Commenced in January 2007
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Edition: International
Paper Count: 32579
The Effects of Pilates and McKenzie Exercises on Quality of Life and Lumbar Spine Position Sense in Patients with Low Back Pain: A Comparative Study with a 4-Week Follow-Up

Authors: Vahid Mazloum, Mansour Sahebozamani, Amirhossein Barati, Nouzar Nakhaee, Pouya Rabiei


Non-specific chronic low back pain (NSCLBP) is a common condition with no exact diagnosis and mechanism for its occurrence. Recently, different therapeutic exercises have taken into account to manage NSCLBP. So, the aim of this study has mainly been placed on comparing the effects of Pilates and Mackenzie exercises on quality of life (QOL) lumbar spine position sense (LSPS) in patients with NSCLBP. In this randomized clinical trial, 47 patients with NSCLBP were voluntarily divided into three groups of Pilates (n=16) (with mean age 37.1 ± 9.5 years, height 168.9 ± 7.4 cm, body mass 76.1 ± 5.9 k), McKenzie (n=15) (with mean age 42.7 ± 8.1 years, height 165.7 ± 6.8, body mass 74.1 ± 4.8 kg) and control (n=16) (with mean age 39.3 ± 9.8 years, height 168.1 ± 8.1 cm, body mass 74.2 ± 5.8 kg). Primary outcome included QOL and secondary was LSPS. Both variables were assessed by the WHOQOL-BREF questionnaires and electrogoniameter, respectively. The measurements were performed at baseline, following a 6-week intervention, and after a 4-week follow-up. The ANCOVA test at P < 0.05 was administrated to analyze the collected data using SPSS software. There was a statistically significant difference between experimental groups and the control group to improve QOL. But, no difference was seen regarding the effects of two exercises on LSPS (p < 0.05). Both Pilates and Mackenzie exercises demonstrated improvement in QOL after 6-week intervention and a 4-week follow-up while none of them considerably affected LSPS. Further studies are required to establish a supporting evidence for the effectiveness of two exercises on NSCLBP.

Keywords: Pilates, Mackenzie, proprioception, low back pain, physical health.

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[1] Manchikanti, L., Singh, V., Falco, F. J., Benyamin, R. M., & Hirsch, J. A. (2014). Epidemiology of low back pain in adults. Neuromodulation: Technology at the Neural Interface, 17(S2), 3-10.
[2] Zhang, Y., Tang, S., Chen, G., & Liu, Y. (2015). Chinese massage combined with core stability exercises for nonspecific low back pain: a randomized controlled trial. Complementary therapies in medicine, 23(1), 1-6.
[3] Freburger, J. K., Holmes, G. M., Agans, R. P., Jackman, A. M., Darter, J. D., Wallace, A. S., Carey, T. S. (2009). The rising prevalence of chronic low back pain. Archives of internal medicine, 169(3), 251-258.
[4] Wand, B. M., & O'Connell, N. E. (2008). Chronic non-specific low back pain–sub-groups or a single mechanism? BMC musculoskeletal disorders, 9(1), 11.
[5] Roach, S. M., San Juan, J. G., Suprak, D. N., Lyda, M., Bies, A. J., & Boydston, C. R. (2015). Passive hip range of motion is reduced in active subjects with chronic low back pain compared to controls. International journal of sports physical therapy, 10(1), 13.
[6] Krismer, M., & Van Tulder, M. (2007). Low back pain (non-specific). Best Practice & Research Clinical Rheumatology, 21(1), 77-91.
[7] Kachanathu, S. J., Alenazi, A. M., Seif, H. E., Hafez, A. R., & Alroumim, A. M. (2014). Comparison between Kinesio taping and a traditional physical therapy program in treatment of nonspecific low back pain. Journal of physical therapy science, 26(8), 1185-1188.
[8] Beneck, G. J., & Kulig, K. (2012). Multifidus atrophy is localized and bilateral in active persons with chronic unilateral low back pain. Archives of physical medicine and rehabilitation, 93(2), 300-306.
[9] Masse-Alarie, H., Beaulieu, L. D., Preuss, R., & Schneider, C. (2015). Task-specificity of bilateral anticipatory activation of the deep abdominal muscles in healthy and chronic low back pain populations. Gait & posture, 41(2), 440-447.
[10] Richardson, C. A., Hodges, P., & Hides, J. A. (2004). Therapeutic exercise for lumbopelvic stabilization. Churchill Livingstone.
[11] Willigenburg, N. W., Kingma, I., Hoozemans, M. J., & van Dieën, J. H. (2013). Precision control of trunk movement in low back pain patients. Human movement science, 32(1), 228-239.
[12] Arokoski, J. P., Valta, T., Kankaanpää, M., & Airaksinen, O. (2004). Activation of lumbar paraspinal and abdominal muscles during therapeutic exercises in chronic low back pain patients. Archives of physical medicine and rehabilitation, 85(5), 823-832.
[13] Andrew J, Cole MD, Stanley A. (2002). Low back pain handbook. 2th ed. Philadelphia: Hanley & Belfus; 133-153.
[14] Standaert, C. J., Weinstein, S. M., & Rumpeltes, J. (2008). Evidence-informed management of chronic low back pain with lumbar stabilization exercises. The spine journal, 8(1), 114-120.
[15] Richardson, C. A., Snijders, C. J., Hides, J. A., Damen, L., Pas, M. S., & Storm, J. (2002). The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine, 27(4), 399-405.
[16] Alexander, K. M., & Kinney LaPier, T. L. (1998). Differences in static balance and weight distribution between normal subjects and subjects with chronic unilateral low back pain. Journal of orthopaedic & sports physical therapy, 28(6), 378-383.
[17] Miller, K., Yarlas, A., Wen, W., Dain, B., Lynch, S. Y., Ripa, S. R., ... & Raffa, R. (2014). The impact of buprenorphine transdermal delivery system on activities of daily living among patients with chronic low back pain: an application of the international classification of functioning, disability and health. The Clinical journal of pain, 30(12), 1015-1022.
[18] Aluko, A., DeSouza, L., & Peacock, J. (2013). The effect of core stability exercises on variations in acceleration of trunk movement, pain, and disability during an episode of acute nonspecific low back pain: a pilot clinical trial. Journal of manipulative and physiological therapeutics, 36(8), 497-504.
[19] Pinto, J. S. S. T., Sarmento, L. A., da Silva, A. P. P., Cabral, C. M. N., & Chiavegato, L. D. (2015). Effectiveness of conventional physical therapy and Pilates' method in functionality, respiratory muscle strength and ability to exercise in hospitalized chronic renal patients: A study protocol of a randomized controlled trial. Journal of Bodywork and Movement Therapies, 19(4), 604-615.
[20] Lim, E. C. W., Poh, R. L. C., Low, A. Y., & Wong, W. P. (2011). Effects of Pilates-based exercises on pain and disability in individuals with persistent nonspecific low back pain: a systematic review with meta-analysis. journal of orthopaedic & sports physical therapy, 41(2), 70-80.
[21] Sonal, S. A. (2014). Effect of repetitive Mckenzie lumbar spine exercises on cardiovascular system. International Journal of Medical Research & Health Sciences, 3(3), 514-520.
[22] Garcia, A. N., Costa, L. D. C. M., da Silva, T. M., Gondo, F. L. B., Cyrillo, F. N., Costa, R. A., & Costa, L. O. P. (2013). Effectiveness of back school versus McKenzie exercises in patients with chronic nonspecific low back pain: a randomized controlled trial. Physical therapy, 93(6), 729.
[23] Norris, C., & Matthews, M. (2008). The role of an integrated back stability program in patients with chronic low back pain. Complementary therapies in clinical practice, 14(4), 255-263.
[24] Chehelamirani, N., Sahaf, R., Rassafiani, M., & Bakhshi, E. (2016). Validity and Reliability of WHOQOL-DIS Questionnaire in Iranian Older People with Disability. Journal of Rehabilitation, 16(4), 334-345.
[25] Nedjat, S., Montazeri, A., Holakouie, K., Mohammad, K., & Majdzadeh, R. (2008). Psychometric properties of the Iranian interview-administered version of the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF): a population-based study. BMC health services research, 8(1), 61.
[26] Dolan, K. J., & Green, A. (2006). Lumbar spine reposition sense: the effect of a ‘slouched’posture. Manual therapy, 11(3), 202-207.
[27] Petersen, T., Kryger, P., Ekdahl, C., Olsen, S., & Jacobsen, S. (2002). The effect of McKenzie therapy as compared with that of intensive strengthening training for the treatment of patients with subacute or chronic low back pain: a randomized controlled trial. Spine, 27(16), 1702-1709.
[28] Mostagi, F. Q. R. C., Dias, J. M., Pereira, L. M., Obara, K., Mazuquin, B. F., Silva, M. F., & Lima, T. B. (2015). Pilates versus general exercise effectiveness on pain and functionality in non-specific chronic low back pain subjects. Journal of bodywork and movement therapies, 19(4), 636-645.
[29] Mazloum V, Sahebozamani M. (2014). The comparison of stabilization exercise program and Pilates method on patients with non-specific chronic low back pain. Daneshvar Medicine, 21(110), 59-68. (Abstract in English).
[30] Mazloum V, Sahebozamani M. (2015). The effects of various exercise-based interventions on nonspecific chronic low back pain: a systematic review on persian studies. Journal of Research in Rehabilitation Sciences, 11(1), 89-98. (Abstract in English).
[31] Wells, C., Kolt, G. S., Marshall, P., Hill, B., & Bialocerkowski, A. (2013). Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews. BMC medical research methodology, 13(1), 7.
[32] Khauv KB, John C. (2014). Health-related quality of life improvements I adult patients with chronic low back pain under low-force chiropractic care: A practice-based study. Chiropr J Aust, 41(4):118–122.
[33] Ali Zamani, S., Ghasemi, G. A., Karimi, A., Salehi, H., (2011). Pilates exercise effect on pain and general health of female patients with chronic low back pain. Journal of Research in Rehabilitation Sciences, 7(1) (Abstract in English).
[34] Yue, P., Liu, F., & Li, L. (2012). Neck/shoulder pain and low back pain among school teachers in China, prevalence and risk factors. BMC public health, 12(1), 789.
[35] Willson, J. D., Dougherty, C. P., Ireland, M. L., & Davis, I. M. (2005). Core stability and its relationship to lower extremity function and injury. Journal of the American Academy of Orthopaedic Surgeons, 13(5), 316-325.
[36] Wong, K. W., Leong, J. C., Chan, M. K., Luk, K. D., & Lu, W. W. (2004). The flexion–extension profile of lumbar spine in 100 healthy volunteers. Spine, 29(15), 1636-1641.
[37] Bener, A., Verjee, M., Dafeeah, E. E., Falah, O., Al-Juhaishi, T., Schlogl, J., ... & Khan, S. (2013). Psychological factors: anxiety, depression, and somatization symptoms in low back pain patients. J Pain Res, 6(1), 95-101.
[38] Vieira, F. T. D., Faria, L. M., Wittmann, J. I., Teixeira, W., & Nogueira, L. A. C. (2013). The influence of Pilates method in quality of life of practitioners. Journal of Bodywork and Movement Therapies, 17(4), 483-487.
[39] Rubinstein, S. M., van Middelkoop, M., Assendelft, W. J., de Boer, M. R., & van Tulder, M. W. (2011). Spinal manipulative therapy for chronic low-back pain: an update of a Cochrane review. Spine, 36(13), E825-E846.
[40] Wajswelner, H., Metcalf, B., & Bennell, K. (2012). Clinical Pilates versus general exercise for chronic low back pain: randomized trial. Med Sci Sports Exerc, 44(7), 1197-205.
[41] Ward, S. R., Kim, C. W., Eng, C. M., Gottschalk, L. J., Tomiya, A., Garfin, S. R., & Lieber, R. L. (2009). Architectural analysis and intraoperative measurements demonstrate the unique design of the multifidus muscle for lumbar spine stability. J Bone Joint Surg Am, 91(1), 176-185.
[42] Deh-bozorgi MN, Letafatkat A, Sabounchi R. (2014). Efficacy of sensorimotor training on proprioception and neuromuscular coordination in patients with chronic nonspecific low back pain. Sport Medicine Studies, 6 (15), 71-88. (Abstract in English).