Search Results (244)

Myocardial ischemia–reperfusion injury (MIRI) significantly compromises the clinical benefits of revascularization and constitutes a central pathological mechanism worsening prognosis in myocardial infarction patients. Accordingly, dissecting the molecular mechanisms underlying MIRI and formulating effective therapeutic interventions are of great clinical significance. Lycium barbarum polysaccharide (LBP), the primary active constituent of Lycium barbarum, has garnered considerable attention in the prevention and treatment of cardiovascular diseases due to its anti-inflammatory, antioxidant, vasomotor function-improving, and antithrombotic properties. This study aims to investigate the ability of LBP to alleviate MIRI, with a specific focus on its role in modulating the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome. Myocardial ischemia/reperfusion (I/R) models in rats and hypoxia/reoxygenation (H/R) models in H9c2 cells were established. Myocardial injury and the therapeutic effect of LBP were evaluated by 2,3,5-Triphenyl tetrazolium chloride (TTC) staining, Hematoxylin-eosin (H&E) staining, Terminal deoxynucleotidyl transferase dUTP Nick-End Labeling (TUNEL) staining, and Enzyme-linked immunosorbent assay (ELISA). To elucidate the specific mechanism underlying LBP against MIRI, an Nrf2-overexpressing cell line was generated in H9c2 cells, and pharmacological inhibition of Nrf2 with ML385 was applied for complementary validation. The effects of LBP on H/R-induced oxidative stress, inflammatory response (IL-18, IL-1β), and pyroptosis-related protein expression (NLRP3, apoptosis associated speck-like protein containing a CARD (ASC), cysteine-dependent aspartate-specific proteases (caspase)-1, Gasdermin D (GSDMD)) were systematically evaluated. LBP administration conferred robust cardioprotection in I/R rats, as evidenced by a significant reduction in myocardial infarct size, improved preservation of myocardial fiber architecture, and attenuated leakage of cardiac injury biomarkers (lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB)). Mirroring these in vivo findings, LBP pretreatment effectively shielded H9c2 cardiomyocytes from H/R insult, markedly enhancing cell viability while curtailing reactive oxygen species (ROS) accumulation and apoptotic activation. A pivotal finding was the pronounced downregulation of Nrf2 in the H/R group, a deficit that was conclusively reversed by LBP treatment. To decisively establish a causal role for Nrf2, we employed a loss-of-function approach; Nrf2 inhibition completely abrogated the protective benefits of LBP, culminating in exacerbated tissue damage, a surge in ROS, and the upregulation of key pyroptosis effectors (NLRP3, ASC, caspase-1, GSDMD). Conversely, a complementary gain-of-function experiment demonstrated that Nrf2 overexpression alone was sufficient to mimic LBP’s effects, significantly blunting H/R-induced ROS production and pyroptosis. LBP alleviates MIRI by inhibiting pyroptosis through activating the Nrf2/NLRP3 axis, thus representing a promising therapeutic candidate for ischemic heart disease with the potential to improve patient outcomes. Full article

Texture feature extraction plays a crucial role in land-use and land-cover (LULC) classification for the remotely sensed images. However, when these images are quantized to a limited number of gray levels to reduce data volume or noise, conventional texture descriptors often lose discriminative power. This study investigates singular values of the gray-level co-occurrence matrix (GLCM) as novel texture features for image classification, with local binary pattern (LBP), complete LBP (CLBP) statistics, and original GLCM features proposed by Haralick et al. for comparison. Under coarse quantization, texture descriptors of LBP and its variants, which encode micro-texture, lose detail, whereas GLCM, which encodes macro-texture, retains structural co-occurrence patterns. This study thus proposes a new feature set, namely the Singular Values of the gray-level co-occurrence matrix (SVGM), for texture discrimination. Experimental analysis indicates SVGM achieves higher class separability by preserving dominant spatial structure while suppressing noise and redundancy. Quantitative evaluation using classical SVMs with multiple kernels, quantum learning models with different kernels, and neural baselines (ANN and 1D-CNN) further shows that SVGM consistently improves classification performance. Within our tested models, quantum kernel SVMs are competitive and achieve the best results on some datasets, while classical models perform best on others. Full article

Background and Objectives: To assess the reliability and construct validity of the Functional Rating Index (FRI) in Italian-speaking individuals with chronic non-specific low back pain (CLBP), in order to improve assessment and clinical management in this population. Materials and Methods: This cross-sectional study consecutively enrolled 75 individuals with CLBP (52 females; mean age 48.71 ± 19.18 years; mean pain duration 298.64 ± 427.52 weeks). Internal consistency and test–retest reliability were evaluated using Cronbach’s α and the intraclass correlation coefficient [ICC_2,1], respectively, while measurement error was estimated through the minimum detectable change (MDC). Construct validity was examined by testing a priori hypotheses through correlations (Pearson’s r) between the FRI and disability measures (Roland–Morris Disability Questionnaire, RMQ; Oswestry Disability Index, ODI), pain intensity (Numerical Rating Scale, NRS), and quality of life (Short-Form Health Survey, SF-36). Results: Cronbach’s α was 0.88, and test–retest reliability showed an ICC_2,1 of 0.86 (95%CI: 0.82–0.93). The MDC was 18.05, corresponding to approximately 20% of the total score. The Italian FRI demonstrated strong correlations with the RMQ (r = 0.70) and ODI (r = 0.77), and a moderate correlation with the NRS (r = 0.60). The physical and social domains of the SF-36 showed stronger negative correlations with the FRI than the mental and emotional domains. Conclusions: The Italian version of the FRI is a reliable and valid instrument for individuals with CLBP and is recommended for both clinical practice and research applications. Full article

Background: Altered gut microbiota and gut-derived inflammation impair glucose regulation and promote metabolic endotoxemia, yet evidence on probiotic effects across combined glycaemic, inflammatory and short-chain fatty acid (SCFA) outcomes remains limited. This study investigated the effects of a 12-week multi-species probiotic on glucose homeostasis, incretin hormones, inflammatory biomarkers and circulating SCFAs in adults with subthreshold depression. Methods: In a 12-week double-blind, randomised, placebo-controlled trial, 39 adults with subthreshold depression were allocated to either a probiotic supplement containing Limosilactobacillus fermentum LF16, Lacticaseibacillus rhamnosus LR06, Lactiplantibacillus plantarum LP01 and Bifidobacterium longum 04 (n = 19) or placebo (n = 20). Fasting glucose, insulin, HOMA-IR, glucose-dependent insulinotropic peptide (GIP), high-sensitivity C-reactive protein (hs-CRP), lipopolysaccharide-binding protein (LBP), soluble CD14 (sCD14) and SCFAs were evaluated at three time points: baseline, week 6 and week 12. Between-group and treatment × time effects were analysed using general linear models. Results: Probiotic supplementation significantly reduced fasting glucose at 12 weeks compared with placebo (−1.8 vs. 0.1 mmol/L; p = 0.036). In the probiotic group, greater reductions in GIP (p = 0.012; p = 0.037), LBP (p < 0.001), sCD14 (p = 0.002; p = 0.001) and hs-CRP (p = 0.047) were also observed compared with placebo. Plasma SCFA concentrations remained largely unchanged, with no significant treatment × time interactions, except for higher valerate levels at 12 weeks in the probiotic group (p = 0.019). Conclusions: Twelve weeks of multi-species probiotic supplementation improved fasting glucose, reduced incretin and inflammatory biomarkers and attenuated metabolic endotoxemia, without alterations in circulating SCFAs. These findings support beneficial modulation of metabolic–immune pathways and highlight the promising role of probiotics to enhance glucose regulation and systemic inflammatory tone in adults with subthreshold depression. Full article

This study investigated the effects of Lycium barbarum polysaccharides (LBP) supplementation on various indicators in coral trout (Plectropomus leopardus), including growth performance, digestive enzyme activity, muscle and skin morphology, inflammatory immune gene expression, as well as immune and antioxidant responses. In the experiment, fish were fed diets supplemented with different concentrations of LBP (0%, 0.05%, 0.1%, 0.2%, 0.5%, and 1%) over a designated experimental period. The results showed that moderate supplementation of LBP significantly improved growth performance, with the optimal concentration being around 0.243%, achieving the highest specific growth rate. LBP supplementation also enhanced intestinal digestive enzyme activity, such as trypsin in the 0.1% and 1% groups, and α-amylase in the 0.5% group. Additionally, LBP improved the nutritional composition of muscle, with the 1% group showing higher crude protein content and the 0.2–1% groups having lower crude fat content. Moderate LBP supplementation improved skin color and pigmentation, increasing the brightness, redness, and yellowness of the dorsal skin, as well as boosting carotenoid and astaxanthin concentrations. It also enhanced the immune and antioxidant functions of the skin (e.g., SOD, CAT, GSH-Px, AKP, and LZ) and improved the immune functions of the mucus (e.g., C3, C4, IgM, IgT, AKP, and LZ). Furthermore, the expression of key pro-inflammatory genes, such as TNF-α and IL-1β, was reduced. These findings suggest that LBP can serve as a natural feed additive to enhance the overall quality and health of coral trout, contributing to sustainable aquaculture practices. Full article

Background/Objectives: This randomized controlled trial aimed to investigate the effects of stabilization exercises combined with pelvic floor muscle training (PFMT) on urinary parameters in individuals with chronic low back pain (CLBP) and urinary incontinence. Methods: A total of 44 women aged 18–65 years were randomized into three groups: PFMT combined with stabilization exercises, standard PFMT group, and a control group. The intervention groups participated in an 8-week exercise program. Urinary symptoms, anxiety, and quality of life were assessed using validated questionnaires. Results: The primary outcome (UDI) demonstrated significantly greater improvement in the PFMT combined with stabilization group compared with both the standard PFMT and control groups (p < 0.01). Post-treatment comparisons indicated that both intervention groups showed significant improvements in urinary symptoms and quality of life compared with the control group (p < 0.05). Conclusions: PFMT combined with stabilization exercises may be an effective approach for improving urinary parameters. Further studies are warranted to better elucidate the efficacy of PFMT combined with stabilization exercises. Trial Registration: ClinicalTrials.gov Identifier: NCT05666427. Full article

Background/Objective: To investigate short-term multidimensional recovery trajectories after physiotherapy with or without adjunctive pain education in individuals with Chronic low back pain (CLBP). Methods: This was a secondary analysis of a randomized controlled trial (RCT) of 92 participants (46 participants per group) comparing physiotherapy alone with physiotherapy plus pain education. Changes from baseline values over six weeks were calculated for pain intensity, disability, psychological well-being, and self-efficacy to define short-term recovery trajectories across domains, and were standardized prior to analysis. Descriptive characterization of recovery dimensions by principal component analysis and identification of different recovery trajectory clusters by k-means clustering were performed. Sensitivity analyses with multinomial logistic regression were performed to determine robustness after adjustment for baseline characteristics. Results: Three recovery trajectories were found: minimal recovery (n = 40), psychosocial-dominant recovery (n = 26), and global recovery (n = 26). In the physiotherapy-only group, participants were classified as minimal recovery (61%) or psychosocial-dominant recovery (39%), with no cases of global recovery. In contradistinction, 57% of participants receiving physiotherapy with pain education were classified as within the global recovery trajectory, with fewer classified as minimal recovery (26%) or psychosocial-dominant recovery (17%). Psychosocial-dominant recovery occurred in both groups, and was characterized by large improvements in psychological well-being and self-efficacy with more modest changes in pain and disability. The distribution of recovery trajectories between treatment groups was large (χ²(2)= 36.25, p < 0.001; Cramer’s V = 0.63). Conclusions: Distinct short-term recovery trajectories were found after physiotherapy with or without pain education in individuals with CLBP, reflecting heterogeneity in multidimensional recovery that is not reflected in mean-based outcome analyses. Full article

This study aimed to assess the relative impact of the Osijek multidisciplinary biopsychosocial program for chronic low back pain (CLBP) compared with standard multimodal care with respect to pain intensity, disability, health-related quality of life, anxiety, depression, stress, and sleep quality using standardized self-assessment questionnaires and a smartwatch. A total of 128 patients treated at the Department of Pain Management, University Hospital Osijek, were randomly allocated to two groups. The multidisciplinary biopsychosocial group participated in a structured four-week program combining education, exercise, and individualized multidisciplinary care, while the multimodal group received conventional conservative treatment including pharmacotherapy and selected physical therapy modalities. The four-week intervention included standardized self-report questionnaires, a sociodemographic data form, and a Fitbit Charge 3 smartwatch for objective monitoring of sleep and physical activity. A significant reduction in pain intensity was observed across numerical scales and most questionnaire measures (Wilcoxon test, p < 0.01), except for the subscale assessing difficulties in performing daily activities due to sleep deprivation. Participants who underwent the multidisciplinary biopsychosocial treatment exhibited significant improvements (p < 0.03) in pain intensity, disability, health-related quality of life, stress, anxiety, and sleep quality compared with those receiving multimodal treatment. In both groups, a weak negative correlation was found between sleep quality and daily step count (Spearman’s rho = −0.234, p = 0.04). A multidisciplinary biopsychosocial program was associated with greater improvements in health-related quality of life, psychological well-being, and sleep quality in patients with chronic low back pain compared with a multimodal conservative approach. Increased daily physical activity was linked to improvements in anxiety and sleep. Although this study was designed as a randomized controlled trial, certain baseline differences between groups should be considered when interpreting the findings. Full article

Background and Aim: Low back pain (LBP) represents an important public health issue, with approximately 20% of acute cases progressing to chronic low back pain (CLBP). In addition to pain, patients with CLBP also suffer from reduced cognitive performance, depressive symptoms and catastrophic thoughts. Central sensitization (CS) is considered a key point in pain persistence. This study examines CS and its impact on cognitive, emotional, and behavioral functioning in patients with CLBP. Methods: In this cross-sectional study, 67 patients with CLBP were classified using the Central Sensitization Inventory (CSI) into groups with (WCS, n = 32) and without central sensitization (WoCS, n = 35). Cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA), emotional functioning using the Center for Epidemiologic Studies Depression Scale (CES-D), and behavioral functioning using the Pain Catastrophizing Scale (PCS), including helplessness, rumination, and magnification domains. Normality was assessed using the Shapiro–Wilk test. Between-group comparisons were performed using Mann–Whitney U, chi-square, or Welch’s t-tests. Multivariable linear regression analyses adjusted for age and gender were conducted. Results: Compared with the WoCS group, patients with central sensitization were older (median 58 vs. 50 years, p = 0.001) and more frequently female (71.9% vs. 40.0%, p = 0.018). The WCS group showed higher PCS total scores (31.8 ± 14.2 vs. 16.0 ± 11.9), higher helplessness (14.3 ± 6.1 vs. 6.9 ± 5.5), rumination (12.7 ± 6.2 vs. 7.0 ± 4.8), and magnification scores (4.8 ± 2.4 vs. 2.1 ± 2.1), higher CES-D scores (26.3 ± 10.4 vs. 11.7 ± 7.2), and lower MoCA scores (23.6 ± 3.0 vs. 26.1 ± 2.1) (all p < 0.001). All associations remained significant after adjustment for age and gender. Conclusions: Central sensitization in CLBP is independently associated with greater pain catastrophizing across all domains, increased depressive symptoms, and reduced cognitive performance, supporting its role as a multidimensional clinical phenotype. Full article

Background: Chronic low back pain (CLBP) is a leading cause of disability worldwide and remains clinically challenging due to its marked heterogeneity and limited correlation between structural pathology and symptoms. Increasing evidence suggests that neuroinflammatory mechanisms and central sensitization (CS) contribute to pain persistence in a clinically relevant subset of patients. This narrative review critically evaluates the current evidence on neuroinflammatory biomarkers in CLBP and discusses their translational potential for mechanism-based patient stratification. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and Google Scholar using terms related to neuroinflammation, biomarkers, CLBP, CS, and glial activation. Studies were preferentially selected according to the following hierarchical criteria: (1) human studies directly investigating neuroinflammatory biomarkers in CLBP; (2) mechanistic human imaging or cerebrospinal fluid studies; (3) translational preclinical investigations providing direct mechanistic relevance; and (4) high-quality systematic reviews providing synthesis of biomarker evidence. As this was a narrative review, study selection was guided by conceptual relevance and translational significance rather than by formal systematic review methodology. Results: Converging evidence supports the involvement of neuroinflammatory processes in subgroups of patients with CLBP. In vivo TSPO-PET imaging and experimental data support glial activation in pain-processing regions. Cerebrospinal fluid studies report elevated chemokines, particularly interleukin-8 and monocyte chemoattractant protein-1, highlighting periphery-to-central nervous system inflammatory cross-talk and the concept of compartmentalized neuroinflammation. In parallel, epigenetic markers such as brain-derived neurotrophic factor DNA methylation have emerged as indirect correlates of CS-related pain phenotypes. In contrast, traditional systemic inflammatory markers show inconsistent and nonspecific associations. Conclusions: Neuroinflammatory biomarkers hold promise for mechanism-based stratification of CLBP, particularly for identifying patients with CS-driven pain. However, major methodological and translational challenges remain, including lack of standardization, limited accessibility of central nervous system-compartment measures, and the need for longitudinal and interventional validation. Future research should prioritize multi-marker and multi-compartment approaches integrated with functional phenotyping to establish clinical utility. Full article

Colibactin, a genotoxin produced by pks⁺ E. coli, imprints highly specific mutational signatures SBS88 and ID18 in colorectal cancer (CRC) and even in normal colonic crypts. Population-scale analyses show these signatures are enriched in early-onset CRC, vary geographically, and are imprinted early during tumor evolution, where probabilistic attribution indicates that colibactin contributes to a measurable fraction of APC driver mutations in colibactin-positive cancers. Beyond colibactin, Fusobacterium nucleatum exerts clade-specific effects on tumor ecology and therapy response, with data supporting both chemoresistance and sensitization to anti-PD-1 in microsatellite stable (MSS) CRC. This article covers mechanistic, genomic, and molecular epidemiology evidence, outlines analytic standards for signature detection (whole-genome sequencing (WGS)/whole-exome sequencing (WES), single-sample fitting, and limits at low mutation counts), and charts translational paths spanning noninvasive screening (stool metagenomics + mutational signatures in tissue/circulating tumor DNA (ctDNA)), risk stratification, and microbial-targeted interventions (antibiotics, phages, ClbP inhibitors). Framing microbiome–genome crosstalk as a tractable axis enables testable clinical hypotheses for precision oncology. Full article

Bee pollen is a nutrient-dense food; however, its dense cell wall limits the bioavailability and digestive absorption of nutrients. This study established a co-fermentation process that combines Lactobacillus strains isolated from bee bread with commercial probiotics to improve the nutritional profile and functional properties of bee pollen. L. acidophilus (LBA1) and L. plantarum (LBP3) were isolated from bee bread and used for single-strain fermentation of bee pollen and its co-fermentation with commercial probiotics. The results indicated that fermentation increased the protein, free amino acid, vitamin C, and flavonoid contents. The co-fermentation product (FHL-99) of LBP3 and the commercial inoculant (99 strains) exhibited the highest cell wall disruption rate (67.57%) in artificial intestinal juice. Ex vivo activity analysis revealed enhanced DPPH, hydroxyl, and ABTS⁺ radical scavenging capacities of fermented bee pollen. Its inhibitory effects on hyaluronidase activity and protein thermal denaturation were also enhanced. FHL-99 demonstrated optimal performance across multiple indices, achieving a DPPH radical scavenging rate of 77.46% and hyaluronidase inhibition rate of 37.38%. In conclusion, synergistic co-fermentation can disrupt pollen cell walls and enrich bioactive constituents, providing an efficient biotechnological approach for the development of high-quality fermented bee pollen products. Full article

Objectives: While Pilates exercise is commonly prescribed for chronic low back pain (CLBP), its effect on normalizing the lumbar flexion–relaxation ratio (FRR) remains unclear. This trial examined whether an 8-week Pilates exercise program (PEP) modifies FRR magnitude and side-to-side asymmetry in women with CLBP and explored associations with trunk kinematics, pain, and functional capacity. Methods: In a randomized controlled pre-test–post-test training design, ninety-six women with CLBP (55.8 ± 5.4 y) were allocated to a PEP group (n = 49) or a usual-care control group (n = 47). The PEP included two supervised 60-minute mat sessions per week over eight weeks. Surface electromyography of the right and left erector spinae and trunk flexion range of motion (TFRoM), measured via inertial sensors, were recorded during the standardized flexion–extension task pre- and post-intervention. Pain intensity (Visual Analog Scale) and functional capacity (Low Back Outcome Score, LBOS) were assessed concurrently. Results: Two-way repeated-measures ANOVA revealed no group × time interaction for global FRR (p = 0.454) or TFRoM (p = 0.745). FRR asymmetry increased by 11% in the PEP group (p = 0.033), with no change observed in the controls (p = 0.143). Compared to the controls, the PEP group exhibited a 30% reduction in pain (p = 0.003) and a 13.4% improvement in LBOS (p < 0.001) compared to the control group (all ps > 0.228). Conclusions: An 8-week Pilates intervention reduces pain and improves functional capacity in women with CLBP but does not restore lumbar extensor relaxation. The observed increase in FRR asymmetry may reflect compensatory or maladaptive redistribution. Full article

Background/Objectives: Meals eaten at movie theaters may have acute, negative health effects due to high refined sugar and moderate sodium content. We aimed to characterize the cardiometabolic response to movie-theater-style meals independently (fasting) and after high-fat meal consumption. Methods: Participants (N = 10; 5M/5F; 18–45 y) completed two meal trials (randomized). At both trials, participants ate a movie-theater-style meal (popcorn, candy, and soda; 884 kcal, 150 g sugar, and 700 mg sodium). At one trial, the movie theater meal was consumed while fasting (Fasting Trial). At the other trial, a high-fat meal (820 kcal; 56 g fat) was consumed 3.5 h prior to the movie theater meal (Fed Trial). Blood was collected (0, 0.5, 1, 2, 3, and 4 h) and endothelial function (i.e., flow-mediated dilation or FMD) was assessed (0, 2, and 4 h) at both trials. Serum metabolic markers (glucose, insulin, triglycerides, and HDL-C) and biomarkers of intestinal permeability (sCD14 and LBP) were measured. Mixed-model ANOVAs (meal × time) and change scores (Δ) were used to compare responses between trials. Results: At both trials, glucose, insulin, and triglycerides increased, while HDL-C decreased (p_time’s ≤ 0.05). ΔInsulin (p = 0.02), but not Δglucose, was higher at Fasting versus Fed. Peak glucose (range = 86–178 mg/dL) and insulin (range = 28.3–307.6 mU/L) were highly variable between participants across trials. Absolute and percent FMD tended to decrease, regardless of trial (p_time’s ≥ 0.08). Conclusions: Overall, the movie theater meal impacted a number of cardiometabolic factors when consumed independently and after a high-fat meal, although there was notable inter-individual variability. Full article

Background: The viscoelastic properties of muscle tissue are important factors affecting muscle performance; they play a significant role in maintaining spinal stability, as well as muscle contraction and function. Changes in these properties can result in pain, restricted movement, or poor posture. However, there is limited information in the literature regarding the viscoelastic properties of the paraspinal muscles, such as tone and stiffness, in individuals with chronic low back pain, which is one of the most common musculoskeletal disorders. The main aim of our study was to investigate the effects of reformer Pilates exercises on muscle viscoelastic properties in individuals with chronic low back pain for 4 weeks. In addition, our secondary aim was to examine the effects of Pilates-based exercises on body anthropometric values, pain intensity, functionality and kinesiophobia levels, sleep, and quality of life in individuals with chronic low back pain and to compare these parameters with a healthy group without low back pain. Methods: The study was carried out in a private clinic center and involved a total of 52 participants: 24 healthy subjects (control group) and 28 subjects with chronic low back pain (CLBP group). Pilates-based exercises were applied 2 days a week for 8 sessions for a total of 4 weeks. Muscle viscoelastic properties, body anthropometric values, pain intensity, functional status, kinesiophobia, sleep quality, and quality of life of all cases were evaluated. Muscle viscoelastic values were measured with a portable myotonometer, MyotonPro. Results: After 4 weeks of Pilates-based training, no significant improvements were observed in the parameters of muscle tone and stiffness in both groups (p > 0.05). It was found that pain intensity (p = 0.001), sleep quality (p = 0.004), quality of life (p = 0.019), and disability level (p = 0.003) improved after 4 weeks of Pilates-based training in subjects with chronic low back pain. In addition, there were significant differences in the parameters of the chest, waist, hip, and thigh circumferences after 4 weeks of Pilates-based training, except for the abdomen, in both groups (p < 0.05). Conclusions: A period of four weeks of Pilates exercises did not lead to significant changes in the muscle viscoelastic properties of the lumbar and abdominal muscles, although performing these exercises did result in regional thinning. The efficacy of Pilates exercises in reducing pain, disability, and kinesiophobia and in improving sleep and quality of life has been demonstrated in individuals suffering from chronic low back pain. Full article