Reformer Pilates Improved Mental, Physical Health in Chronic Neck, Back Pain

A new study has found that Reformer Pilates increased active living in patients with chronic low back pain and chronic neck pain and comprehensively enhanced mental and physical health.1

“Although Reformer Pilates exercises have become increasingly popular in recent years, the findings of existing studies remain inconsistent.2 Therefore, the present study aims to investigate the effects of Reformer Pilates on various dimensions of pain perception—including pain intensity, coping strategies, pain-related beliefs, and fear of movement—as well as on fatigue and sleep quality in young adult women with chronic musculoskeletal pain,” lead investigator Nilay Şahan, PhD, PT, Department of Occupational Therapy, Faculty of Health Sciences, Çankırı Karatekin University, Çankırı, Turkey, and colleagues wrote.1

Şahan and colleagues conducted a randomized, controlled, single-center study to investigate the effect of Reformer Pilates exercises on pain severity, pain coping methods, pain beliefs, fear of movement, fatigue and sleep quality in young adult patients with chronic low back pain and neck pain.

The study included 54 women aged between 30 and 50 randomized into 2 groups (n = 27 each). The Reformer Pilates (RP) group received a 6-week exercise program (45 min/twice per week), while the control group (CG) didn’t receive any exercise program. The study measured Brief Pain Questionnaire, Pain Coping Scale, Pain Beliefs Scale, Tampa Kinesiophobia Scale, FACIT Fatigue Scale and Pittsburg Sleep Quality Index before and after the interventions.1

At baseline, group characteristics were largely homogenous. After the intervention, Şahan and colleagues found statistical differences in favor of RP with a small to large effect size in pain parameters (P <.05; Cohen’s d = 0.17–1.45), large effect size in fear of movement, small effect size in fatigue and medium effect size in sleep quality (P <.05; Cohen’s d = 0.43–0.86). Specifically, they observed significant reductions in worst pain intensity (Mean difference (MD) = 2.18, 95% CI: 1.52–2.84, P <.001), least pain intensity (MD = 1.88, 95% CI: 1.29–2.48, P <.001), average pain (MD = 1.81, 95% CI: 1.21–2.42, P <.001) and current pain (MD = 2.14, 95% CI: 1.57–2.72, P <.001).1

They also found that that in Brief Pain Inventory, there were significant improvements in general activity (MD = 2.52, 95% CI: 1.86–3.17, P <.001), mood (MD = 2.62, 95% CI: 2.01–3.24, P <.001), walking ability (MD = 2.03, 95% CI: 1. 40-2.67, P <.001), work (MD = 1. 55, 95% CI: 1.04–2.06, P <.001), relationships with others (MD = 1.96, 95% CI: 1.30–2.61, P <.001), sleep (MD = 1.92, 95% CI: 1.24–2.61, P <.001) and enjoyment of life (MD = 2.48, 95% CI: 1.71–3.24, P <.001). Furthermore, active pain coping strategies (MD = -2.62, 95% CI: -4.01 to -1.24, P <.001) and improvement in the psychological subscale of the Pain Beliefs Scale (MD = 0.61, 95% CI: 0.21–1.01, P = .001) were significant between groups. Lastly, they found improvements in fear of movement (MD = 3.00, 95% CI: 2.44–3.55, P <.001), fatigue (MD = -6.18, 95% CI: -9.48 to -2.88, P <.001) and sleep quality (MD = 2.22, 95% CI: 1.26–3.18, P <.001). The effect sizes of these changes ranged from small to large (Cohen’s d = 0.17 to 1.45).1

After evaluating the treatment effects evaluated in terms of minimal clinically important difference (MCID), Şahan and colleagues found that only the improvements in pain intensity and fatigue scales met the threshold for clinical significance. Investigators did not find any statistical differences between the pain beliefs organic sub-heading of the Pain Beliefs Scale and in the passive strategies sub-headings of the Pain Coping Scale (P <.05).1

“According to the results of the study, Reformer Pilates exercises reduce pain perception and help patients with chronic musculoskeletal pain to cope with pain by providing body and mind unity. While previous studies have predominantly focused on the physical benefits of Pilates, the present study extends the scope by evaluating the neurophysiological and cognitive effects of Reformer Pilates, particularly in relation to pain beliefs and coping strategies. In this regard, it is believed to make a meaningful contribution to the existing gap in the literature,” Şahan and colleagues wrote.1

REFERENCES

1. Şahan N, Uluğ N, Özeren A. Effects of reformer pilates on pain, psychological factors, and sleep in chronic musculoskeletal pain: a randomized controlled trial. BMC Psychology. 2025;13(1). doi: 10.1186/s40359-025-03207-9

2. Denham-Jones L, Gaskell L, Spence N, Pigott T. A systematic review of the effectiveness of pilates on pain, disability, physical function, and quality of life in older adults with chronic musculoskeletal conditions. Musculoskelet Care. 2022;20(1):10–30. https://doi.org/10.1002/msc.1563