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26]

Original Article

Comparative Effect of Mat Pilates and Egoscue Exercises

in Asymptomatic Individuals with Lumbar Hyperlordosis:
A Randomized Controlled Trial
Gayatri S. Kudchadkar, Peeyoosha Gurudut, Aarti Welling
Department of Orthopedic Physiotherapy, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India

Abstract Context: Correcting lumbar hyperlordosis, a main cause of back pain, will reduce the stress on the lumbar
spine thereby preventing future problems in back and lower limb. Clinical trials are lacking where mat Pilates,
Egoscue exercises and lumbar stabilization exercises are compared for their effect on spinal malalignment.
Aims: This study aims to compare the effectiveness of Pilates, Egoscue, and lumbar stabilization exercises
for reducing hyperlordosis angle in asymptomatic individuals with lumbar hyperlordosis.
Settings and Study Design: A randomized controlled trial conducted on volunteer participants from Health
Science University of Belagavi.
Materials and Methods: Asymptomatic individuals with lumbar hyperlordosis (n = 51) were randomly
allocated to Pilates, Egoscue and Lumbar stabilization groups. Outcomes assessed were index of lumbar
lordosis, pelvic tilt, and tolerance to exercise performance which was measured at baseline and after 4 weeks.
Results: There was significant reduction in the hyperlordosis score (P < 0.001) in the three study groups
when compared for pre‑and post‑intervention scores. However, more reduction was seen in the Pilates and
Egoscue groups compared to the lumbar stabilization. Pilates and Egoscue groups were equally effective in
Lumbar lordosis angle (P = 0.68) and pelvic tilt (P = 0.51). Participants of Pilates group graded the exercises
with superior tolerance to performance (P < 0.0006) than Egoscue and Lumbar stabilization.
Conclusion: Pilates group and Egoscue group were equally effective and superior to lumbar stabilization
group in correction of hyperlordosis. Further, ease of performance of exercise was rated high for Pilates
than the Egoscue exercise. These exercises should be included by the clinicians in preventive or corrective
rehabilitation towards spinal posture malalignments.

Keywords: Correction, Exercises, Hyperlordosis, Lumbar spine, Posture

Address for correspondence: Dr. Peeyoosha Gurudut, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India.
E‑mail: [email protected]

INTRODUCTION be 6.2% in the general population and 90% in construction

workers.[1] It is estimated that 1 out of 25 people will leave
The prevalence of low back pain (LBP) in India is found to their job due to LBP.[2] Studies have shown that approximately
90.5% of people having LBP have alteration in the lumbar
Access this article online spine alignment.[3] A study states that 70% of the population
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DOI: For reprints contact: [email protected]

10.4103/ijptr.ijptr_38_19
How to cite this article: Kudchadkar GS, Gurudut P, Welling A. Comparative
effect of mat pilates and egoscue exercises in asymptomatic individuals
Received: 20‑05‑2019, Revised: 08-11-2019, with lumbar hyperlordosis: A randomized controlled trial. Indian J Phys Ther
Accepted: 10‑11‑2019, Web Published: 23-12-2019 Res 2019;1:79-88.

© 2019 Indian Journal of Physical Therapy and Research | Published by Wolters Kluwer ‑ Medknow 79

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Kudchadkar, et al.: Mat pilates vs. egoscue exercises on lumbar hyperlordosis

with LBP has postural deviations in spine changing the colleges of Health Science University, Belagavi, Karnataka,
normal relationships between spine and pelvis.[2,4] India from April 2018 to March 2019. The study was
approved by the Institutional Research and Ethics Committee
Maintenance of normal limits of lumbar lordosis is necessary (KIPT/183/14/05/18). The trial is registered with the Clinical
for obtaining ideal posture.[5] Lumbar hyperlordosis is an Trial Registry‑India (CTRI/2018/07/015086). All the individual
acquired disorder having increased concavity posteriorly that participants in this study gave written informed consent.
may be caused due to poor posture, inactivity, improper shoes,
etc.[6,7] This occurs to compensate the inclination of the sacrum Participants and randomization
to get back its upward orientation.[8] Lumbar hyperlordosis is All individuals with lumbar hyperlordosis were screened
characterized by muscle imbalance with the tightness of back for inclusion and exclusion criteria. Individuals were
and hamstring muscles with weakness of abdominals.[6,9,10] informed about the aims and procedure of the study and
were included if they had positive prone hip extension
According to Kendall’s theory, exercises are the commonest test,[22] no physical complaints at spine, within the age group
method to correct abnormal posture, with stretching of of 18–40 years, and anterior pelvic tilt angle of  >13°.[23]
shortened soft tissue structures and strengthening the weak Individuals were excluded if they had any history of back
musculature.[11] Pilates exercises aim at promoting good posture injury, LBP having localized or radiating pain, undergone
by improving the strength and flexibility of the muscles around treatment for LBP in past 6 months, and practiced any kind
the lumbar spine.[12] Various studies have shown its effectiveness of exercise or sports activity during last 6 months.
in the management of lumbar hyperlordosis in the immediate
postpartum period,[9] LBP[13] and chronic mechanical neck Sample size calculated was fifty‑one  (51), based on the
pain.[14] Lumbar stabilization exercises are motor control previous literature considering effect size with α value 1.96
conventional exercises that provide internal stabilization at and β value 0.842.[8] Allocation to the groups was done
spine and trunk enhancing the control of the neuromuscular using lottery method. The subject randomly picked up the
system, strength, and endurance.[15,16] Literature has shown it chit, with each number corresponding to the group.[24] The
to be effective in LBP,[17] and in spinal and the pelvic pain.[18] individuals were subsequently allocated into three study
groups, viz. Pilates, Egoscue, and Lumbar stabilization
A novel form of exercise known as the Egoscue groups with 17 in each group [Figure 1].
exercises, was developed where focus was to target the
musculoskeletal dysfunction with the theory to bring Measurement of treatment outcomes
back the postural balance through corrective exercises. It Degree of lumbar lordosis using index of lumbar lordosis
is suggested to be effective in rectifying poor posture.[19,20] A 61 cm Surveyor’s flexi curve was used. It was molded to
To the best of our knowledge and literature search, only the curve of the spine and traced on a paper to calculate
one study has been published to evaluate the efficacy of the index of lordosis. Maximum width and the total length
Egoscue exercises in chronic hip and knee pain and is of the curve were measured. The formula used was θ° = 4
found to be effective.[21] However, no study has been done (arc tan [2H/L]), where L = vertical line joining the T12 and
to see the effect of these exercises on spinal malalignment. S2 vertebrae and H = maximum width that is the deepest
part of the curvature [Figure 2a].[25]
Further, there was paucity of literature where comparison
was done between the Pilates and stabilization exercises Percentage of lumbar lordosis using index of lumbar lordosis
on hyperlordosis correction. Hence, the present study was Same instrument and procedure as used for the degree
undertaken to compare the effects of the exercises on correction of the lumbar lordosis except for the formula used:
of lumbar lordosis. The aim of the study was to assess and IL = lumbar width/lumbar length × 100 [Figure 2a].[26]
compare the effectiveness of Mat Pilates, Egoscue exercises
and Lumbar stabilization, in reduction of lumbar lordosis Anterior pelvic tilt using pelvic inclinometer
angle, anterior pelvic tilt and to see the tolerance to exercise The subject was asked to stand with the feet shoulder‑width
performance (TTEP) in asymptomatic individuals with apart. Even pressure was applied to both the arms of the
lumbar hyper‑lordosis. inclinometer at anterior superior iliac spine and posterior
superior iliac spine, with a bubble in the center the reading
MATERIALS AND METHODS was then measured in degrees [Figure 2b].[27]

Study design and ethical consideration Tolerance to exercise performance using Borg’s scale
The study was a parallel design randomized controlled The scale consists of 6–20 scores on which the words are
trial conducted on volunteer participants from constituent printed as “very very light” at 7 and “very very hard” at 19.
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Kudchadkar, et al.: Mat pilates vs. egoscue exercises on lumbar hyperlordosis

Figure 1: CONSORT chart

In this scale 6 states no exertion and 20 states maximum Pilates group (n = 17)

exertion.[28] This was done to guage the difficulty level Individuals in this group received Mat Pilates exercises
of the exercises that were performed in each group and with each week having a different set of exercises
to find which exercises were graded with more ease of [Table 1 and Figure 3].[7,9,31] Each exercise was performed
performance. for 5 times.

Intervention Egoscue group (n = 17)

Table 1 shows exercise and dosage including the The Egoscue group received a total of 10 exercises which
included static back alone and with breathing, abdominal
progression for 3 study groups.
contraction while in the static back position, abductor press,
Common intervention overhead extension, elbow curls on wall, static wall, upper
spinal twist, pelvic tilts, supine groin progressive, and air
The common treatment given to the participants of
bench exercises [Table 1 and Figure 4].[19]
the three study groups consisted of stretching exercises
[Table 1]. The passive stretching was given to hamstring, Lumbar stabilization group (n = 17)
ilipsoas, rectus femoris and tendo-achilles muscles The Lumbar stabilization group received stabilization
bilaterally.[29,30] Three stretches were given with each stretch exercises which included crook lying, crook lying with
was held for 30 s. one leg extended and resting down on couch, prone
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Table 1: Exercise chart

Groups Pilates group Egoscue group Lumbar stabilization group
Common Stretching for Hamstring muscle, Rectus femoris muscle, Iliopsoas muscle, Tendoachillis muscle
intervention
Exercises Week 1: Leg slides, hip release, knee to chest, Static back and static back with Crook lying position, crook lying
spinal rotation, single knee extension, cat stretch, breathing, abdominal contraction with one leg extended and resting
neutral to imprint [Figure 3a] while in the static back position, down on the couch, prone lying with
Week 2: Imprint table top position, ab prep, Imprint abductor press, overhead extension, arms at the side and head turned to
table top toe touching floor, imprint table top elbow curls on wall, static wall, upper opposite side, quadruped position
knee extensions, spine twist, Ab prep in table top spinal twist, pelvic tilts, supine groin with head at neutral, Supine lying with
position, bridging [Figure 3b] progressive, and air bench [Figure 4] one knee flexed resting on couch and
Week 3: Half roll back, pull up; pull up with leg other knee flexed to be held without
extension, swimming exercise, single leg extension, support, supine lying with both the
leg circles, and single leg stretch [Figure 3c] legs extended and one leg raise, plank
Week 4: Bridging on the ball, spine stretch forward, position, erect sitting on chair, sobath
single leg lift, double knee lifts, upward dog, and ball [Figure 5]
shell stretch [Figure 3d]
Dosage Each exercise was performed for 5 times Week 1: 3 times with 30 s hold time Week 1: 3 times with 30 s hold time
Week 2: 5 times with 30 s hold time Week 2: 5 times with 30 s hold time
Week 3: 15 times with 30 s hold time Week 3: 15 times with 30 s hold time
Week 4: 20 times with 30 s hold time Week 4: 20 times with 30 s hold time

between the groups was done using independent

t‑test/Mann–Whitney U‑test and within the group with
Paired t‑test/Wilcoxon sign rank test. Comparison of the
difference in pre‑and post‑between the groups is done by
ANOVA. P < 0.05 was considered as statistically significant.

RESULTS

Table 2 provides details on the demographic profile and

the baseline characteristics of participants.

There was a statistically significant reduction in the mean

of Index of lumbar lordosis (degree and percentage) and
anterior pelvic tilt scores among all the three groups, when
a b
compared for pre‑and post‑intervention scores indicating
Figure 2: (a) Calculation of index of lumbar lordosis, (b) Measuring
improvement with all three forms of exercises. For TTEP
the pelvic tilt with the pelvic inclinometer in Pilates Group, the P value was significant (P < 0.0006);
but the P value for Egoscue group and lumbar stabilization
lying with arms at the side and head turned to opposite groups were 0.1559 and 0.7768, respectively, which was not
side, quadruped position with head in neutral, supine statistically significant [Table 3].
lying with one knee flexed resting on couch and other Index of lumbar lordosis (degrees and percentage) and
knee flexed to be held without support, supine lying pelvic tilt for Pilates group (P < 0.0001) and Egoscue
with both the legs extended and one leg raise, sitting on group (P < 0.0001) were significantly different from
chair erect, plank position, sitting erect on Bobath ball Lumbar stabilization group [Table 4]. However, there
[Table 1 and Figure 5].[16] was no significant difference between Pilates group and
Egoscue group (P = 0.68) in degrees, (P = 0.9361) for
Exercises in all the three groups were done on alternate percentage and (P = 0.51) for pelvic tilt. The lumbar
days for 3 times in a week for a period of 4 weeks with lordosis angle (degrees and percentage) and pelvic tilt
stretching prior to the exercises. reduced in all the 3 groups, but more reduction was seen
in the Pilates group and Egoscue group when compared
Statistical analysis to the lumbar stabilization group.
Statistical analysis was done using R software version 3.5.1
(2018, Vienna, Australia). Normality distribution was For TTEP in Pilates group, the P value was (P < 0.0006)
assessed using the Kruskal–Wallis test. Comparison in the Pilates group. But the P value for Egoscue group
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a b

c d
Figure 3: (a) Pilates week 1 exercises (i) Hip release (ii) Spinal Rotation (iii) Cat stretch (iv) Neutral to imprint (v) Knee to chest (vi) Single
knee extension (vii) Leg slides, (b) Pilates week 2 exercises (i) Bridging (ii) Spine twist (iii) Imprint table top position (iv) Imprint table top knee
extension (v) Imprint table top touching floor (vi) Ab prep in table top position (vii) Ab prep (c) Pilates week 3 exercises (i) Half roll back (ii) Single
leg extension (iii) Single leg stretch (iv) Leg circles (v) Pull up (vi) Pull up with extension (vii) Swimming extension, (d) Pilates week 4 exercises
(i) Bridging on ball (ii) Double knee lift (iii) Upward dog (iv) Spine stretch forward (v) Shell stretch

Table 2: Summary of the demographic data and the baseline and lumbar stabilization groups were 0.1559 and 0.7768
characteristics respectively which was not statistically significant
Factors Group P
[Table 3]. Ease of exercise performance was graded
Group A Group B Group C
Gender, n (%)
during the exercise and the individuals in Pilates group
Male 6 (35.29) 2 (11.77) 2 (11.77) ‑ were able to tolerate the exercise better while Egoscue
Female 11 (64.71) 15 (88.23) 15 (88.23)
Age# 23.94±1.30 22.71±1.49 22.77±1.35 0.0261* exercise group found the exercises to be difficult to
BMI# 26.91±4.23 24.41±3.03 23.18±4.90 0.0347* perform whereas in lumbar stabilization group graded
#
Kruskal‑Wallis test, *The significance. Group A indicates the Pilates
Group, Group B indicates the Egoscue Group and Group C indicates the
the exercises to be constant throughout the exercise
lumbar stabilization Group time.

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a b c

d e f g

h i j

k
Figure 4: Egoscue exercises (a) Static back (b) Static back with abdominal contraction (c) Abductor press (d) Pelvic tilts (e) Static extension (f)
Elbow curls (g) Air bench (h) Static wall (i) Overhead extension (j) Spinal twist (k) Supine groin progression

and lumbar stabilization exercises in individuals with

lumbar hyperlordosis.
a b c The result from the statistical analysis showed that the
Pilates group and Egoscue group were better in the
reduction of lumbar lordosis and anterior pelvic tilt as
d e f compared to lumbar stabilization group. Further individuals
in the Pilates group reported better TTEP than the other
groups.

Lumbar hyperlordosis could have been reduced with Pilates

intervention due to the following reasons. Hyperlordosis
is characterized by tightness of the lumbar multifidus,
g h i thoracolumbar fascia, erector spinae, rectus femoris and
Figure 5: Lumbar stabilization exercises (a) Crook lying (b) Supine iliopsoas along with weakness of abdominal muscles, pelvic
lying with leg raise (c) Crook lying with Ext (d) Prone lying (e) Plank floor muscles and asymmetrical tension in lumbo pelvic
position (f) Quadripod position (g) Supine lying with one knee flexed
(h) Sitting on Bobath (i) Sitting on chair
region. Pilates exercises focus on core and breath control
that activates local muscles especially the diaphragm, lumbar
DISCUSSION multifidus, pelvic floor muscle, transverse abdominal
muscle, and the obliques.[6] Another possible reason for the
The present randomized controlled trial was done to change in lumbar lordosis angle and the anterior pelvic tilt
compare the effect of Pilates exercises, Egoscue exercises could be that Pilates exercises involve muscle conditioning

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Table 3: Comparison of pre‑ and post‑intervention for 3 study groups

Time Group
points Group A Group B Group C
Mean±SD P Mean±SD P Mean±SD P
TTEP#
Pre 9.94±2.13 0.0006* 16.06±1.68 0.1559 6.24±0.44 0.7768
Post 8.06±2.05 15.35±1.69 6.29±0.47
ILL
Pre 48.88±4.13 <0.0001* 47.07±5.31 <0.0001* 45.71±6.34 0.0091*
Post 39.16±4.35 38.09±6.08 43.43±6.04
LLC
Pre 32.16±8.25 <0.0001* 32.4±9.21 <0.0001* 29.85±7.54 0.0004*
Post 23.26±8.21 23.62±10.18 26.66±7.49
PT
Pre 25.04±3.03 <0.0001* 21.38±4.40 <0.0001* 21.29±5.10 <0.0001*
Post 18.53±3.04 15.45±3.85 19.21±5.42
#
Wilcoxon sign rank test, *The significance. Group A indicates the Pilates Group, Group B indicates the Egoscue Group and Group C indicates
the lumbar stabilization Group. TTEP: Tolerance to exercise performance, ILL: Index lumbar lordosis (degrees), LLC: lumbar lordosis curve in
(percentage), PT: Pelvic tilt (degrees), SD: Standard deviation

Table 4: Comparison of between group differences for all the outcome measures
Group A Group B Group C
Outcome Difference Relative change (%) Difference Relative change (%) Difference Relative change (%) P
TTEP# 1.88±0.99 −18.91 0.71±2.02 −4.4 −0.06±0.66 0.8 0.0005*
ILL 9.72±1.93 −19.90 8.98±2.48 −19.10 2.28±3.17 −4.99 <0.0001*
LLC 8.91±2.21 −27.67 8.61±2.24 −26.74 3.19±2.92 −10.69 <0.0001*
PT 6.51±1.40 −26.00 5.93±1.58 −27.74 2.08±1.60 −9.77 <0.0001*
#
Kruskal‑Wallis test. Group A indicates the Pilates Group, Group B indicates the Egoscue Group and Group C indicates the Lumbar stabilization Group.
TTEP: Tolerance to exercise performance, ILL: Index lumbar lordosis (degrees), LLC: lumbar lordosis curve in (percentage), PT: Pelvic tilt (degrees),
*Statistically significant

that focuses on recruiting most abundantly used motor change was seen in lumbar posture which was unexpected
units. Type I fibers are recruited the most in day to day finding according to authors. The reason for no change in
activities which are abundant in mitochondria, oxidative the lumbar angle was mentioned to be probably because
enzymes, and capillaries. Pilates exercise mainly focuses on individuals were not encouraged to maintain good posture
Type I fibers, thereby improving the strength and endurance while doing activities of daily living. However, present
of these fibers at the lumbar spine. This improvement study showed positive results in which young participants
will enhance synchronous stimulation of these motor were included as compared to the above‑mentioned study
units conditioning the muscles that are responsible for where older adults formed the study population.[32] Another
maintaining lumbar lordosis.[9] study was done to see the effect of Pilates on spine posture.
The change was seen in the thoracic curve and length of
A study was conducted by McNellis et  al. to check the
the spine while the minimal change was seen in lumbar
effectiveness of Pilates exercises on lumbar hyperlordosis.
lordosis and pelvic tilt. This insignificant improvement
The findings of the study showed improvements in the
could be due to the fact that the exercises were performed
lumbar hyperlordosis after 4 weeks.[31] Another study was
done to show the efficacy of Pilates exercises on lumbar only once in a week.[33]
hyperlordosis immediately after the postpartum period
In the present study Pilates exercises also showed
and found a significant decrease in lumbar hyperlordosis.[9]
improvement in an anterior pelvic tilt. This could be due
Similar improvements in another study were noted after
8 weeks of Pilates exercises on lumbar lordosis correction.[7] to the fact that Pilates exercises focus on posterior pelvic
The findings of these studies were in accordance with the tilt. Posterior pelvic tilt has been promoted to cause
findings of the present study. co‑contraction of the local stabilization musculature.
This will recruit abdominal muscles thereby preventing
However, literature also shows studies with contradicting excessive anterior pelvic tilt which will reduce the lumbar
results using Pilates as an intervention for lumbar spine hyperlordosis.[34] Habibi et  al. stated that the weakness
posture correction. Yi‑lang et al. conducted a study where of anterior pelvic muscle causes an increase in lumbar
Pilates exercises were given in older adults. No significant lordosis. Secondly, hamstring muscle is connected to the

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pelvic bone. Changing the length of hamstring can change contradictory results. A study was conducted to see the
the position of pelvis thereby correcting and changing the effect of abdominal strengthening on lumbar lordosis and
spinal curvatures.[35] pelvic tilt which did not show any change in lumbar lordosis
angle, the reason could be that the protocol used mainly
The main motive of the Egoscue Method is to apply focused on abdominal muscle rather than focusing on
corrective exercises to get the whole body or the spine trunk extensors and hip muscles to correct the imbalance.[10]
closer to “ideal” posture which will help in reducing the Another study was done to see the effectiveness of lumbar
pain. In the present study, the exercises selected were mainly stabilization, Pilates exercises and dynamic strengthening
focused on the lumbar and pelvic region. This might have exercises in LBP. The findings showed that lumbar
corrected the posture at the lumbar spine and the pelvis stabilization was superior then Pilates and Dynamic
in turn reducing the curvature of the lumbar spine and strengthening exercise group. This indifference could
pelvic tilt. The exercises included have caused more of be due to the fact that the outcome measures used were
the posterior tilting at the pelvis than the anterior tilting. different in both the studies and the study population
Egoscue exercises have stretched and strengthened the included was patients with LBP.[16]
muscles effectively in order to correct the spine and the
pelvis posture. They are majorly corrective exercises and In one of the study, the authors have concluded that
the main focus of these exercises is that it corrects the Pilates‑based exercise program was feasible for the elder
whole body posture.[19] population.[32] In present study Pilates exercises were
progressed from simple form to advanced form across
Literature suggests corrective exercises to improve 4 weeks. Individuals in Egoscue exercise group found the
posture positively and since Egoscue exercises are similar exercises to be difficult to perform with more soreness
to corrective exercises it has also shown beneficial due to longer and static hold time, however lumbar
effect. A  study was conducted by Yazidi et  al. to see stabilization group graded the exercises to be constant
the effectiveness of corrective exercises on thoracic throughout the exercise time, although the exercises were
kyphosis and lumbar lordosis which showed significant given in a progressive manner by increasing the number
improvements after 8 weeks.[8] These results were similar of repetitions.
to the present study as the corrective exercises focuses on
the strengthening, endurance, and flexibility of the muscle This study had limitations like the follow up was not done
which will accelerate the posture correction. to better understand the carryover effect and recurrence
rate. Standard outcome measures like X‑ray could have
Till date, only one study has been published on Egoscue been used to measure the angle of lordosis. Other
exercises. A study was conducted to see the effect of curvatures of the spine could have been assessed as change
Egoscue exercises in hip and knee pain conducted for in one spinal curvature will change the curvature at the
2 weeks. Significant improvements in pain and function other spinal levels.
were seen. This change was due to the correction of
the malaligned posture which will reduce the overuse More studies using Egoscue exercises can be conducted on
or increases the activity of underused skeletal muscle to the different patient population. Electromyography can be
correct the muscle imbalance.[25] Similar effect might have used to study the muscle activity of abdominal and the trunk
occurred in the present study as there was a change in extensor muscles during the Egoscue exercise. Comparative
lumbar spine posture. study between older and younger individuals can be done
for LBP or posture corrections using the same exercises.
Lumbar stabilization exercises are said to reduce the load on
the spine and reduce the stress on the spinal structures.[36] CONCLUSION
Stabilization exercises have been planned to improve the
neuromuscular control system and perfect the dysfunction. Pilates exercises, Egoscue exercises, and Lumbar
Lumbar stabilization exercises help in enhancing motor units stabilization exercises for 4 weeks were all effective in
which are regulated by a large unit muscle system as well as the reducing the lumbar hyperlordosis angle and anterior pelvic
local muscular system. This helps in building up the postural tilt. However, Pilates group and Egoscue group were found
control of the muscles of the trunk and abdominal.[37] to be equally effective and superior to lumbar stabilization
group. Further, ease of performance of exercise was rated
In literature review done so far on the efficacy of lumbar highest for Pilates followed by lumbar stabilization which
stabilization exercises on the lumbar spinal curve shows was followed by the Egoscue exercise.
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Muscles). Philadelphia: Lippincott Williams and Wilkins; 2005.
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The authors certify that they have obtained all appropriate prediction rule for identifying a subgroup of patients with low back
pain likely to benefit from Pilates‑based exercise. J Orthop Sports Phys
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given his/her/their consent for his/her/their images and 14. de Araujo Cazotti L, Jones A, Roger‑Silva D, Ribeiro LHC, Natour J.
other clinical information to be reported in the journal. Effectiveness of the Pilates Method in the Treatment of Chronic
The patients understand that their names and initials will Mechanical Neck Pain: A randomized controlled trial. Arch Phys Med
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not be published and due efforts will be made to conceal 15. Cynn HS, Oh JS, Kwon OY, Yi CH. Effects of lumbar stabilization
their identity, but anonymity cannot be guaranteed. using a pressure biofeedback unit on muscle activity and lateral
pelvic tilt during hip abduction in sidelying. Arch Phys Med Rehabil
Acknowledgment 2006;87:1454‑8.
16. Bhadauria  EA, Gurudut  P. Comparative effectiveness of lumbar
We are grateful to the head of the institution for granting stabilization, dynamic strengthening, and Pilates on chronic low back
us permission to conduct the study and use the research pain: Randomized clinical trial. J Exerc Rehabil 2017;13:477‑85.
related infrastructure. Our heartfelt thanks to the Health 17. Stanford ME. Effectiveness of specific lumbar stabilization exercises:
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18. Ferreira  PH, Ferreira  ML, Maher  CG, Herbert  RD, Refshauge  K.
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participating in the study, without whom the study would review. Aust J Physiother 2006;52:79‑88.
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20. Egoscue P, Gittines R. The Egoscue Method of Health Through
Financial support and sponsorship Motion. William Morrow Paperbacks; 1993.
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Conflicts of interest and Dissertations 2014:5280.
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Rochon R. Interexaminer reliability of the hip extension test for
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