for the main comparison.
| Pilates compared with minimal intervention for low back pain | ||||||
|
Patient or population: patients with low back pain Settings: primary or tertiary care Intervention: Pilates Comparison: minimal intervention | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Minimal intervention | Pilates | |||||
|
Pain NRS: scale from 0 to 100 (worse pain) Follow‐up: short‐term (less than 3 months from randomisation) |
The mean pain at short‐term follow‐up ranged across control groups from 33.9 to 52 points |
The mean pain at short‐term follow‐up in the intervention groups was
14.05 lower (18.9 to 9.2 lower) |
Mean difference ‐14.05 (‐18.91 to ‐9.19) | 265 participants (6 studies) | ⊕⊕⊝⊝ low1,2 | This is a moderate effect that is clinically relevant in this patient group |
|
Pain NRS: scale from 0 to 100 (worse pain) Follow‐up: intermediate‐term (more than 3 months and less than 12 months) |
The mean pain at intermediate‐term follow‐up ranged across control groups from 53 to 58.3 points |
The mean pain at intermediate‐term follow‐up in the intervention group was 10.5 lower (18.5 to 2.6 lower) |
Mean difference ‐10.54 (‐18.46 to ‐2.62) | 146 participants (2 studies) |
⊕⊕⊕⊝ moderate1 | This is a moderate effect that is clinically relevant in this patient group |
|
Disability Multiple scales: scale from 0 to 100 (worse disability) Follow‐up: short‐term (less than 3 months from randomisation) |
The mean disability at short‐term follow‐up ranged across control groups from 13.3 to 44.1 points |
The mean disability at short‐term follow‐up in the intervention groups was 7.95 lower (13.2 to 2.7 lower) |
Mean difference ‐7.95 (‐13.23 to ‐2.67) | 248 participants (5 studies) |
⊕⊕⊝⊝ low1,4 | This is a small effect that may be clinically relevant in this patient group |
|
Disability Multiple scales: scale from 0 to 100 (worse disability) Follow‐up: intermediate‐term (more than 3 months and less than 12 months) |
The mean disability at intermediate‐term follow‐up ranged across control groups from 27.9 to 44.4 points |
The mean disability at intermediate‐term follow‐up in the intervention groups was
11.2lower (18.4 to 3.9 lower) |
Mean difference ‐11.17 (‐18.41 to ‐3.92) | 146 participants (2 study) |
⊕⊕⊕⊝ moderate1 | This is a moderate effect that is clinically relevant in this patient group |
|
Function Patient Specific Functional Scale: used in a 11‐point scale from 0 to 10 (greater functional ability) Follow‐up: short‐term (less than 3 months from randomisation) |
The mean function at short‐term follow‐up in the control group was 6.4 points |
The mean function at short‐term follow‐up in the intervention group was 1.1 higher (0.2 to 2.0 higher) |
Mean difference 1.10 (0.23 to 1.97) | 86 participants (1 study) |
⊕⊕⊝⊝ low1,3 | This is a small effect that may be clinically relevant in this patient group (results from 1 single study) |
|
Function Patient Specific Functional Scale: used in a 11‐point scale from 0 to 10 (greater functional ability) Follow‐up: intermediate‐term (more than 3 months and less than 12 months) |
The mean function at intermediate‐term follow‐up in the control group was 6.1 points |
The mean function at intermediate‐term follow‐up in the intervention group was 0.8 higher (0.0 lower to 1.6 higher) |
Mean difference 0.80 (‐0.00 to 1.60) | 86 participants (1 study) |
⊕⊕⊝⊝ low1,3 | The difference is not statistically or clinically significant (results from 1 single study) |
|
Global impression of recovery Global Perceived Effect Scale: scale from ‐5 to +5 (greater recovery) Follow‐up: short‐term (less than 3 months from randomisation) |
The mean global impression of recovery at short‐term follow‐up in the control group was 1.7 points |
The mean global impression of recovery at short‐term follow‐up in the intervention group was 1.5 higher (0.7 to 2.3 higher) |
Mean difference 1.50 (0.70 to 2.30) | 86 participants (1 study) |
⊕⊕⊝⊝ low1,3 | This is a small effect that may be clinically relevant in this patient group (results from 1 single study) |
|
Global impression of recovery Global Perceived Effect Scale: scale from ‐5 to +5 (greater recovery) Follow‐up: intermediate‐term (more than 3 months and less than 12 months) |
The mean global impression of recovery at intermediate‐term follow‐up in the control group was 1.7 points |
The mean global impression of recovery at intermediate‐term follow‐up in the intervention group was 0.7 higher (0.1 lower to 1.5 higher) |
Mean difference 0.70 (‐0.11 to 1.51) | 86 participants (1 study) |
⊕⊕⊝⊝ low1,3 | The difference is not statistically or clinically significant (results from 1 single study) |
| Adverse events | See comment | See comment | Not estimable | See comment | Only 1 included trial assessed adverse events and none were reported | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1Downgraded one level due to imprecision (fewer than 400 participants, total).
2 Downgraded one level due to risk of bias (> 25% of the participants were from studies with a high risk of bias).
3Downgraded one level due to clear inconsistency of results.
4Downgraded one level due to inconsistency (I² > 50%).