Chronic low back pain is one of the most prevalent and debilitating conditions among older adults, often compromising physical function and overall quality of life. Structured physical exercise, particularly the Pilates method, is widely recommended for managing this condition. However, existing literature primarily focuses on younger populations using mat-based group classes. This pilot study utilizes an exploratory mixed-methods design to investigate the feasibility and preliminary outcomes of a 12-week individualized, machine-based Classical Pilates program on quality of life and low back pain in active older adults (aged 55 to 75 years). Participants will complete 24 individual sessions (twice a week). The aim is to assess changes in physical domains of quality of life and perceived low back pain intensity, while gathering qualitative contextual insights on body awareness and psychosocial well-being.
The study is designed as an exploratory, quasi-experimental, single-arm pilot study. Participants presenting with moderate disability caused by low back pain (Oswestry Disability Index = 21% to 40%) will undergo a structured exercise protocol utilizing the Classical Pilates method on machines in a one-on-one setting. The intervention spans 12 weeks, consisting of two individual 50-minute sessions per week. The pedagogical structure is divided into two distinct Classical approach components: the "Skeleton" (core base exercises on the Reformer and Mat) and the "System" (adaptations and specific exercises on auxiliary equipment like the Wunda Chair, Cadillac, and Barrels). Exercise progression is individualized based on biomechanical control, absence of pain, and ability to maintain a neutral lumbopelvic position. Resistance is modified primarily via adjustable springs on the equipment. Exercise intensity is strictly monitored using the Talk Test to ensure a light-to-moderate exertion level suitable for the geriatric demographic. Assessments are conducted at baseline and post-intervention (12 weeks) using the WHOQOL-Bref for quality of life and the Oswestry Disability Index Version 2.0 for low back pain disability. Additionally, a qualitative focus group will be conducted post-intervention with a subsample of participants to capture contextual insights regarding mobility, psychosocial benefits, and daily habit integration.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
16
A 12-week program consisting of two individual 50-minute sessions per week. The protocol integrates "Skeleton" exercises (Mat and Reformer) and "System" exercises (auxiliary equipment). The periodization varies the positional stimulus (starting on Mat for the first 6 weeks, and starting on Reformer for the final 6 weeks). Intensity is maintained at a light-to-moderate level, monitored continuously via the Talk Test.
Instituto Politécnico de Leiria
Leiria, Leiria District, Portugal
Change in Quality of Life
Assessed using the World Health Organization Quality of Life Brief (WHOQOL-Bref) questionnaire. It evaluates four domains: physical, psychological, social relationships, and environment. Responses for each item are recorded on a five-point scale ranging from 1 (minimum) to 5 (maximum), and the total domain scores are transformed to a 0 to 100 scale, where 0 is the minimum possible score and 100 is the maximum possible score. Higher scores indicate a better perceived quality of life.
Time frame: Baseline (Week 0) and Post-Intervention (Week 13).
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