Effects of Pilates on low back pain : a scoping review

Abstract

The purpose of this scoping review was to map and synthesise the existing literature on Pilates-based interventions for low back pain (LBP), with particular attention to reported outcome domains, programme characteristics, and delivery context, and to identify gaps to inform future research and clinical practice. This scoping review was conducted in accordance with the Joanna Briggs Institute methodology and the PRISMA-ScR framework. Searches were performed in August 2025 using Google Scholar and HyDi (including Medline, Embase, CINAHL, Cochrane Library, PEDro, and Scopus). Eligible studies included randomised controlled trials and systematic reviews or metaanalyses involving adults with non-specific or subacute LBP in which Pilates was the primary intervention. Data were charted on population characteristics, intervention format, dose, supervision, comparator, and reported outcomes across clinical and psychosocial domains. Findings were synthesised narratively. The literature predominantly reports outcomes related to pain intensity, functional disability, and health-related quality of life, with fewer studies assessing psychosocial variables such as kinesiophobia or fear of movement. Pilates interventions varied substantially in delivery format (mat – versus equipment-based), frequency, duration, and level of supervision. Across studies, Pilates was commonly compared with minimal intervention or other exercise approaches, with short-term improvements in patient-reported outcomes frequently described. However, heterogeneity in intervention protocols, outcome measures, follow-up duration, and reporting of instructor qualifications limited cross-study comparability. Reporting of mechanistic outcomes and long-term follow-up was sparse. This scoping review demonstrates that the current literature on Pilates for LBP is characterised by diverse intervention approaches and outcome reporting, with a primary focus on pain and disability outcomes. While Pilates is commonly positioned as a guideline-consistent exercise option, important gaps remain regarding patient selection, instructor expertise, mechanistic pathways, and longterm outcomes. Future research should prioritise standardised reporting of intervention characteristics, broader biopsychosocial outcome assessment, and clearer description of delivery context to support more definitive evaluations.