OBJECTIVE: To assess the effectiveness of the Pilates method on pain, function, quality of life, and consumption of pain medication in patients with mechanical neck pain.
DESIGN: The design was a randomized controlled trial, with a blinded assessor and intention-to-treat analysis.
SETTING: The study took place in the outpatient clinic of the rheumatology department, referral center.
PARTICIPANTS: Patients (N=64) with chronic mechanical neck pain were randomly allocated to 2 groups: the Pilates group (PG) and a control group (CG).
INTERVENTIONS: The PG attended 2 sessions of Pilates per week, for 12 weeks. The protocol included Pilates exercises performed on a mat and on equipment and was adapted depending on the physical fitness of each participant; the repetitions varied from 6 to 12, respecting patient reports of fatigue and pain, using a single series for each exercise. The CG received only the standard pharmacological treatment. Both groups were instructed to use acetaminophen 750 mg if necessary. Patients were evaluated at baseline after 45, 90, and 180 days.
MAIN OUTCOME MEASURES: We used the Numerical Pain Scale for pain, the Neck Disability Index for function, and the SF-36 questionnaire for quality of life.
RESULTS: The groups were homogeneous at baseline, the only exception being body mass index (BMI), with the PG showing higher BMI. Regarding the assessment between groups over time, statistical differences were identified for pain (P<.001), function (P<.001) and the SF-36 (functional capacity, P=.019; pain, P<.001; general health, P=.022; vitality, P<.001; mental health, P=.012) with the PG consistently achieving better results. Drug consumption was lower in PG patients (P=.037).
CONCLUSIONS: This trial demonstrated the effectiveness of the Pilates method for the treatment of chronic mechanical neck pain, resulting in improvement of pain, function, quality of life, and reduction of the use of analgesics.
|Rehab Clinician (OT/PT)|
It's difficult to score. The study design resulted in 3/4 of those recruited not meeting inclusion criteria. It's not clear where those that they listed as "excluded" went in their flow diagram. Lack of active comparator is the most glaring limitation. I don't know what to do with the information.
Any non-opioid modalities for chronic pain are relevant in today's environment. This appears to be designed as well as a study like this can be designed (impossible to do a placebo-control, for example).
The key findings of this research show how useful this treatment modality could be with this client group. 'The Pilates method program used in this trial improved pain, function, and quality of life, and reduced the use of analgesics in patients with chronic mechanical neck pain. Moreover, this method had no harmful effects on such patients'.
It’s possible that any ongoing exercise class would show a positive effect.
The author's results were not surprising since prior evidence demonstrates that patients with neck pain benefit from exercise vs. doing nothing or just taking pain meds. The study would have been better served by comparing 2 different exercise regimens with a cost effectiveness analysis in addition to a control group.