Is Pilates an effective tool for the management of kinesiophobia in musculoskeletal disorders?

BACKGROUND Kinesiophobia is a common condition often manifested in patients with musculoskeletal disorders within the process of rehabilitation. Recently, the literature has been investigating whether Pilates could contribute to the management of kinesiophobia in various musculoskeletal disorders. However, aggregated data regarding its effectiveness are absent from literature. AIM To evaluate recordings of the Pilates method in kinesiophobia related to musculoskeletal disorders. METHODS PubMed, ScienceDirect, Scopus and Pedro databases were all scrutinized for randomized controlled trials, by two or more intervention groups, where at least one group received a Pilates-based intervention and which had been conducted in patients aged 18-65 years with musculoskeletal disorders, having assessed at least one outcome related to kinesiophobia. The systematic review was based on the PRISMA guidelines. RESULTS We have identified five studies, with a total of 366 patients with musculoskeletal disorders. Three of them showed that a Pilates-based intervention by either mat or equipment can combat kinesiophobia in patients with musculoskeletal conditions, while another showed that Pilates exercises with equipment may have better long-term effects on kinesiophobia compared to Pilates mat. CONCLUSION Overall, a strong level of research evidence has been amassed for the Pilates intervention as well as a moderate level of research evidence for the effectiveness of equipment-based Pilates in reducing kinesiophobia in patients with musculoskeletal disorders. While the underlying mechanisms driving such a result remain unknown, it appears that Pilates can influence both biological and psychological factors in musculoskeletal disorders, thus resulting in the management of kinesiophobic behaviours.