The effectiveness of Pilates exercise in the treatment of patients with chronic low back pain (CLBP) is still unestablished. Understanding how to identify people with CLBP who may benefit, or not benefit, from Pilates exercise and the benefits and risks of Pilates exercise will aid in trial design. This study’s aim was to establish a consensus regarding the indications, contraindications, and precautions of Pilates exercise and the potential benefits and risks of Pilates exercise for people with CLBP. A panel of 30 Australian physical therapists experienced in the use of Pilates exercise were surveyed using the Delphi technique. Three electronic questionnaires were used to collect participant opinions. Answers to open-ended questions were analyzed thematically, combined with research findings, and translated into statements about Pilates exercise. Participants then rated their level of agreement with statements using a 6-point Likert scale. Consensus was achieved when 70% of panel members agreed or disagreed with an item. Thirty physical therapists completed the 3 questionnaires. Consensus was reached on 100% of items related to the benefits, indications, and precautions of Pilates exercise, on 50% of items related to risks, and on 56% of items related to contraindications. Participants agreed that people who have poor body awareness and maladaptive movement patterns may benefit from Pilates exercise, whereas those with pre-eclampsia, unstable spondylolisthesis, or a fracture may not benefit. Participants also agreed that Pilates exercise might improve functional ability, movement confidence, body awareness, posture, and movement control. The findings reflect the opinions of only 30 Australian physical therapists and not all health professionals nationally or internationally. For this reason, these findings need to be verified in future research trials.
The findings of this study add to a better understanding of the indications, contraindications, and precautions of Pilates exercise and the benefits and risks of Pilates exercise for patients with CLBP. This information can aid in design of future trials investigating the effectiveness of Pilates exercise.