Pilates for quality of life, fatigue and body image in head and neck cancer survivors

This study analyzed the effect of a protocol based on the Mat Pilates method in an intervention group compared to a usual care control group, on quality of life, fatigue and body image of head and neck cancer survivors.

The study was designed as a randomized clinical trial with 30 survivors, allocated into an intervention group and a control group.

• The intervention group underwent a 12-week Mat Pilates, twice a week, one hour long.
• The control group attended two lectures and received weekly follow-up throughout the study period.

Data collection took place through individual face-to-face interviews, focusing on assessing the outcomes: quality of life (FACT-H&N); fatigue (FACT-F) and body image (BIS).

The Mat Pilates group showed significant improvements compared to the control group in both intra-group and inter-group analyses across the variables:

• quality of life (in total score (p = 0.007)/(p = 0.003),
• family well-being (p = 0.001)/(p = 0.008),
• functional well-being (p = 0.001)/(p = 0.001)),
• body image in the total score (p = 0.001)/(p = 0.001),
• subscales: body image (p = 0.046)/(p = 0.010),
• body care (p = 0.026)/(p = 0.010),
• body touch (p = 0.013)/(p = 0.022),
• fatigue (p = 0.006)/(p = 0.003).

The authors concluded that, based on these findings, future research could delve deeper into understanding the long-term effects of Mat Pilates interventions on quality of life, body image, and fatigue levels among survivors of head and neck cancer.

These conclusions are prudently cautious. The reason for this caution probably is the fact that the findings tell us far less than the results might imply.

The naive reader would think they show the effectiveness of pilates excercises. This, however, would be erroneous. The positive results are to be expected, if only  due to the extra attention given to the verum patients or the disappointment of the control group for not receiveing it.

If we truly want to evaluate the specific effects of a treatment like pilates, we need to design a different type of study. Nobody doubts that group excercise can improve plenty of subjective parameters. The question, I think, is whether pilates is better in achieving this aim than other forms of excercise. Thus we might need an equivalence study comparing two or more forms of excercise. Such studies are more difficult to plan and conduct. Yet, without them, I fear that we will not be able to determine the value of specific forms of excercise.