<b>Effectiveness of Pilates Exercises With Breathing Re-Education on Pain, Endurance, Sleep Disturbance, and Neck Disability in Working Women With Chronic Non-Specific Neck Pain</b>

Background: Chronic non-specific neck pain is highly prevalent among working women and is commonly associated with pain, reduced cervical endurance, sleep disturbance, and functional disability. Exercise-based rehabilitation is widely used, and Pilates has shown potential benefit, but the added value of breathing re-education remains insufficiently defined. Objective: To evaluate the effectiveness of Pilates exercises combined with breathing re-education on pain intensity, deep cervical flexor endurance, sleep disturbance, and neck-related disability in working women with chronic non-specific neck pain. Methods: A parallel-group randomized controlled trial was conducted at Ghurki Trust Teaching Hospital, Lahore, from June 2024 to January 2025. Fifty-six participants were randomized, and 52 completed the study. Participants were allocated to either Pilates plus breathing re-education or Pilates alone for 6 weeks, with supervised sessions conducted three times weekly. Outcomes included Numeric Pain Rating Scale, Craniocervical Flexion Test, Insomnia Severity Index, and Neck Disability Index-Urdu, assessed at baseline, week 3, and week 6. Results: The combined intervention demonstrated greater improvement than Pilates alone across all outcomes by week 6. Pain decreased from 5.58±0.50 to 3.03±0.45 versus 5.42±0.70 to 4.15±0.61, endurance increased from 18.42±1.27 to 22.46±1.17 mmHg versus 18.35±1.09 to 19.38±1.06 mmHg, ISI decreased from 17.38±3.51 to 11.65±3.19 versus 18.73±2.63 to 16.38±2.45, and NDI decreased from 24.73±5.35 to 13.46±5.51 versus 24.08±4.76 to 20.65±4.54. Significant between-group and time effects were reported for major endpoints. Conclusion: Pilates combined with breathing re-education was more effective than Pilates alone in improving pain, endurance, sleep disturbance, and disability over six weeks in working women with chronic non-specific neck pain.