The effects of the Pilates method on psychosocial factors associated with non-specific low back pain: A systematic review with meta-analysis

Objective: The aim of this review was to examine whether Pilates could influence the psychosocial factors associated with NSLBP Method: This review was conducted in accordance with the PRISMA guidelines. Seven databases were inspected from inception to March 2022: Pubmed, Scopus, Ovid, Embase, Sportdiscus, Psychinfo and ScienceDirect. Two independent authors reviewed the articles following the PICO(S) criteria, extracted the data and assessed the risk of bias. Where possible, meta-analysis was performed using a random-effect model to compare the effect of Pilates versus a control group. Heterogeneity was assessed by the I² statistic. Results: On the 1009 identified articles, 8 were deemed eligible for this systematic review comprising a total of 928 participants (658 women; 270 men) who had low back pain for at least 3 months and were followed for a period of at least 6 weeks and up to 12 months. Three studies were considered at low risk of bias, one at high and five with some concern. Conclusion: The qualitative and quantitative synthesis of the data suggests that, on the short term, Pilates has a positive influence on kinesiophobia, catastrophizing, self-efficacy and fear avoidance in people with non-specific low back pain compared to a control group without Pilates. On the long term, Pilates has a positive influence on kinesiophobia, self-efficacy and fear avoidance. The degree of certainty of the evidence assessed with the GRADE approach varies from low to very low.