Effects of pilates exercises on radiographic lumbo-pelvic alignment and range of motion in non-specific low back pain patients

Objectives: To determine the effects of Pilates exercises on lumbo-pelvic alignment in non-specific low back pain (NSLBP) patients. Methods: Twenty-two patients (Male:7; Female:15) with NSLBP aged 20–65 years were recruited and classified based on a modified O'Sullivan's classification system into flexion pattern (FP) or active extension pattern (EP) groups. Oswestry Disability index (ODI), Roland-Morris Disability Questionnaire (RMDQ) as well as radiographic lumbar global range of motion (ROM) and lumbo-pelvic alignment were measured Pre- and immediately post-intervention and at 6- and 12-month. The intervention included supervised six-weeks Pilates program with 60 min per session and up to two sessions per week. Results: Lumbar lordosis, sacral slope and sacral inclination were found to be significantly different between the FP and EP groups based on the O'Sullivan's classification system. However, despite the significant changes in RMDQ (p = 0.001), no significant changes were found for any of the alignment parameters (p > 0.05) post intervention for both groups. For lumbar global ROM, a statistically significant change was observed for the EP group (p = 0.028) but not for the FP group (p = 0.249). No significant correlations were identified between any of the self-reported outcomes, radiographic alignment and ROM parameters. Conclusions: Patients self-perceived long-term functional improvements based on responding to questionnaires after Pilates exercises were not reflected in significant changes in lumbo-pelvic alignment or lumbar ROM. This may be due to the current cohort demonstrating within normal ranges due to the lesser severity of their condition, but further research is needed for clarification.