The Definition and Application of Pilates Exercise to Treat People With Chronic Low Back Pain

Pilates exercise is suggested for people with chronic low back pain (CLBP).  Although in the literature, Pilates exercise is described and applied differently to treat people with CLBP. This creates difficulty in evaluating its effectiveness. The purpose of this stusdy was to establish a consensus regarding the definition and application of Pilates exercise to treat people with CLBP. The authors used the Delphi technique to survey a panel of 30 Australian physiotherapists, experienced in treating people with CLBP using Pilates exercise. They used 3 electronic questionnaires to collect opinions. Answers to open-ended questions were analysed thematically, combined with systematic literature review findings, and translated into statements about Pilates exercise for people with CLBP. Participants then rated their level of agreement with these statements using a six-point Likert scale. Consensus was achieved when 70% of panel members strongly agreed, agreed, or somewhat agreed with an item, or strongly disagreed, disagreed, or somewhat disagreed. Thirty physiotherapists completed all 3 questionnaires and reached a consensus on the majority of items. Participants agreed that Pilates exercise requires body awareness, breathing, movement control, posture, and education. It was recommended that people with CLBP should undertake supervised sessions for 30-60 minutes twice per week for 3-6 months. Participants also suggested that people with CLBP would benefit from individualized assessment and exercise prescription, supervision and functional integration of exercises, and use of specialised equipment.


The findings from this study contribute to a superior understanding of Pilates exercise and how it is applied by physiotherapists to treat people with CLBP. The authors concluded that this information provides direction for future research into Pilates exercise, though the findings must be interpreted within the context of study limitations.