Pain, Function and Trunk/Hip Flexibility Changes Immediately after Clinical Pilates Exercises in Young Adults with Mild Chronic Low Back Pain

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Thanks for the opportunity of reviewing the present work.

 

Here below my comments for the authors.

Abstract

 

Background: as the subtitle says, here would be expected a backgroudn sentence rather than straight the aim. In case the authors, for some reason, would prefere starting with the aim, this must be stated. As it is now, the sentence is unclear as the authors start with “To investigate…”, maybe they meant the aim of the study was to…

 

Introduction

 

37-38: this sentence, related to the pandemic period sounds a bit out of context. Please consider to eliminate or to give some context in line with previous and following concepts.

 

Is not clear by what DMA Clinical Pilates differs from simple pilates (please consider to explain) and how this may induce improvements in strength, besides flexibility.

 

In turn, how improvements in these aspects may improve sympoms of LBP?

 

All these aspects are not clear enough in the introduction 

 

The authors tend to use interchangeably the terms stiffness, range of motion and flexibility. Please, consider to uniform your terminology and make clear/define precisely the aspect that must be underlined here.

 

Methods:

 

A graph representing the study design would be helpful.

 

Discussion:

 

The authors may consider to explain,  comparing with previous studies, why DMA clinical pilates should be preferred than classic pilates interventions. Does it give bigger acute results? Is it more easy to be done or more pleasant? 

 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The prospective cohort study presented for review was conducted correctly. The planned methodology is unquestionable, except for the reliability of the finger-to-floor test.

Author Response

We noted the reviewer’s concerns about the finger-to-floor test and have included a sentence in the discussion, cited below.

“Future measurement of FTFT could consider the use of digital tape measure using laser beam to minimise potential measurement error.”

Reviewer 3 Report

Comments and Suggestions for Authors

The study aims to contribute to the generation of clinical evidence that Pilates treatment is effective in reducing lumbar pain. The methodology seems ok; however, I have some observations regarding the lack of technology used to objectively quantify the parameters under investigation, considering the abundance of research that exists to instrument subjective scales. Additionally, the study design has the following problems:

 

Small Sample Size: The small sample size of 18 participants limits the generalizability of the results.

Selection Bias: Participants were recruited from an educational institution and through word of mouth, which may not represent the general population.

Lack of Control Group: The absence of a control group makes it difficult to attribute the observed changes solely to the Pilates Clinical intervention.

Participant Fatigue: Repeated strength and flexibility tests could induce participant fatigue, potentially affecting objective measures.

Reliance on Self-Reported Measures: While objective measures were used, subjective measures of pain and function can be influenced by psychological and individual perception factors.

Short Duration of the Study: The immediate post-intervention measurements do not reflect the long-term effects of Pilates Clinical exercises on managing chronic low back pain.

Limited Intervention Scope: The study focused only on mat exercises from the DMA Clinical Pilates approach, not evaluating the impact of other types of Pilates exercises.

Even so, it is understood that the authors aimed to verify this in a clinical environment, making their methodology valid in this context. The results are interesting, although, as they themselves mention, they are limited by the aforementioned methodological issues. However, the study provides a foundation for further research but requires more robust designs to validate and expand upon these findings.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf