title: Pilates exercise or stationary cycling for chronic nonspecific low back pain: does it matter? a randomized controlled trial with 6-month follow-up.
abstract: METHODS
  Randomized controlled trial.
  
  
  OBJECTIVE
  This is the companion study to a previous publication that presented 8-week pain, disability, and trunk muscle motor control results. The objective of this study was to compare the effect of 8 weeks of specific trunk exercises and stationary cycling on outcomes measures of catastrophizing and fear-avoidance beliefs (FAB) in patients with chronic nonspecific low back pain, and provide 6-month outcome data for all self-report measures.
  
  
  BACKGROUND
  It is thought that any form of moderate-to-vigorous physical activity is sufficient to address catastrophizing and FAB, and concomitant levels of pain and disability.
  
  
  METHODS
  Sixty-four patients with low back pain were randomly assigned to 8 weeks of specific trunk exercise group (SEG), or stationary cycling group (CEG). Self-rated pain, disability, catastrophizing and FAB scores were collected before, immediately after (8 wk), and 6 months after the training program. Clinically meaningful improvements were defined as greater than a 30% reduction from baseline in pain and disability scores. "Intention-to-treat" principles were used for missing data. Per-protocol analysis was performed on participants who attended at least two-thirds of the exercise sessions.
  
  
  RESULTS
  At 8 weeks, disability was significantly lower in the SEG compared with the CEG (d = 0.62, P = 0.018). Pain was reduced from baseline in both the groups after training (P < 0.05), but was lower for the SEG (P < 0.05). FAB scores were reduced in the SEG at 8 weeks, and in the CEG at 6 months. No between-group differences in FAB scores were observed. Similar reductions in catastrophizing in each group were observed at each time point. At 6 months, the overall data pattern suggested no long-term difference between groups. Per-protocol analysis of clinically meaningful improvements suggests no between-group differences for how many patients are likely to report improvement.
  
  
  CONCLUSIONS
  Inferential statistics suggest greater improvements at 8 weeks, but not 6 months, for the SEG. Inspection of clinically meaningful changes based on a minimum level of adherence suggests no between-group differences. If a patient with low back pain adheres to either specific trunk exercises or stationary cycling, it is reasonable to think that similar improvements will be achieved.
  
  
  METHODS
  2.
authors.affiliation: School of Science and Health, University of Western Sydney, Penrith South, NSW 2751, Australia. p.marshall@uws.edu.au
authors.forename: Paul W M
authors.initials: PW
authors.lastname: Marshall
authors.forename: Suzanne
authors.initials: S
authors.lastname: Kennedy
authors.forename: Cristy
authors.initials: C
authors.lastname: Brooks
authors.forename: Chris
authors.initials: C
authors.lastname: Lonsdale
mesh_terms: D001642:Bicycling / Q000502:physiology*; D002908:Chronic Disease; D004185:Disability Evaluation; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005239:Fear / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008390:Markov Chains; D009010:Monte Carlo Method; D010147:Pain Measurement; D057566:Self Report; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult