelines, poor methodological transparency in protocol reporting limits reproducibility and optimal clinical application.
Downloads
References
1. Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016;388(10053):1545–602.
2. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. The Lancet. 2018;391(10137):2356–67.
3. Miyamoto GC, Moura KF, Franco YR dos S, Oliveira NTB de, Amaral DDV, Branco ANC, et al. Effectiveness and Cost-Effectiveness of Different Weekly Frequencies of Pilates for Chronic Low Back Pain: Randomized Controlled Trial. Phys Ther. 2016;96(3):382–9.
4. Clinical Guidelines to Address Low Back Pain: Using the Evidence to Guide Physical Therapist Practice. J Orthop Sports Phys Ther. 2021 Nov;51(11):533-4.
5. Barros NMR, Araujo GGC, Machado DMN, Silva J dos S, Silva EA da, Santos MAM dos. Eficácia do exercício no tratamento da dor lombar: uma revisão sistemática. Anais do I Congresso Nacional de Saúde Multidisciplinar / Rebeca Christine Geressait Reis Araujo et al. (Org.). São Luís, Editora Pascal, 2023.
6. Oliveira IGG, Santana YND. Efeito Do Método Pilates Na Incapacidade Funcional De Pacientes Com Lombalgia Crônica Inespecífica: Uma Revisão Sistemática. Faculdade Nobre de Feira de Santana; 2020. Disponível em: <https://unifan.net.br/old2026/wp-content/uploads/2022/11/efeito-do-metodo-pilates-na-incapacidade-funcional-de-pacientes-com-lombalgia-cronica-inespecifica-uma-revisao-sistematica.pdf> [2023 setembro].
7. Matheve T, Hodges P, Danneels L. The Role of Back Muscle Dysfunctions in Chronic Low Back Pain: State-of-the-Art and Clinical Implications. J Clin Med. 2023;12(17):5510.
8. Barcellos RF. A Eficácia Do Método Pilates Na Dor Lombar Inespecífica: Uma Revisão Da Literatura. [Monografia de especialização]. Universidade Federal de Minas Gerais; 2022. Disponível em: <https://repositorio.ufmg.br/handle/1843/53163> [2023 setembro].
9. Hochheim M, Ramm P, Wunderlich M, Amelung V. Association between chronic low back pain and regular exercise, sedentary behaviour and mental health before and during COVID-19 pandemic: insights from a large-scale cross-sectional study in Germany. BMC Musculoskelet Disord. 2022;23(1):860.
10. Bentes R do N. Variação da resposta sintomática dolorosa na coluna lombar pela manipulação visceral. Fisioter Bras. 2021;22(1):1–9.
11. Miyamoto GC, Costa LOP, Galvanin T, Cabral CMN. The efficacy of the addition of the Pilates method over a minimal intervention in the treatment of chronic nonspecific low back pain: a study protocol of a randomized controlled trial. J Chiropr Med. 2011;10(4):248–54.
12. Nascimento PRC do, Costa LOP. Prevalência da dor lombar no Brasil: uma revisão sistemática. Cad Saúde Pública. 2015;31(6):1141–56.
13. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. The Lancet. 2017;389(10070):736–47.
14. Krenn C, Horvath K, Jeitler K, Zipp C, Siebenhofer-Kroitzsch A, Semlitsch T. Management of non-specific low back pain in primary care – A systematic overview of recommendations from international evidence-based guidelines. Prim Health Care Res Dev. 2020;21:e64.
15. Grooten WJA, Boström C, Dedering Å, Halvorsen M, Kuster RP, Nilsson-Wikmar L, et al. Summarizing the effects of different exercise types in chronic low back pain – a systematic review of systematic reviews. BMC Musculoskelet Disord. 2022;23(1):801.
16. Oliveira CB, Maher CG, Pinto RZ, Traeger AC, Lin CWC, Chenot JF, et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2018;27(11):2791–803.
17. Ferraz V de S, Peixoto C, Ferreira Resstel AP, Cerqueira de Paula YT, Gomes de Souza Pegorare AB. Effect of the pilates method on pain and quality of life in pregnancy: A systematic review and meta-analysis. J Bodyw Mov Ther. 2023;35:220–7.
18. Romão CIG, Mercê CIA, Cordeiro JFC, Brito AMVV de, Branco MAC. The Effect Of Pilates Exercises On Muscle Electrical Activation In Adults With Chronic Low Back Pain: A Systematic Review. Coluna/Columna 2022;21(3):e262482.
19. Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 2018;391(10137):2368–83.
20. Steffens D, Maher CG, Pereira LSM, Stevens ML, Oliveira VC, Chapple M, et al. Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med. 2016;176(2):199–208.
21. Parveen A, Kalra S, Jain S. Effects of Pilates on health and well-being of women: a systematic review. Bull. Fac. Phys. Ther. 2023;28(1):17.
22. Miyamoto GC, Costa LOP, Galvanin T, Cabral CMN. Efficacy of the addition of modified Pilates exercises to a minimal intervention in patients with chronic low back pain: a randomized controlled trial. Phys Ther. 2013;93(3):310–20.
23. Miyamoto GC, Franco KFM, van Dongen JM, Franco YRDS, de Oliveira NTB, Amaral DDV, et al. Different doses of Pilates-based exercise therapy for chronic low back pain: a randomised controlled trial with economic evaluation. Br J Sports Med. 2018;52(13):859–68.
24. Silva JM da, Bianchin JF, Schmit EFD, Candotti CT, Vieira A. Effect of different Pilates workout endings on the kyphotic and lumbar lordotic angles. Fisioter mov. 2021;34:e34117.
25. Mello NF, Costa DL, Vasconcellos SV, Lensen CMM, Corazza ST. The effect of the Contemporary Pilates method on physical fitness, cognition and promotion of quality of life among the elderly. Rev bras geriatr gerontol. 2018;21:597–603.
26. Giannakou I, Gaskell L. A qualitative systematic review of the views, experiences and perceptions of Pilates-trained physiotherapists and their patients. Musculoskeletal Care. 2021;19(1):67–83.
27. Wells C, Kolt GS, Bialocerkowski A. Defining Pilates exercise: A systematic review. Complement Ther Med. 2012;20(4):253–62.
28. Fretta T de B, Boing L, Stein F, Santos L dos, Guimarães AC de A. Improved self-esteem after mat Pilates method intervention in breast cancer women undergoing hormone therapy: randomized clinical trial pilot study. Rev bras cineantropom desempenho hum. 2021;23:e76311.
29. Cuddy P, Gaskell L. “How do Pilates Trained Physiotherapists utilize and value Pilates Exercise for MSK conditions? A Qualitative Study”. Musculoskeletal Care. 2020;18(3):315–29.
30. da Luz MAJ, Costa LOP, Fuhro FF, Manzoni ACT, Oliveira NTB, Cabral CMN. Effectiveness of mat Pilates or equipment-based Pilates exercises in patients with chronic nonspecific low back pain: a randomized controlled trial. Phys Ther. 2014;94(5):623–31.
31. La Touche R, Escalante K, Linares MT. Treating non-specific chronic low back pain through the Pilates Method. J Bodyw Mov Ther. 2008;12(4):364–70.
32. Lorenz Y, Severo IM. Tecnologias de educação em saúde : guia prático para o desenvolvimento de materiais educativos [ebook]. Porto Alegre: Moriá. 2024. Disponível em: <https://doi.org/https://lume.ufrgs.br/handle/10183/271013> [2024 fevereiro].
33. Echer IC. Elaboração de manuais de orientação para o cuidado em saúde. Rev Lat Am Enfermagem. 2005;13(5):754–7.
34. Torres D de FM. Fisioterapia: guia prático para a clínica. Guanabara Koogan, 2000.
35. World Health Organization. WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. 2023. Disponível em: <https://www.who.int/publications/i/item/9789240081789> [2023 agosto].
36. Avaliação sistema CEP/Conep Hospital de Clínicas de Porto Alegre. Disponível em: <https://sites.google.com/hcpa.edu.br/area-do-pesquisador/projetos/projetos-seres-humanos-e-outros/avalia%C3%A7%C3%A3o-sistema-cepconep> [2023 agosto].
37. Shea B J, Reeves B C, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008
38. Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;9(9):CD009790.
39. Cordeiro ALL, Oliveira APS, Cerqueira NS, Santos FAF, Oliveira AMS. Pilates method on pain in patients with low back pain: systematic review. BRJP. 2022;5(3):265–71.
40. Brazil AV, Ximenes AC, Radu AS, Fernades AR, Appel C, Maçaneiro CH, et al. Diagnóstico e tratamento das lombalgias e lombociatalgias. Rev Bras Reumatol. 2004;44(6):419–25. Disponível em: <https://www.scielo.br/j/rbr/a/33bmVkrT4rXNw6TRTBKDtPm/?format=html&lang=pt> [2023 agosto].
41. Guerra PH, Garcia LMT, Ribeiro EHC, Maretti ALR, Andrade DR, Florindo AA. Identificação e análise das diretrizes nacionais de atividade física nas Américas. Ciên Saúde Colet. 2021;26:2961–8.
42. Passarelli JAB. Revisão Sistemática dos Benefícios do Pilates para Pessoas com Lombalgias. Prospectus. 2023;5(1):348–58.
43. McNutt M. Reproducibility. Science. 2014;343(6168):229.
44. Valdez D, Vorland CJ, Brown AW, Mayo-Wilson E, Otten J, Ball R, et al. Improving open and rigorous science: ten key future research opportunities related to rigor, reproducibility, and transparency in scientific research. F1000Res. 2020;9:1235
45. Wallach JD, Boyack KW, Ioannidis JPA. Reproducible research practices, transparency, and open access data in the biomedical literature, 2015–2017. PLoS Biol. 2018;16(11):e2006930. .
46. The INCLUDE Ethnicity Framework. Trial Forge. National Institute for Health Research (NIHR). Disponível em: <https://www.trialforge.org/trial-forge-centre/include/> [2024 janeiro].
47. Treweek S, Banister K, Bower P, Cotton S, Devane D, Gardner HR, et al. Developing the INCLUDE Ethnicity Framework—a tool to help trialists design trials that better reflect the communities they serve. Trials. 2021;22(1):337.
48. World Health Organization. WHO releases guidelines on chronic low back pain / OMS lança diretrizes sobre dor lombar crônica. Disponível em: <https://www.who.int/news/item/07-12-2023-who-releases-guidelines-on-chronic-low-back-pain> [2024 fevereiro].
49. De Lima DF, Luiz O do C. Atividade física na promoção da saúde: uma avaliação das diretrizes. Semin. Cienc. Biol. Saude. 2015;36(2):57–66.
50. World Health Organization. Recomendaciones mundiales sobre actividad física para la salud. 2010;56. Ginebra. Disponível em: <https://iris.who.int/handle/10665/44441> [2023 setembro].
51. Yamato TP, Maher CG, Saragiotto BT, et al. Pilates for low back pain. Cochrane Database Syst Rev. 2015;2015(7):CD010265.
52. Santos F, Corrêa L, Ramos V, Bernardo L, Gonçalves G, Novelino S, Costa I. O efeito do método Pilates no tratamento da lombalgia em indivíduos economicamente ativos: uma revisão sistemática da literatura. In: Bernardo LH, Gonçalves GB, Costa IS, Novelino SY. Recursos fisioterapêuticos: uma abordagem pluralista – uma coletânea de artigos. Piracanjuba-GO: Editora Conhecimento Livre: 2022. p. 65-80.
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Luciana dos Passos e Silva, Vítor Augusto Fronza, Dênis Komonski Selau, Norton da Macena Barbosa, Daniel Umpierre, Andresa Conrado Ignacio, Fernanda Dias Massierer, Larissa Xavier Neves da Silva, Luiz Fernando Alvarenga
This work is licensed under a Creative Commons Attribution 4.0 International License.
When submitting a manuscript to the Revista Brasileira de Atividade Física & Saúde, the authors retain the copyright to the article and authorize the Revista Brasileira de Atividade Física & Saúde to publish the manuscript under the Creative Commons Attribution 4.0 License and identify it as the original publication source.
