title: Comparative effectiveness of Pilates and yoga group exercise interventions for chronic mechanical neck pain: quasi-randomised parallel controlled study.
abstract: OBJECTIVE
  To determine the effectiveness of Pilates and yoga group exercise interventions for individuals with chronic neck pain (CNP).
  
  
  METHODS
  Quasi-randomised parallel controlled study.
  
  
  METHODS
  Community, university and private practice settings in four locations.
  
  
  METHODS
  Fifty-six individuals with CNP scoring ≥3/10 on the numeric pain rating scale for >3 months (controls n=17, Pilates n=20, yoga n=19).
  
  
  METHODS
  Exercise participants completed 12 small-group sessions with modifications and progressions supervised by a physiotherapist.
  
  
  METHODS
  The primary outcome measure was the Neck Disability Index (NDI). Secondary outcomes were pain ratings, range of movement and postural measurements collected at baseline, 6 weeks and 12 weeks. Follow-up was performed 6 weeks after completion of the exercise classes (Week 18).
  
  
  RESULTS
  NDI decreased significantly in the Pilates {baseline: 11.1 [standard deviation (SD) 4.3] vs Week 12: 6.8 (SD 4.3); mean difference -4.3 (95% confidence interval -1.64 to -6.7); P<0.001} and yoga groups [baseline: 12.8 (SD 7.4) vs Week 12: 8.1 (SD 5.6); mean difference -4.7 (95% confidence interval -2.1 to -7.4); P<0.00], with no change in the control group. Pain ratings also improved significantly. Moderate-to-large effect sizes (0.7 to 1.8) and low numbers needed to treat were found. There were no differences in outcomes between the exercise groups or associated adverse effects. No improvements in range of movement or posture were found.
  
  
  CONCLUSIONS
  Pilates and yoga group exercise interventions with appropriate modifications and supervision were safe and equally effective for decreasing disability and pain compared with the control group for individuals with mild-to-moderate CNP. Physiotherapists may consider including these approaches in a plan of care.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01999283.
authors.affiliation: Wayne State University, Physical Therapy Program, Detroit, MI, USA; University of Michigan-Flint, Physical Therapy Department, Flint, MI, USA. Electronic address: kdunleavy@phhp.ufl.edu.
authors.forename: K
authors.initials: K
authors.lastname: Dunleavy
authors.affiliation: Oakland Physical Therapy, Novi, MI, USA.
authors.forename: K
authors.initials: K
authors.lastname: Kava
authors.affiliation: Wayne State University, Physical Therapy Program, Detroit, MI, USA; University of Florida, Department of Physical Therapy, Gainesville, FL, USA.
authors.forename: A
authors.initials: A
authors.lastname: Goldberg
authors.affiliation: Wayne State University, Physical Therapy Program, Detroit, MI, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Malek
authors.affiliation: Wayne State University, Physical Therapy Program, Detroit, MI, USA; University of Florida, Department of Physical Therapy, Gainesville, FL, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Talley
authors.affiliation: Wayne State University, Department of Pharmacy Practice, Detroit, MI, USA.
authors.forename: V
authors.initials: V
authors.lastname: Tutag-Lehr
authors.affiliation: Wayne State University, Physical Therapy Program, Detroit, MI, USA.
authors.forename: J
authors.initials: J
authors.lastname: Hildreth
mesh_terms: D059350:Chronic Pain / Q000534:rehabilitation*; D004185:Disability Evaluation; D026241:Exercise Movement Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000534:rehabilitation*; D010147:Pain Measurement; D016896:Treatment Outcome; D015013:Yoga
keywords: Chronic neck pain; Pilates; Yoga