A influência das variáveis biopsicossociais sobre os efeitos do método pilates em pacientes com dor lombar crônica

Abstract

INTRODUCTION: Nonspecific chronic low back pain (NCLBP) is one of the main public health problems worldwide, with significant impacts on individuals’ functionality and quality of life. The Pilates method has been widely used in the treatment of NCLBP, but the factors influencing clinical response are still not fully understood. OBJECTIVE: To investigate the influence of biopsychosocial variables on the effects of the Pilates method in individuals with NCLBP, using data from a randomized controlled trial. METHODS: Secondary analysis of a randomized controlled trial. RESULTS: The outcomes analyzed were the minimal clinically important difference (MCID) in pain and functional disability. Baseline sample characterization variables for pain (ΔPain), such as age, weight, height, BMI, NCLBP duration in months, Roland-Morris Disability Questionnaire (RMDQ), Hip Stability Isometric Test (HipSIT), Patient-Specific Functional Scale (PSFS), Tampa Scale for Kinesiophobia (TSK), group (high or low), sex, marital status, family income, prior treatment before the intervention, medication use, smoking, diagnosis of depression, and associated comorbidities were similar between both groups. Higher numerical pain rating scale (NPRS), higher education level, and no prior physical activity practice before the intervention were variables that distinguished participants who improved more in ΔPain. Baseline sample characterization variables for disability (ΔDisability) age, weight, height, BMI, NCLBP duration in months, RMDQ, NPRS, HipSIT, group, sex, education level, marital status, family income, prior treatment before the intervention, smoking, and associated comorbidities were similar between both groups. The variables lower PSFS, lower TSK, no medication use, and presence of a depression diagnosis distinguished participants who improved more in ΔDisability. Younger age and lower family income were predictors of greater improvement in ΔPain, while none of the other variables predicted improvement in ΔPain or ΔDisability regarding the effects of the Pilates method for NCLBP. CONCLUSION: Clinical Pilates provides relevant benefits in pain and functionality for people with NCLBP, regardless of most biopsychosocial factors, although younger individuals and those with lower socioeconomic status tend to experience greater pain reduction. The findings reinforce the effectiveness and applicability of the Pilates method as a comprehensive intervention in the management of NCLBP.