Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews

Wells, Cherie; Kolt, Gregory S.; Marshal, Paul; Hill, Bridget; Bialocerkowski, Andrea
March 2013
BMC Medical Research Methodology;2013, Vol. 13 Issue 1, p1
Academic Journal
Background: Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods: This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results: A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion: There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately.


Related Articles

  • Framework for selecting best practices in public health: a systematic literature review. Ng, Eileen; de Colombani, Pierpaolo // Journal of Public Health Research;2015, Vol. 4 Issue 3, p157 

    Evidence-based public health has commonly relied on findings from empirical studies, or research-based evidence. However, this paper advocates that practice-based evidence derived from programmes implemented in real-life settings is likely to be a more suitable source of evidence for inspiring...

  • Purpose and procedure.  // Evidence Based Medicine;Aug2006, Vol. 11 Issue 4, p97 

    The article focuses on the purpose of the journal "Evidence-Based Medicine." The journal gives summaries of articles related to new developments in the field of internal medicine, family practice, pediatrics, etc., in order to update the knowledge of clinicians. Certain criteria for the review...

  • Natural orifice translumenal endoscopic surgery: critical appraisal of applications in clinical practice. Sodergren, Mikael H.; Clark, James; Athanasiou, Thanos; Teare, Julian; Yang, Guang-Zhong; Darzi, Ara // Surgical Endoscopy;Apr2009, Vol. 23 Issue 4, p680 

    Natural orifice translumenal endoscopic surgery (NOTES), with its focus on eliminating incision-related complications, promises to revolutionize the way surgery is performed. This study aimed to summarize the clinical applications of NOTES for humans, outline the techniques used, and discuss the...

  • Systematic reviews in Journal of Physiotherapy. Elkins, Mark; Ada, Louise // Journal of Physiotherapy (Australian Physiotherapy Association);2010, Vol. 56 Issue 2, p69 

    The author reflects on the systematic review, a research design which generates results that provide a significant guide for the clinical practice of physiotherapy. He explores the Overview Quality Assessment Questionnaire which has been applied to evaluate the quality of systematic reviews in...

  • BODY CONTROL PILATES.  // Business Traveller (UK/Europe Edition);Apr2012, p51 

    The article offers information about the Body Control Pilates for back pain offered by Back4Good.

  • Segmental stabilizing exercises and low back pain. What is the evidence? A systematic review of randomized controlled trials. Rackwitz, Berid; de Bie, Rob; Limm, Heribert; von Garnier, Katharina; Ewert, Thomas; Stucki, Gerold // Clinical Rehabilitation;Jul2006, Vol. 20 Issue 7, p553 

    Study design: A systematic review of randomized controlled trials. Objectives: To evaluate the effectiveness of segmental stabilizing exercises for acute, subacute and chronic low back pain with regard to pain, recurrence of pain, disability and return to work. Methods: MEDLINE, EMBASE, CINAHL,...

  • Rumination in Generalized Anxiety and Social Phobia: A Qualitative Systematic Review. VĂLENAŞ, SERGIU P.; SZENTAGOTAI, AURORA T. // Transylvanian Journal of Psychology;2014, Vol. 15 Issue 1, p61 

    Rumination has often been investigated in relation to the etiology and maintenance of major depression. Evidence now suggests that rumination is also associated with anxiety disorders. However, there are relatively few studies that examine ruminative response in clinical samples such as...

  • Transparent Reporting of Trials Is Essential. Altman, Douglas G // American Journal of Gastroenterology;Aug2013, Vol. 108 Issue 8, p1231 

    Reports of randomized controlled trials (RCTs) inform the care of future patients and are especially important to clinicians and systematic reviewers. Readers should satisfy themselves that the study methods were sound. Clinicians should consider the relevance to their own patients, both...

  • The Importance of Clinical Significance in AAOS CPGs. JEVSEVAR, DAVID S. // AAOS Now;May2013, Vol. 7 Issue 5, p41 

    The article focuses on the importance of clinical significance in formulating evidenced-based clinical practice guidelines (CPGs). It states that in developing CPGs, clinical organization like the American Academy of Orthopaedic Surgeons (AAOS) should focus on evidence evaluation. It adds that...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics