Letter to the editor

Resumo

Dear Daniela Aparecida Biasotto-Gonzalez (Editor in chief of the ConScientiae Saúde)

We would like to present our sincere greetings and discuss the article “Efeito do Método Pilates na dor lombar: revisão integrativa” published in the ConScientiae Saúde, number 1, volume 18 and pages 133-140.¹ The article aimed to do evaluate the use of the Pilates method by physiotherapists on low-back pain. It the above-mentioned article, the authors discussed important aspects of the Pilates method over individuals who had low-back pain such as postural adjustments and strengthening improvements.

The Pilates method was first named “Centrology”, by its creator Joseph Pilates at the beginning of century XX.² It has been chosen by therapists to treat several clinical conditions.^3,4 Considering low-back pain, it is important to note that it is one of the main musculoskeletal conditions that disable people of different sexes and ages.⁵ Also, it presents a lifetime prevalence from approximately 49-90%.⁶

An important Cochrane systematic review published in 2015, showed that the Pilates method was able to decrease pain (mean difference of approximately 14 points in a 0 to 100 scale for pain) compared to minimal interventions during the short-term (less than 3 months). Besides, for an intermediate period (between 3 to 6 months) it decreased approximately 10 points (in a 0 to 100 scale for pain) compared to minimal interventions. Considering the comparison of the Pilates method to stationary cycling, cognitive activation of the trunk muscles, leg stretches, upper body weights, elastic bandage, Swiss ball, and floor exercises, the results showed that the Pilates method did not demonstrate to be more effective.⁷

In the method section of the integrative review, the eligibility criteria were not suited to answer the objective of the study properly, due to the limitation about language, period of publishing, and sample characteristics. Also, the exclusion criteria were the opposite of inclusion criteria. It is important to mention that for research; it was considered only two databases and the authors did not analyze the quality of the studies included.

At this point, the elaboration of reviews about the effects of the Pilates method on low-back pain must be done cautiously. Novelty studies are necessary. However, from the moment that exists a high-quality Cochrane systematic review, the publishing of reviews related to a theme must be evaluated. Clinical practice must be supported by systematic reviews of high-quality clinical trials. Nonetheless, at the moment that an integrative review concludes that the Pilates method generates positive effects to treat low-back pain without performing the proper analysis it is considered beyond the study design may provide.