School of Health Sciences, University of East Anglia, Norwich, UK.
Locomotor Services, Homerton Healthcare NHS Foundation Trust, London, UK.
Musculoskeletal Care. 2023 Mar;21(1):78-96. doi: 10.1002/msc.1667. Epub 2022 Jul 1.
To compare the effects of Pilates exercise (PE) with other forms of exercise on pain and disability in individuals with chronic non-specific low back pain (CNSLBP) and to inform clinical practice and future research.
Systematic review with meta-analysis conducted and reported in line the Preferred Reporting Items for Systematic review and Meta-analysis.
Six electronic databases were searched from inception to April 2021.
Randomised controlled trials (RCTs) comparing the effect of PE with other forms of exercise for adults with CNSLBP on pain and disability.
Two reviewers assessed the risk of bias of the trials, guided by the Cochrane RoB2 tool. Available data were extracted for meta-analysis with subgroup analysis. Pilates exercise was compared to general exercise (GE), direction-specific exercise (DSE) and spinal stabilisation exercise (SSE). Certainty of evidence was interpreted following the Grading of Recommendations Assessment, Development and Evaluation approach.
Eleven RCTs were included. A low certainty of evidence supported PE was more effective than GE in pain reduction [Effect size (ES) 0.44]. Moreover, very low levels of certainty were revealed for effectiveness of PE compared with DSE for pain reduction (ES 0.65) and equivalence of PE and SSE for pain and disability.
This review found no strong evidence for using one type of exercise intervention over another when managing patients with CNSLBP. Existing evidence does not allow this review to draw definitive recommendations. In the absence of a superior exercise form clinicians should work collaboratively with the patient, using the individual's goals and preferences to guide exercise selection. Further appropriately designed research is warranted to explore this topic further.
比较核心稳定性训练（CSE）与其他运动形式对慢性非特异性下腰痛（CNSLBP）患者疼痛和功能障碍的影响，并为临床实践和未来研究提供信息。
系统综述，按照系统综述和荟萃分析的首选报告项目进行，并报告。
从开始到 2021 年 4 月，在 6 个电子数据库中进行了搜索。
比较 CSE 与 CNSLBP 成人其他运动形式对疼痛和功能障碍影响的随机对照试验（RCT）。
两位审查员根据 Cochrane RoB2 工具评估了试验的偏倚风险。对可用数据进行了荟萃分析和亚组分析。核心稳定性训练与一般运动（GE）、定向运动（DSE）和脊柱稳定运动（SSE）进行了比较。按照推荐评估、制定和评估方法（Grading of Recommendations Assessment, Development and Evaluation approach）解释证据的确定性。
纳入了 11 项 RCT。低确定性证据支持 CSE 在减轻疼痛方面比 GE 更有效[效应量（ES）0.44]。此外，对于 CSE 与 DSE 相比减轻疼痛（ES 0.65）和 CSE 与 SSE 相比减轻疼痛和功能障碍的有效性，也揭示了非常低水平的确定性。
本综述发现，在管理 CNSLBP 患者时，没有强有力的证据支持使用一种运动干预而不是另一种。现有的证据不允许本综述得出明确的建议。在没有优越的运动形式的情况下，临床医生应与患者合作，使用个体的目标和偏好来指导运动选择。需要进一步进行适当设计的研究来进一步探讨这个问题。
