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Effects of a Pilates protocol in individuals with non-specific low back pain compared with healthy individuals: Clinical and electromyographic analysis

  • Morgana Cardoso Alves
    Affiliations
    Programa de Pós Graduação em Ciências da Reabilitação da Universidade Federal de Santa Catarina (PPGCR-UFSC), Araranguá, SC, Brazil

    Laboratório de Avaliação e Reabilitação do Aparelho Locomotor da Universidade Federal de Santa Catarina (LARAL-UFSC), Araranguá, SC, Brazil
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  • Romeu Joaquim de Souza Neto
    Affiliations
    Laboratório de Avaliação e Reabilitação do Aparelho Locomotor da Universidade Federal de Santa Catarina (LARAL-UFSC), Araranguá, SC, Brazil
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  • Rafael Inácio Barbosa
    Affiliations
    Programa de Pós Graduação em Ciências da Reabilitação da Universidade Federal de Santa Catarina (PPGCR-UFSC), Araranguá, SC, Brazil

    Laboratório de Avaliação e Reabilitação do Aparelho Locomotor da Universidade Federal de Santa Catarina (LARAL-UFSC), Araranguá, SC, Brazil
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  • Alexandre Márcio Marcolino
    Affiliations
    Programa de Pós Graduação em Ciências da Reabilitação da Universidade Federal de Santa Catarina (PPGCR-UFSC), Araranguá, SC, Brazil

    Laboratório de Avaliação e Reabilitação do Aparelho Locomotor da Universidade Federal de Santa Catarina (LARAL-UFSC), Araranguá, SC, Brazil
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  • Heloyse Uliam Kuriki
    Correspondence
    Corresponding author at: Rua Pedro João Pereira, 150 – Mato Alto, 88905-060 Araranguá, Santa Catarina, Brazil.
    Affiliations
    Programa de Pós Graduação em Ciências da Reabilitação da Universidade Federal de Santa Catarina (PPGCR-UFSC), Araranguá, SC, Brazil

    Laboratório de Avaliação e Reabilitação do Aparelho Locomotor da Universidade Federal de Santa Catarina (LARAL-UFSC), Araranguá, SC, Brazil
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      Highlights

      • Pilates is an effective method to reduce pain and disability.
      • Pilates is an effective method top improve flexibility, endurance and muscle force.
      • Pilates shows same effects in low back pain and clinical healthy people.
      • Pilates leads to improvement in motor behavior of trunk muscles.

      Abstract

      Background

      Electromyography may be useful for assessing and understanding trunk muscle activation, and Pilates is commonly used as a treatment for low back pain. The objective of this study was to verify electromyography of trunk muscles after a Pilates protocol in individuals with non-specific low back pain and in healthy individuals.

      Methods

      Volunteers were divided into two groups: non-specific low back pain (n = 19) and clinically healthy (n = 16) groups. Clinical assessments, classification of patients into subgroups, electromyography evaluations of the right lumbar extensor and right transverse abdominal/internal oblique muscle of the abdomen were performed before and after an 8-week Pilates protocol.

      Findings

      Comparisons were made before and after the protocol and with the control group. There was significant improvement in pain, flexibility, resistance and strength of trunk muscles. In addition, after the Pilates, there was a decrease in the time elapsed between the onset and peak of lumbar muscle activation during the evaluation of trunk extension in the low back pain group, coming closer to the time of the abdominal muscle, as it also occurred in the control group.

      Interpretation

      Pilates caused clinical improvement and balanced trunk muscle activation in the low back group, becoming similar to that of the control group. Furthermore, the effects of the proposed protocol were the same between the groups. Thus, Pilates may be indicated for management of non-specific low back pain.

      Keywords

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      References

        • Abreu A.M.
        • et al.
        Versão brasileira do Fear Avoidance Beliefs Questionnaire. Cad. Saúde Pública.
        Rio de Janeiro. 2008; 3: 615-623
        • Airaksinen O.
        • et al.
        European guidelines for the management of chronic non specific low back pain.
        Eur. Spine J. 2006; 15: 192-300
        • Bazrgari B.
        • Xia T.
        Application of advanced biomechanical methods in studying low back pain – recent development in estimation of lower back loads and large-array surface electromyography and findings.
        J. Pain Res. 2017; 10
        • Borges J.
        • et al.
        Pilates exercises improve low back pain and quality of life in patients with HTLV-1 virus: a randomized crossover clinical trial.
        Journal of Bodywork & Movement Therapies. 2013; 18
        • Byrnes K.
        • Wu P.J.
        • Whiller S.
        Is Pilates an effective rehabilitation tool? A systematic review.
        Journal of Bodywork & Movement Therapies. 2018; 22
        • Celich K.L.S.
        • Galon C.
        Dor crônica em idosos e sua influência nas atividades da vida diária e convivência social.
        Rev. Bras. Geriatr. Gerontol. 2009; 12 (S.I.): 345-359
        • Conceição J.S.
        • Mergener C.R.
        Eficácia do método Pilates no solo em pacientes com lombalgia crônica: relato de casos.
        Revista Dor. 2012; 13: 385-388
        • Cruz-Díaz D.
        • et al.
        The effectiveness of 12 weeks of Pilates intervention on disability, pain and kinesiophobia in patients with chronic low back pain: a randomized controlled trial.
        Clin. Rehabil. 2018; 32: 1249-1257
        • De Luca C.J.
        Surface Electromyography: Detection and Recording.
        DelSys Incorporated, 2002
        • Dellito A.
        • et al.
        Low back pain: clinical practice guidelines linked to the international classification of functioning, disability, and health from the Orthopaedic Section of the American Physical Therapy Association.
        J. Orthop. Sports Phys. Ther. 2012; 42: 1-58
        • Ekstrom R.A.
        • Osborn R.W.
        • Hauer P.L.
        Surface electromyographic analysis of the low back muscles during rehabilitation exercises.
        J Orthop Sports Phys Ther. 2008; 38: 736-745
        • Elfiving B.
        • Dedering Â.
        • Németh G.
        Lumbar muscle fatigue and recovery in patients with long-term low-back trouble – electromyography and health-related factors.
        Clin. Biomech. 2003; 18: 619-630
        • Faria M.B.M.
        • Faria W.C.
        O efeito do método Pilates no tratamento da dor lombar crônica inespecífica: uma revisão de literatura. Conexão ci.: r. cient.
        8, n. 1. UNIFOR-MG, Formiga2013: 75-84
        • Garcia A.N.
        • et al.
        Effectiveness of back school versus McKenzie exercises in patients with chronic nonspecific low back pain: a randomized controlled trial.
        Phys. Ther. 2013; 93: 729-747
        • Hartvigsen J.
        • et al.
        Low back pain 1: what low back pain is and why we need to pay attention.
        Lancet. 2018; 391: 2356-2367
        • Hebert J.J.
        • Koppenhaver S.L.
        • Walker B.F.
        Subgrouping patients with low back pain: a treatment-based approach to classification.
        Sports Health: A Multidisciplinary Approach. 2011; 3: 534-542
        • Hermens H.J.
        • et al.
        Development of recommendations for SEMG sensors and sensor placement procedures.
        J. Electromyogr. Kinesiol. 2000; 10: 361-374
        • Hodges P.W.
        • Richardson C.A.
        Inefficient muscular stabilization of the lumbar spine associated with low back pain: a motor control evaluation of transversus abdominis.
        Spine. 1996; 21 ([S.I.]): 2640-2650
        • Hoy D.
        • et al.
        The global burden of low back pain: estimates from the Global Burden of Disease 2010 study.
        Ann. Rheum. Dis. 2014; 73: 968-974
        • Hwang J.A.
        • et al.
        The effects of sensorimotor training on anticipatory postural adjustment of the trunk in chronic low back pain patients.
        J. Phys. Ther. Sci. 2013; 25: 1189-1192
        • Isacowitz R.
        • Clippinger K.
        Anatomia do Pilates: guia ilustrado de pilates de solo para estabilidade do core e equilíbrio.
        Manole, São Paulo2013
        • Jassi F.J.
        • et al.
        Acurácia de testes funcionais na identificação da pré-ativação de músculos lombopélvicos.
        Rev. Bras. Med. Esporte. 2016; 22 (S.I): 291-296
        • Joyce A.A.
        • Dana H.K.
        Core training in low back disorders: role of the Pilates method.
        Core Training, Pilates Method, and the Spine. 2017; 16
        • Jubany J.
        • Marina M.
        • Ângulo-Barroso R.
        Electromyographic and Kinematic Analysis of Trunk and Limb Muscles During a Holding Task in Individuals With Chronic Low Back Pain and Healthy Controls.
        American Academy of Physical Medicine and Rehabilitation, 2017
        • Kankaanpää M.
        • Taimela S.
        • Airaksinen O.
        Reference change limits of the paraspinal spectral EMG in evaluation of low back pain rehabilitation.
        Pathophysiology. 1998; 5: 217-224
        • Kliziene I.
        • et al.
        Effects of a 16-week Pilates exercises training program for isometric trunk extension and flexion strength.
        Journal of Bodywork & Movement Therapies. 2017; 21
        • Kuriki H.U.
        • Chaves T.C.
        • Alves M.C.
        A estabilização segmentar por meio do método Pilates no tratamento da dor lombar.
        in: Associação Brasileira de Fisioterapia Traumato-ortopédica; Silva MF, Barbosa RI, organizadores. PROFISIO: Programa de atualização em fisioterapia traumato-ortopédica:Ciclo 1. Artmed Panamericana, Porto Alegre2017: 135-181 (Sistema de Educação Continuada a Distância, v.1)
        • La Touche R.
        • Escalante K.
        • Linares M.T.
        Treating non-specific chronic low back pain through the Pilates method.
        J. Bodyw. Mov. Ther. 2008; 12: 364-370
        • Lee C.W.
        • Hyun J.
        • Kim S.G.
        Influence of Pilates mat and apparatus exercises on pain and balance of businesswomen with chronic low back pain.
        J. Phys. Ther. Sci. 2014; 26: 475-477
        • Lund J.P.
        • et al.
        The pain adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity.
        Can. J. Physiol. Pharma- col. 1991; 69 (n.69): 683-694
        • Machado P.M.
        • et al.
        Effectiveness of the Pilates method for individuals with nonspecific low back pain: clinical and electromyographic aspects.
        Motriz, Rio Claro. 2017; 23
        • Magee D.J.
        Avaliação musculoesquelética.
        5. ed. Manole, São Paulo2010
        • Maher C.
        • Underwood M.
        • Buchbinder R.
        Non-specific low back pain.
        Lancet. 2017; 389: 736-747
        • Marques N.R.
        EMG activity of trunk stabilizer muscles during centering principle of Pilates method.
        J. Bodyw. Mov. Ther. 2013; 17: 185-191
        • Mcneill W.
        Core stability is a subset of motor control.
        Journal of Bodywork & Movement Therapies. 2010; 14
        • Miyamoto G.C.
        • 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: 859-868
        • Mostagi F.Q.R.C.
        • et al.
        Pilates versus general exercise effectiveness on pain and functionality in non-specific chronic low back pain subjects.
        J. Bodyw. Mov. Ther. 2015; 19: 636-645
        • Natour J.
        • et al.
        Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial.
        Clin. Rehabil. 2015; 29: 59-68
        • Nava-Bringas T.I.
        • et al.
        Fear-avoidance beliefs increase perception of pain and disability in Mexicans with chronic low back pain.
        Rev. Bras. Reumatol. 2017; 57
        • Oliveira N.T.B.
        • et al.
        Análise biomecânica do tronco e pelve em exercícios do método PILATEs: revisão sistemática.
        Fisioter Pesq. 2015; 22: 443-455
        • Paho
        Tratamento de dor lombar é tema de novo fascículo sobre uso racional de medicamentos.
        2016
        • Panhale V.P.
        • Gurav R.S.
        • Nahar S.K.
        Association of physical performance and fear-avoidance beliefs in adults with chronic low back pain.
        Annals of Medical and Health Sciences Research. 2016; 6
        • Pereira T.L.B.
        • Souza T.A.S.
        • Silva Z.M.A.
        Melhora da funcionalidade e da intensidade da dor em pacientes com dor lombar através do método Pilates: uma revisão de literatura.
        3. Interfaces Científicas - Saúde e Ambiente, Aracaju2014: 75-82 (n.1)
        • Posadzki P.
        • Lizis P.
        • Hagner-Derengowska M.
        Pilates for low back pain: a systematic review.
        Complement. Ther. Clin. Pract. 2011; 17: 85-89
        • Pranata A.
        • et al.
        Lumbar extensor muscle force control is associated with disability in people with chronic low back pain.
        Clin. Biomech. 2017; 46 (n.46): 46-51
        • Richardson C.A.
        • Jull G.A.
        Muscle control - pain control. What exercise would you prescribe?.
        Man. Ther. 1995; 1: 2-10
        • Rossi D.M.
        • et al.
        Rate of force development and muscle activation of trunk muscles in women with and without low back pain: a case-control study.
        Physical Therapy in Sport. 2017; 26
        • Santos E.P.
        • Vieira W.H.B.
        • Prestes J.
        Eletromiografia na fadiga dos músculos eretores da espinha em diferentes posturas.
        Fisioterapia Brasil. 2010; 11: 293-298
        • Silva M.C.
        • Fassa A.G.
        • Valle N.C.J.
        Dor lombar crônica em uma população adulta do Sul do Brasil: prevalência e fatores associados. Rio de Janeiro, Cad.
        Saúde Pública. 2004; 20
        • Suehiro T.
        • et al.
        Altered trunk muscle recruitment patterns during lifting in individuals in remission from recurrent low back pain.
        J. Electromyogr. Kinesiol. 2018; 39: 128-133
        • Travell J.
        • Rinzter S.
        • Herman M.
        Pain and disability of the shoulder and arm.
        JAMA. 1942; 120
        • Van Dieen J.H.
        • Luc P.J.S.
        • Cholewicki J.
        Trunk muscle activation in low-back pain patients, an analysis of the literature.
        J. Electromyogr. Kinesiol. 2003; 13
        • Vianin M.
        Psychometric properties and clinical usefulness of the Oswestry Disability Index.
        Journal Of Chiropractic Medicine. 2008; 7 (s.l): 161-163
        • Wells C.
        • Kolt G.S.
        • Bialocerkowski A.
        Defining Pilates exercise: a systematic review.
        Complement Ther Med. 2012; 20: 253-262
        • Yamato T.P.
        • et al.
        Pilates for low back pain (Cochrane review) [with consumer summary].
        Cochrane Database Syst. Rev. 2015; 7 (n. 7)