Indications, benefits, and risks of Pilates exercise for people with chronic low back pain: a Delphi survey of Pilates-trained physical therapists.
BACKGROUND
The effectiveness of Pilates exercise for treating people with chronic low back pain (CLBP) is yet to be established. 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 assist in trial design.


OBJECTIVE
The purpose of this study 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.


METHODS
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.


RESULTS
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 may improve functional ability, movement confidence, body awareness, posture, and movement control.


CONCLUSIONS
The findings reflect the opinions of only 30 Australian physical therapists and not all health professionals nationally or internationally. These findings, therefore, need to be verified in future research trials.


CONCLUSIONS
These findings contribute to a better understanding of the indications, contraindications, and precautions of Pilates exercise and the benefits and risks of Pilates exercise for people with CLBP. This information can assist in design of future trials examining the effectiveness of Pilates exercise.
C. Wells, BAppSci(Physio), MManipTher, Discipline of Physiotherapy, Faculty of Health, University of Canberra. University Drive, Bruce, Australian Capital Territory, Australia 2617. At the time of the study, Ms Wells was a PhD student at School of Science and Health, University of Western Sydney, Penrith, New South Wales, Australia. cherie.wells@canberra.edu.au.
Cherie
C
Wells
G.S. Kolt, PhD, School of Science and Health, University of Western Sydney.
Gregory S
GS
Kolt
P. Marshall, PhD, School of Science and Health, University of Western Sydney.
Paul
P
Marshall
A. Bialocerkowski, PhD, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia.
Andrea
A
Bialocerkowski
D000328:Adult; D001315:Australia; D026241:Exercise Movement Techniques / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006306:Health Surveys; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D059825:Physical Therapists; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome