TITLE OF THE TOPIC: A comparative study to evaluate hemodynamic changes in response to Pilates exercises in mechanical low back pain patients and healthy individuals.

Dr. Jyoti Mann, Assistant Professor, Geetanjali college of Physiotherapy, Udaipur, Rajasthan  

Abstract:
Background: Pilates exercises for the lumbar spine, which are done repeatedly, have been used in the management of low back pain for over three decades. The cardiovascular effects of exercises that involve postural stabilization, core strengthening, arm exercises and of exercises performed in lying are well known, but there are seldom studies performed to assess the cardiovascular effects of these commonly used Pilates exercises. Therefore the study focused on evaluating the effects of 6 commonly used Pilates exercises on the cardiovascular system.

METHODOLOGY:
This study includes 60 subjects both male and female of age 30-50 years who were eligible as per the inclusion criteria were divided into two groups- Group A (Low Back Pain individuals=30 subjects) and Group B (Healthy individuals= 30 subjects). Pre- participation questionnaire along with consent form and PARQ (Physical Activity Readiness Questionnaire) was given to subjects to fulfill criteria for selection. Each subject performed six Pilates exercises such as- Knee fold, Single leg stretch, Spine twist, Flight, Single leg stretch in standing and Hip extension for six weeks ; four days in a week. With each week repetitions and bouts were increased from 5and3 to 15and 13 respectively. Heart Rate and Blood Pressure (Systolic and Diastolic BP) were recorded pre and post intervention each day every week. Heart Rate was measured by manual palpatory method and Blood Pressure by Sphygmomanometer.

RESULTS:
Results showed that there was a significant difference in HR (p<0.05 in wk.4, p<0.05 in wk.5); SBP (p<0.01 in wk.1, p<0.01 in wk.2, p<0.05 in week 4); DBP (p<0.05 in wk.4, p<0.01 in wk.5, p<0.01 in wk.6) during pre exercise session and HR, SBP and DBP were significantly higher almost in all weeks during post exercise session of LBP and healthy individuals. Although, LBP individuals experienced more cardiovascular demand as number of repetitions increased but the intervention has cardiovascular effects on healthy individuals too.

CONCLUSION:
Pilates exercises have cardiovascular effects on low back pain patients. This effect was increased as the number of repetitions increase. Adequate cautions need to be taken while prescribing Pilates exercises complaining of low back pain with symptomatic or asymptomatic cardiovascular diseases. Proper cardiovascular monitoring will be required for low back pain as well as healthy individuals while prescribing Pilates exercises.

KEY WORDS: low back pain, pilates, heart rate, blood pressure.