The aim of this study was to determine the effects of the Pilates method for patients with non-specific acute, subacute or chronic low back pain. The Pilates method is one of the most common forms of intervention based on exercise used for treating patients with low back pain. However, its effectiveness is not well established. The authors conducted searches on CENTRAL, MEDLINE, EMBASE, CINAHL, PEDro and SPORTDiscus up to March 2014. We included randomised controlled trials examining the effectiveness of Pilates in patients with acute, subacute or chronic non-specific low back pain. The outcomes evaluated were pain, disability, function, and global impression of recovery. Two independent reviewers screened for potentially eligible studies, assessed risk of bias, and extracted the data. We evaluated the overall quality of evidence using the GRADE approach and treatment effect sizes were described using mean differences and 95% confidence intervals. Searches retrieved 126 trials, of which 10 were included in the review (n = 510 participants). Seven studies were considered to have low risk of bias, and three were considered at high risk of bias. When compared to minimal intervention, Pilates reduces pain at short and intermediate term with low to moderate quality evidence and medium effect sizes. For disability, there is also a significant difference in favour to Pilates with low to moderate quality evidence and small effect size for short term and medium effect size for intermediate term compared with minimal intervention. It is unclear whether Pilates is better than other exercises for short-term pain, but there is low quality evidence that Pilates reduces pain at intermediate term. For disability, there is moderate quality evidence that there is no significant difference between Pilates and other exercise, either in the short term, or in the intermediate term.
There is low to moderate quality evidence that Pilates is more effective than minimal intervention with most of the effect sizes being considered medium. However, there is no conclusive evidence that Pilates is superior to other forms of exercise.