Pilates
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The Pilates Group will undergo a specific exercise program including modified [38] mat-based and equipment-based Pilates exercises. In the first session, participants will receive basic training on the Pilates method and power house activation, which is the isometric contraction of the transverse abdominis, multifidus, and pelvic floor muscles during expiration [12, 44]. Power house activation will always be combined with the exercises in order to stabilize low back. The session will be divided into: warm-up and global stretching (5 min), exercises for the upper and lower limbs, abdomen, and spine (45 min), global stretching (5 min), and relaxing local massage (5 min). There will be a minimum of five exercises and a maximum of 15 exercises in each session. Each exercise will be selected individually, according to the objective of the treatment and preference of the patient and adapted if patient’s pain worsens. For example, if the objective of the treatment is to strengthen gluteus muscles and patient cannot get into a desired position or feels pain, the exercise will be adapted to another position or equipment without changing its objective. The exercises will be modified so that they can be performed at three levels of difficulty: basic, intermediate, and advanced (Additional file 1: Appendix 1 and Additional file 2: Appendix 2). In the first session, the patients will perform the basic exercises. The progress to a new level of difficulty will occur whenever postural compensations decrease, and the patient can perform eight to 10 repetitions easily and without pain.
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