Original research
Effectiveness of the Pilates Method in the Treatment of Chronic Mechanical Neck Pain: A Randomized Controlled Trial

https://doi.org/10.1016/j.apmr.2018.04.018Get rights and content

Abstract

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.

Section snippets

Study Design and Subjects

A randomized controlled trial was performed with a blinded assessor. The sample consisted of 64 individuals diagnosed with chronic mechanical neck pain who met the following inclusion criteria: (1) individuals from either sex; (2) aged 18 to 65 years old; (3) with pain for more than 3 months, according to the Neck Pain Task Force criteria4; (4) pain intensity between 3 and 8 cm on a 10 cm Numerical Pain Scale (NPS).

Excluded from the study were patients who had (1) a diagnosis of fibromyalgia;

Results

We initially recruited 244 individuals; 143 people did not meeting the inclusion criteria and 37 refused to participate. A total of 32 individuals were randomly included in each group. Two participants in the CG did not complete all of the scheduled assessments. One participant did not want to wait until the end of the study to start practicing Pilates, and another participant left the study due to a health problem unrelated to neck pain (brain aneurysm) (fig 1).

Regarding the collected data, 2

Discussion

The results of this trial show the benefit of Pilates for patients with chronic mechanical neck pain for pain, function, and some domains of quality of life. Pilates has therapeutic properties, and is often prescribed for individuals with chronic low back pain.13, 19 However, only a single pilot study using Pilates mat exercises for the treatment of chronic neck pain was found in the literature.23

The groups in the present study were homogeneous relative to the clinical characteristics at

Conclusion

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.

Supplier

  • a.

    SPSS, version 17.0; IBM.

References (31)

  • Z. Dimitriadis et al.

    Respiratory weakness in patients with chronic neck pain

    Man Ther

    (2013)
  • S. O’Leary et al.

    Training mode-dependent changes in motor performance in neck pain

    Arch Phys Med Rehabil

    (2012)
  • B. Cagnie et al.

    Individual and work related risk factors for neck pain among office workers: a cross sectional study

    Eur Spine J

    (2007)
  • D. Falla et al.

    The change in deep cervical flexor activity after training is associated with the degree of pain reduction in patients with chronic neck pain

    Clin J Pain

    (2012)
  • R. Fejer et al.

    The prevalence of neck pain in the world population: a systematic critical review of the literature

    Eur Spine J

    (2006)
  • Cited by (0)

    Clinical Trial Register No.: NCT02433821.

    View full text