Reformer Pilates vs Conventional Physiotherapy in Chronic Low Back Pain

Comparison of Reformer Pilates Exercises and Conventional Physiotherapy on Pain, Disability and Quality of Life in Individuals With Non-Specific Chronic Low Back Pain: A Randomized Controlled Trial

Non-specific chronic low back pain is one of the most prevalent musculoskeletal disorders worldwide and is associated with functional limitations and reduced quality of life. Exercise-based physiotherapy approaches are strongly recommended in clinical guidelines. Pilates exercises are frequently used due to their potential effects on core stability and movement control, while conventional physiotherapy remains a commonly applied treatment method. However, randomized controlled trials directly comparing these interventions are limited.

This study aims to compare the short-term effects of reformer Pilates exercises and conventional physiotherapy on pain intensity, functional disability and health-related quality of life in individuals with non-specific chronic low back pain.

This study is designed as a prospective randomized controlled trial with two parallel groups. Participants meeting eligibility criteria will be randomly allocated to reformer Pilates or conventional physiotherapy groups using computer-generated randomization.

Both groups will receive treatment three times per week for six weeks. The reformer Pilates program will focus on trunk stabilization, coordination and flexibility. The conventional physiotherapy program will include electrotherapy modalities and therapeutic exercises.

Participants will be evaluated before and after the intervention. Primary outcome will be pain severity measured by NRS. Secondary outcomes will include functional disability measured by ODI and quality of life assessed by SF-12.

Inclusion Criteria:

Individuals aged between 18 and 65 years

• Diagnosis of non-specific chronic low back pain lasting at least 12 weeks
• Average low back pain intensity ≥3 on the Numeric Rating Scale (NRS) during the last week
• Ability to participate in exercise sessions three times per week
• Providing written informed consent

Exclusion Criteria:

• Specific causes of low back pain (tumor, infection, inflammatory rheumatic disease, vertebral fracture)
• Radiculopathy or significant neurological deficits (progressive motor loss, severe sensory deficit, cauda equina syndrome)
• History of lumbar spine surgery within the past 6 months or current surgical indication
• Participation in regular Pilates or structured exercise programs within the last 3 months
• Severe cardiopulmonary disease or uncontrolled hypertension contraindicating exercise
• Pregnancy or early postpartum period
• Severe psychiatric or cognitive disorders affecting study compliance
• Participation in another physiotherapy or rehabilitation program during the study period