Clinical pilates exercises for adults with chronic low back pain improves single-leg squat postural control and lumbopelvic-hip flexibility

Background
Pilates is a frequently used management strategy for chronic low back pain for its efficacy in pain relief and function. However, movement performance changes such as single-leg squat have not been studied. It is unclear if simple movement-specific Pilates exercises lead to changes in lower back or hamstrings flexibility. This study investigated the immediate changes in postural sway of single-leg squat, hamstrings flexibility and lumbar flexion flexibility after a brief session of Clinical Pilates exercises in adults with non-specific chronic low back pain.

Methods
Forty adults with chronic low back pain were assessed on single-leg squat postural sway, hamstrings flexibility and lumbar flexion flexibility. Participants were then assessed with Clinical Pilates assessment to identify movements that are easy to do and pain-free. Two to four Pilates exercises based on the identified movements were then prescribed as the intervention. A post-intervention assessment concluded the session. Repeated measures statistical test was used to study changes over time and between the problem and non-problem sides for postural sway parameters and hamstrings flexibility. Paired sample t-test was used to evaluate lumbar flexion flexibility changes.

Results
The participants showed statistically significant improvements on the problem side in three postural sway variables – vertical force variance, p < 0.001, η2 = 0.39, terminal knee flexion angle, p = 0.004, η2 = 0.19, and squat duration, p < 0.001, η2 = 0.29, hamstrings flexibility, p = 0.004, η2 = 0.2, and lumbar flexion flexibility, mean difference = 0.64 cm [95% CI: 0.49, 0.79] cm, p < 0.001.

Significance
A brief session of Clinical Pilates exercises enabled individuals with chronic low back pain to squat deeper and faster while maintaining the same level of postural stability.