THE EFFECT OF PILATES EXERCISES ON MUSCLE ELECTRICAL ACTIVATION IN ADULTS WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW

Romão, Catarina Isabel Guerreiro; Mercê, Cristiana Isabel André; Cordeiro, Jéssica Filipa Costa; Brito, António Manuel Vitória Vences de; Branco, Marco António Colaço

doi:10.1590/S1808-185120222103262482

Catarina Isabel Guerreiro Romão Correspondence: Catarina Isabel Guerreiro Romão. Rua Infante Sagres, Lote 158, 1º direito, Lagos, Portugal.8600-743. catarinaromao97@gmail.com

Escola Superior de Desporto de Rio Maior, Instituto Politécnico de Santarém, Department of Physical Activity and Health, Rio Maior, Portugal

https://orcid.org/0000-0002-9782-1133

Cristiana Isabel André Mercê

Escola Superior de Desporto de Rio Maior, Instituto Politécnico de Santarém, Department of Physical Activity and Health, Rio Maior, Portugal

Centro Interdisciplinar de Estudo da Performance Humana, CIPER, Universidade de Lisbon, Faculty of Human Motricity, Cruz Quebrada, Portugal

https://orcid.org/0000-0001-5146-6597

Jéssica Filipa Costa Cordeiro

Escola Superior de Desporto de Rio Maior, Instituto Politécnico de Santarém, Department of Physical Activity and Health, Rio Maior, Portugal

https://orcid.org/0000-0002-8574-2550

António Manuel Vitória Vences de Brito

Escola Superior de Desporto de Rio Maior, Instituto Politécnico de Santarém, Department of Physical Activity and Health, Rio Maior, Portugal

Centro de Investigação em Qualidade de Vida, CIEQV, Rio Maior, Portugal

https://orcid.org/0000-0001-6964-8559

Marco António Colaço Branco

Escola Superior de Desporto de Rio Maior, Instituto Politécnico de Santarém, Department of Physical Activity and Health, Rio Maior, Portugal

Centro Interdisciplinar de Estudo da Performance Humana, CIPER, Universidade de Lisbon, Faculty of Human Motricity, Cruz Quebrada, Portugal

https://orcid.org/0000-0001-5238-1069

Correspondence: Catarina Isabel Guerreiro Romão. Rua Infante Sagres, Lote 158, 1º direito, Lagos, Portugal.8600-743. catarinaromao97@gmail.com

All authors declare no potential conflict of interest related to this article.

CONTRIBUTIONS OF THE AUTHORS: Each author made significant individual contributions to this manuscript. CIGR: Conceptualization, Investigation, Formal analysis, Writing - Original Draft, Visualization; CIAM: Conceptualization, Methodology, Writing - Review & Editing, Visualization; JFCC: Conceptualization, Investigation, Formal analysis, Visualization; AMVVB: Writing - Review & Editing,Visualization; MACB: Conceptualization,Visualization, Writing - Review & Editing, Supervision.

Study conducted at the Instituto Politécnico de Santarém, Rio Maior, Portugal.

Reviewed by: Dr. Alexandre Fogaça Cristante

Author (year)

Participants (nº) Age (years) = Mean (SD)

Intervention

Exercise (frequency; duration)

Variables - Evaluation Instrument

Results

Conclusions

Machado P.M. et al.³⁷37 Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377-84.

Experimental Group (CLBO)" antes da apresentação do N

N = 12; both sexes; Age: 25.41 (± 6.27) years; Pain level: 3.83 (± 3.45)

Pilates

Individual and face-to-face exercises, 50-minute sessions twice a week for two months.

sEMG (Lumbar Multifídus, Transverse Abdominal and Internal Oblique)-electromyography; muscular endurance; strength - dynamometer flexibility; quality of life; pain level (VAS); fear avoidance beliefs questionnaire (FABQF)

After intervention: less activation in the multifidus (p = 0.025), greater trunk extension strength (p = 0.005) and increased time from start to peak muscle activation (p = 0.02).

The Pilates method after 8 weeks proved to be effective for: improving the motor behavior of the stabilizing muscles of the trunk; clinical signs of pain; inability; flexibility; muscle strength and endurance in patients with nonspecific low back pain.

Alves M. C. et al.³3 Alves MC, De Souza Neto RJ, Barbosa RI, Marcolino AM, Kuriki HU. Effects of a Pilates protocol in individuals with non-specific low back pain compared with healthy individuals: Clinical and electromyographic analysis. Clin Biomech. 2019;72:172-8.DOI: 10.1016/j.clinbiomech.2019.12.009.
https://doi.org/10.1016/j.clinbiomech.20...

Experimental Group (nonspecific low back pain) N = 19; 6 men and 13 women Age: 26.94 (± 1.62) years

Control Group (healthy) N = 16; 2 men and 14 women Age: 28.75 (± 1.59) years

Pilates

Participants had individual and in-person sessions of 50 to 60 minutes, twice a week, for eight weeks (16 sessions in total). They did not take any drugs.

sEMG (Lumbar Multifídus, Transverse Abdominal and Internal Oblique)-electromyography; Muscle resistance extensors of the lumbar spine (Sorensen test) and the lumbar square (tests of the right and left lateral bridge) - dynamometer The Fear Avoidance Beliefs Questionnaire (FABQF); the OswestryDisability Index (ODI); pain level (VAS) only forparticipants in the experimental group

Significant differences only for the duration of the right lumbar extensor and onset before and after intervention; and muscle endurance (p = 0.04); and for pain level 3.78 (0.66) to 0.50 (0.34) (p = 0.01).

For the other parameters, the effects of the intervention were similar in both groups.

After the Pilates protocol, individuals with low back pain had decreased pain and lower disability scores, as well as fewer fears and beliefs related to pain in the practice of physical activity and improved flexibility, endurance and muscle strength.

Knox M.F. et al.³⁶36 Knox MF, Chipchase LS, Schabrun SM, Marshall PWM. Improved compensatory postural adjustments of the deep abdominals following exercise in people with chronic low back pain. J Electromyogr Kinesiol. 2017;37:117-24.DOI:10.1016/j.jelekin.2017.10.009.
https://doi.org/10.1016/j.jelekin.2017.1...

Experimental Group (CLBP) N=12

Control Group (CLBP) N = 12

Pilates

Everyday activities

Participants in the experimental group performed three exercise sessions / week for 8 weeks.

sEMG (rectus abdominis, transverse, internal oblique and spinal erector)-electromyography; compensatory postural adjustments, anticipation - unilateral trunk flexion; pain level (VAS); Oswestry Disability Index (ODI)

Reduction in the disability scale score in the experimental group (p = 0.001). Compared to the initial moment, the onset of activation of the spinal erector later changed in the experimental group (p = 0.009). Onset TrA/IO was different on each side (p <0.001), with early onset for TrA/IO compared between the same side. The amplitude of TrA/IO in compensatory adjustments increased only in the experimental group (p = 0.012).

8 weeks of exercise can improve motor control in people with CLBP, highlighted by the increase in compensatory postural adjustments in the transversus abdominis and internal oblique. Muscular adaptation for compensatory postural adjustments promoted a pattern of activity similar to that of healthy individuals.

Study	Pre-Pain Level M ± SD	Post- Pain Level M ± SD	Significance Level	Scale
Alves M. C. et al.³3 Alves MC, De Souza Neto RJ, Barbosa RI, Marcolino AM, Kuriki HU. Effects of a Pilates protocol in individuals with non-specific low back pain compared with healthy individuals: Clinical and electromyographic analysis. Clin Biomech. 2019;72:172-8.DOI: 10.1016/j.clinbiomech.2019.12.009. https://doi.org/10.1016/j.clinbiomech.20...	3.78 ± 0.66	0.50 ± 0.34	p ≤ 0.01	VAS
Machado P.M. et al.³⁷37 Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377-84.	3.83 ± 0.99	0.75 ± 0.50	p ≤ 0.01	VAS
Knox M.F. et al.³⁶36 Knox MF, Chipchase LS, Schabrun SM, Marshall PWM. Improved compensatory postural adjustments of the deep abdominals following exercise in people with chronic low back pain. J Electromyogr Kinesiol. 2017;37:117-24.DOI:10.1016/j.jelekin.2017.10.009. https://doi.org/10.1016/j.jelekin.2017.1...	4.87 ± 2.03	2.97 ± 2.30	----	VAS

Study	Exercises	Muscle	Variable	Pre Pilates (M+- SD)	Pos Pilates (M+- SD)	Significance Leve
Alves M. C. et al.³3 Alves MC, De Souza Neto RJ, Barbosa RI, Marcolino AM, Kuriki HU. Effects of a Pilates protocol in individuals with non-specific low back pain compared with healthy individuals: Clinical and electromyographic analysis. Clin Biomech. 2019;72:172-8.DOI: 10.1016/j.clinbiomech.2019.12.009. https://doi.org/10.1016/j.clinbiomech.20...	Trunk Extension	RLE	Onset	1.03(0.18)	1.48(0.11)	p≤0.01
			Duration	6.00(0.32)	5.86(0.29)	----
			RMS	0.61(0.03)	0.51(0.02)	p=003
		RTrA/IO	Onset	2.18(0.44)	1.63(0.36)	----
			Duration	7.25(0.45)	6.87(0.41)	----
			RMS	0.12(0.00)	0.12(0.00)	----
Machado PM. et al.³⁷37 Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377-84.	Trunk Extension	LM	Onset	0.70(0.18)	1.22(0.10)	p=0.02
			Duration	4.99(0.31)	5.69(0.38)	----
			RMS	0.62(0.05)	0.48(0.03)	p=0.025
		TrA/IO	Onset	2.15(0.53)	1.79(0.59)	----
		TrA/IO	Duration	6.66(0.69)	6.72(0.71)	----
Knox MF. et al.³⁶36 Knox MF, Chipchase LS, Schabrun SM, Marshall PWM. Improved compensatory postural adjustments of the deep abdominals following exercise in people with chronic low back pain. J Electromyogr Kinesiol. 2017;37:117-24.DOI:10.1016/j.jelekin.2017.10.009. https://doi.org/10.1016/j.jelekin.2017.1...	PPAs	RA	Amplitude	3.12(1.58)	2.67(1.63)	----
		TrA/IO Ipsi	Amplitude	1.73(0.92)	1.14(1.33)	p<0.001
		TrA/IO Contra	Amplitude	4.24(1.62)	3.79(1.52)	----
		ES Ipsi	Amplitude	9.45(7.80)	8.01(3.08)	p<0.05
		ES Contra	Amplitude	16.40(7.52)	14.26(11.00)	----
	CPAs 1	RA	Amplitude	6.04(2.02)	5.36(2.58)	----
		TrA/IOIpsi	Amplitude	6.95(2.45)	8.56(4.98)	p=0.012
		TrA/IOContra	Amplitude	3.70(0.95)	3.58(1.37)	----
		ES	Amplitude	13.26(8.38)	11.78(4.78)	----
	CPAs 2	RA	Amplitude	8.49(6.57)	8.01(8.73)	---
		TrA/IOIpsi	Amplitude	5.21(2.10)	8.63(6.49)	p≤0.05
		TrA/IOContra	Amplitude	5.07(1.70)	4.60(1.39)	---
		ES Ipsi	Amplitude	12.70(4.42)	12.59(8.93)	----
		ES Contra	Amplitude	6.39(2.74)	7.94(7.17)	----

Study	Exercise	Muscle	Variable	Pre Pilates (M+- SD)	Pos Pilates (M+- SD)	Significance Level
Alves M. C. et al.³3 Alves MC, De Souza Neto RJ, Barbosa RI, Marcolino AM, Kuriki HU. Effects of a Pilates protocol in individuals with non-specific low back pain compared with healthy individuals: Clinical and electromyographic analysis. Clin Biomech. 2019;72:172-8.DOI: 10.1016/j.clinbiomech.2019.12.009. https://doi.org/10.1016/j.clinbiomech.20...	Trunk Extension –MVIC	RLE	Force	14.09(2.93)	24.28(2.53)	p≤0.01
	Right side bridge		Resistance	23.62(4.44)	37.77(5.00)	p=0.04
	Left side bridge		Resistance	23.07(5.03)	36.64(4.23)	p=0.04
	Sorensen Test		Resistance	44.46(6.11)	87.64(8.29)	p≤0.01
Machado P.M. et al.³⁷37 Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377-84.	Trunk Extension –MVIC	LM	Force	10.06(1.60)	18.50(2.15)	p=0.005
	Right side bridge		Resistance	14.09(2.35)	30.94(4.37)	p=0.003
	Left side bridge		Resistance	12.99(2.09)	32.38(5.37)	p=0.003
	Sorensen Test		Resistance	36.41(6.95)	74.40(9.69)	p=0.04

[1] Correspondence: Catarina Isabel Guerreiro Romão. Rua Infante Sagres, Lote 158, 1º direito, Lagos, Portugal.8600-743. catarinaromao97@gmail.com

Brasil

Brasil

THE EFFECT OF PILATES EXERCISES ON MUSCLE ELECTRICAL ACTIVATION IN ADULTS WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW

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