OBJECTIVE:The present meta-analysis aimed to examine evidence from randomized controlled trials in order to determine the effects of mat Pilates on measures of physical functional performance in the elderly.

DESIGN:A search was conducted in the MEDLINE/PubMed, Scopus, Scielo and PEDro databases between February and March 2017. Only RCTs that were written in English; included subjects 60 years-old; utilized mat Pilates exercises; included a comparison (control) group; and reported performance-based measures of physical function (balance, flexibility, muscle strength and cardiorespiratory fitness) were included. The methodological quality of the studies was analyzed according to the PEDro scale and the best-evidence synthesis. The meta-analysis was conducted with the Review Manager 5.3 software.

RESULTS:The search retrieved 518 articles, nine of which fulfilled the inclusion criteria. High methodological quality was found in five of these studies. Meta-analysis indicated a large effect of mat Pilates on dynamic balance (SMD=1.10, 95%CI=0.29-1.90), muscle strength (SMD=1.13, 95%CI=0.30-1.96), flexibility (SMD=1.22, 95%CI=0.39-2.04) and cardiorespiratory fitness (SMD=1.48, 95%CI=0.42-2.54) of elderly subjects.

CONCLUSION:There is evidence that mat Pilates improves dynamic balance, lower limb strength, hip and lower back flexibility and cardiovascular endurance in elderly individuals. Further high-quality studies are necessary to clarify the effects of mat Pilates on other physical functional measurements among older adults.

INTRODUCTION AND HYPOTHESIS: The purpose of this study is to determine whether a Pilates exercise program and a pelvic floor muscle-training (PFMT) program could provide similar improvements in pelvic muscle strength. METHODS: Sixty-two women with little or no pelvic floor dysfunction were randomized to Pilates or PFMT. Each group had 24 biweekly 1-h sessions with either a physical therapist or Pilates instructor. Strength was measured via perineometry (cmH(2)O). Two questionnaires--pelvic floor distress inventory (PFDI-20) and pelvic floor impact questionnaire (PFIQ-7)--were also collected. RESULTS: At baseline, the Pilates and PFMT groups measured 14.9 +/- 12.5 and 12.5 +/- 10.4 cmH(2)O, respectively (p = 0.41). Both the Pilates and PFMT groups got stronger (6.2 +/- 7.5 cmH(2)O, p = 0.0002 and 6.6 +/- 7.4 cmH(2)O, p = 0.0002, respectively), with no difference between groups p = 0.85. PFIQ and PFDI scores improved from baseline but not between groups. CONCLUSIONS: Further study is required to determine if Pilates can actually treat pelvic floor dysfunction.

OBJECTIVE: To describe the use of Pilates therapy and sacro-occipital technique in the management of a 39-year-old woman with scoliosis who had undergone spinal fusion many years earlier. Clinical Features: The patient had progressive severe low back pain that had worsened over the years after her surgery and had prevented her from activities such as carrying her son or equipment necessary for her job as a photographer. Intervention and Outcome: The patient was provided a series of Pilates exercises used to overcome her chronic habituation and muscle weakness. Although this therapy went on for some time, she did begin to stabilize and increase physical activity. At present, she is no longer limited in her physical activity, although she still exhibits some symptoms from her scoliosis. CONCLUSION: The addition of Pilates therapy can be useful to care for patients with chronic low back pain and deconditioning.

BACKGROUND:Postmenopausal women experience a variety of symptoms, among which sleep disorder is one of the most common problems. Acupressure and Pilates exercise programs are effective nonpharmaceutical treatments which can improve sleep quality. In the present study, we aimed to compare the effects of acupressure and Pilates-based exercises on the sleep quality of postmenopausal women referred to medical clinics.

MATERIALS AND METHODS:In this single-blinded randomized controlled clinical trial, we recruited 108 women aged 40-60 years who were randomly assigned into one control and two intervention groups using balanced block randomization method (three groups of 36 each). The patients in the Pilates exercise group participated in an exercise training program of three 1-hour sessions per week for 6 consecutive weeks. The participants of acupressure group received acupressure intervention three times a week for 6 weeks. The sleep quality of all participants was assessed and recorded using the Pittsburgh Sleep Quality Index (PSQI) once before and once after the intervention.

RESULTS:The results showed no statistically significant difference among the three groups on the total scores of sleep quality after the intervention. The intragroup comparison revealed that the changes in the mean total scores were significant in both the intervention groups (P<0.001) but not in the control group (P = 0.76).

CONCLUSIONS:Pilates-based exercises and acupressure can effectively improve women's sleep quality. Both techniques can be applied as effective alternative and complementary methods for improving sleep quality during the postmenopausal period.

BACKGROUND: There is a need to find ways to increase the physical activity levels and improve the body composition and blood pressure of girls. METHODS: Thirty 11-year-old girls were recruited from two after school programs in Houston Texas in Spring 2005. Participants from one program (16) were randomly assigned to intervention, the other (14) served as controls. BMI, BMI percentile, waist circumference and blood pressure were assessed before and after the intervention. Pilates classes were provided free of charge for an hour per day at the intervention site, 5 days a week, for 4 weeks. Four participants wore heart rate monitors during every session and completed enjoyment and perceived exertion questionnaires. Repeated measures analysis of variance with time (within) and group (between) as factors was performed. RESULTS: Mean attendance was 75%, mean heart rate 104 bpm, mean perceived exertion 5.9 (1-10 scale) and enjoyment 4.4 (1-5 scale). There was a significant (P = 0.039) time by group interaction for BMI percentile. Graphs indicated that this difference was influenced by large reductions in the BMI percentile of healthy girls. CONCLUSIONS: Girls enjoyed Pilates, and participation for 4 weeks lowered BMI percentile. Pilates holds promise as a means of reducing obesity.

This study aims to examine the effect of a 16-week Pilates exercise program on the ego resiliency and depression in elderly women. Before participating in Pilates exercise programs, researcher explained the purpose and the intention of the research to elderly women who were willing to participate in this research. A total of 148 elderly women agreed to participate in the program and they filled in ego resiliency and depression questionnaires. Then, the elderly participated in the 16-week Pilates exercise program and completed the same questionnaires afterwards. Collected data was analyzed by the SPSS ver. 20.0 program and results of paired t-test were as follows; there were statistically significant differences in all subvariables of the ego resiliency such as self-confidence (t=7.770, P<0.001), communication efficiency (t=2.690, P<0.01), optimistic trait (t=1.996, P<0.05), and anger management (t=4.525, P<0.001) after elderly women participated in the 16-week Pilates exercise program, there was a statistically significant difference in depression of elderly women who participated in the 16-week Pilates exercise program (t=-6.506, P<0.001) which was statistically lower than before their participation in the program. Consequently, participating in the Pilates exercise program can help improve the ego-resiliency and alleviate depression of the elderly women.

Methods of exercise such as Pilates and taiji quan, which have been shown to have beneficial effects on physical and mental characteristics, have been studied more often in samples of older participants. The purpose of this investigation was to examine the effects of a semester of either Pilates or taiji quan training on perceived self-efficacy, sleep quality and mood, as well as strength and balance in college-age individuals. Self-efficacy was found to be improved in the Pilates and taiji quan groups and there was a trend towards improvement in sleep quality. Mood was found to be improved significantly in the Pilates group while the taiji group showed a trend towards improvement. There were no changes or group differences in the strength or balance measures. Pilates and taiji quan are effective exercise modes to improve mental parameters in college-age individuals.

Methods of exercise such as Pilates and taiji quan, which have been shown to have beneficial effects on physical and mental characteristics, have been studied more often in samples of older participants. The purpose of this investigation was to examine the effects of a semester of either Pilates or taiji quan training on perceived self-efficacy, sleep quality and mood, as well as strength and balance in college-age individuals. Self-efficacy was found to be improved in the Pilates and taiji quan groups and there was a trend towards improvement in sleep quality. Mood was found to be improved significantly in the Pilates group while the taiji group showed a trend towards improvement. There were no changes or group differences in the strength or balance measures. Pilates and taiji quan are effective exercise modes to improve mental parameters in college-age individuals.

Altan L, Korkmaz N, Bingol U, Gunay B. Effect of Pilates training on people with fibromyalgia syndrome: a pilot study. OBJECTIVE: To investigate the effects of Pilates on pain, functional status, and quality of life in fibromyalgia, which is known to be a chronic musculoskeletal disorder. DESIGN: Randomized, prospective, controlled, and single-blind trial. SETTING: Physical medicine and rehabilitation department. PARTICIPANTS: Women (N=50) who had a diagnosis of fibromyalgia syndrome (FMS) according to the American College of Rheumatology criteria. INTERVENTION: The participants were randomly assigned into 2 groups. In group 1, a Pilates exercise program of 1 hour was given by a certified trainer to 25 participants 3 times a week for 12 weeks. In group 2, which was designed as the control group, 25 participants were given a home exercise (relaxation/stretching) program. In both groups, pre- (week 0) and posttreatment (week 12 and week 24) evaluation was performed by one of the authors, who was blind to the group allocation. MAIN OUTCOME MEASURES: Primary outcome measures were pain (visual analog scale) and Fibromyalgia Impact Questionnaire (FIQ). Exploratory outcome measures were number of tender points, algometric score, chair test, and Nottingham Health Profile. RESULTS: Twenty-five Pilates exercise and 24 relaxation/stretching exercise participants completed the study. In group 1, significant improvement was observed in both pain and FIQ at week 12 but only in FIQ at 24 weeks. In group 2, no significant improvement was obtained in pain and FIQ at week 12 and week 24. Comparison of the 2 groups showed significantly superior improvement in pain and FIQ in group 1 at week 12 but no difference between the 2 groups at week 24. CONCLUSIONS: We suggest Pilates as an effective and safe method for people with FMS. Our study is the first clinical study designed to investigate the role of the Pilates method in FMS treatment. We believe that further research with more participants and longer follow-up periods could help assess the therapeutic value of this popular physical exercise method.

The objective of this study was to determine the effect of 16 weeks of mat-based Pilates training on health perception and sleep quality among elderly women. A randomized and controlled trial was conducted in Caxias do Sul, Brazil, in 2015, in which 61 healthy older women were divided into two groups: experimental group (EG; n=31, average of 64.25 years old, SD 0.14) and control group (CG; n=30, average of 63.75 years old, SD 0.08). The EG participants performed mat-based Pilates exercises twice a week in 60-min sessions, whereas the CG did not train. All participants completed Brazilian-adapted and validated versions of the Pittsburgh Sleep Quality Index (PSQI-BR) and General Health Questionnaire (GHQ-12) at baseline and after 16 weeks. Significant time x group interaction effects were found for the GHQ-12 total score (p<0.001,η=0.19), and the depression (p=0.002,η=0.15) and social dysfunction subscales (p=0.001,η=0.18), as well as the PSQI-BR total score (p=0.017,η=0.09), and the sleep latency (p=0.023,η=0.09) and use of sleeping medication subscales (p=0.019,η=0.09), indicating better improvements (reductions) in these outcome variables for the Pilates EG when compared to the CG. All significant effects were classified as moderate to high. These results indicate that 16 weeks of mat-based Pilates training significantly improves the perceived health status and some sleep quality indices among elderly women. However, more studies are needed to assess the effectiveness of equipment-based Pilates exercises among this population.

The aim of this study was to investigate the effects of an 8-week Pilates exercise program on menopausal symptoms and lumbar strength and flexibility in postmenopausal women. In total, 74 postmenopausal women were recruited and randomly allocated to a Pilates exercise group (n=45) and a control group (n=29). Menopausal symptoms were measured through a questionnaire, while lumbar strength was measured through a lumbar extension machine, and lumbar flexibility was measured through sit-and-reach and trunk lift tests performed before and after the Pilates exercise program, respectively. The Pilates exercises consisted of 7-10 min for warm-up, 35-40 min for the main program modified from Pilates Academy International, and 5-7 min for the cool-down, and were performed 3 times a week for 8 weeks. The results showed a significant decrease in menopausal symptoms except urogenital symptoms. Also, the results presented a significant increase in lumbar strength and flexibility after 8 weeks of the Pilates exercise program. We concluded that an 8-week Pilates exercise program is effective in decreasing menopausal symptoms and increasing lumbar strength and flexibility.

BACKGROUND:Various studies have shown the efficacy of conventional isometric, Pilates and yoga exercises. However, data on the effects and comparison of these specific exercises on the cervical muscle morphology are insufficient or lacking.

OBJECTIVE:To investigate the effects of different exercise treatments on neck muscles in patients with chronic neck pain.

DESIGN:A randomized study.

METHODS:Fifty-six patients with chronic neck pain were randomized into 3 groups as follows: Pilates group (n = 20), yoga group (n = 18) and isometric group (n = 18). Demographics and background information were recorded. The thickness and cross-sectional area of neck muscles were evaluated by ultrasound imaging. Cervical motions were measured with a goniometer. Pain severity was evaluated withthe McGill Pain Scale, disability with the Neck Disability Index, quality of life with the Nottingham Health Profile, and emotional status with the Beck Depression Inventory. In addition to a conventional physio-therapy programme, 15 sessions of physical therapy, including hot pack, ultrasound, andtranscutaneous electrical nerve stimulation (TENS), were provided to all patients. All groups performed the exercises for 6 weeks. The aforementioned assessments were performed before and 6 weeks after the treatment.

RESULTS:Although pain, disability, depression and quality of life improved similarly within all groups (all p < 0.05), muscle thickness values as regards the semispinalis capitis were increased only in the Pilates group (p = 0.022).

STUDY LIMITATIONS:The lack of complex (progressive resistive) exercise treatment protocols, short treatment duration and partial supervision.

CONCLUSION:All 3 types of exercise had favourable effects on pain and functional scores, but no differences were found among the groups, except for the Pilates group, in which the semispinalis capitis muscle increased in thickness.

BACKGROUND:Various studies have shown the efficacy of conventional isometric, Pilates and yoga exercises. However, data on the effects and comparison of these specific exercises on the cervical muscle morphology are insufficient or lacking.

OBJECTIVE:To investigate the effects of different exercise treatments on neck muscles in patients with chronic neck pain.

DESIGN:A randomized study.

METHODS:Fifty-six patients with chronic neck pain were randomized into 3 groups as follows: Pilates group (n = 20), yoga group (n = 18) and isometric group (n = 18). Demographics and background information were recorded. The thickness and cross-sectional area of neck muscles were evaluated by ultrasound imaging. Cervical motions were measured with a goniometer. Pain severity was evaluated withthe McGill Pain Scale, disability with the Neck Disability Index, quality of life with the Nottingham Health Profile, and emotional status with the Beck Depression Inventory. In addition to a conventional physio-therapy programme, 15 sessions of physical therapy, including hot pack, ultrasound, andtranscutaneous electrical nerve stimulation (TENS), were provided to all patients. All groups performed the exercises for 6 weeks. The aforementioned assessments were performed before and 6 weeks after the treatment.

RESULTS:Although pain, disability, depression and quality of life improved similarly within all groups (all p < 0.05), muscle thickness values as regards the semispinalis capitis were increased only in the Pilates group (p = 0.022).

STUDY LIMITATIONS:The lack of complex (progressive resistive) exercise treatment protocols, short treatment duration and partial supervision.

CONCLUSION:All 3 types of exercise had favourable effects on pain and functional scores, but no differences were found among the groups, except for the Pilates group, in which the semispinalis capitis muscle increased in thickness.

BACKGROUND: There are very few randomized controlled studies on exercise in cancer patients. Consequently, there are no guidelines available with regard to the exercises that can be recommended and difficulties are encountered in the clinical practice as to which exercise is more suitable to the patients. AIM: The purpose of this study was to investigate the impact of pilates exercises on physical performance, flexibility, fatigue, depression and quality of life in women who had been treated for breast cancer. DESIGN: Randomized controlled trial SETTING: Out patient group, Department of Physical Medicine and Rehabilitation and Medical Oncology Department, University Hospital. POPULATION: Fifty-two patients with breast cancer were divided into either pilates exercise (group 1) and control group (group 2). METHODS: Patients in Group 1 performed pilates and home exercises and patients in group 2 performed only home exercises. Pilates exercise sessions were performed three times a week for a period of eight weeks in the rehabilitation unit. MAIN OUTCOME MEASURES: Subjects were assessed before and after rehabilitation program, with respect to, 6-min walk test (6MWT), modified sit and reach test, Brief Fatigue Inventory (BFI), Beck Depression Index (BDI) and the European Organisation for Research and Treatment of Cancer Quality of Life C30 (EORTC QLQ-C30) and EORTC QLQ BR23. RESULTS: After the exercise program, improvements were observed in Group 1 in 6-minute walk test, BDI, EORTC QLQ-C30 functional, and EORTC QLQ-C30 BR23 functional scores (P<0.05). In contrast, no significant improvement was observed in Group 2 after the exercise program in any of parameters in comparison to the pre-exercise period (P>0.05). When the two exercise groups were compared, there were significant differences in 6MWT in pilates-exercise group (P<0.05). CONCLUSION: Pilates exercises are effective and safe in female breast cancer patients. There is a need for further studies so that its effect can be confirmed. CLINICAL REHABILITATION IMPACT: This study addressed the effects of pilates exercise, as a new approach, on functional capacity, fatigue, depression and quality of life in breast cancer patients in whom there are doubts regarding the efficacy and usefulness of the exercise.

BACKGROUND AND PURPOSE: The purpose of this study was to examine the effects of Pilates exercises on shoulder range of motion (ROM), pain, mood, and upper-extremity (UE) function in women who had been treated for breast cancer. PARTICIPANTS: The participants were 4 women who had undergone axillary dissection and radiation therapy for stage I to IV breast cancer. METHODS: A nonconcurrent, multiple-baseline, single-subject research design was used to examine the effects of Pilates exercises on the 4 outcomes. RESULTS: Visual analyses of the data suggest a modest effect of the Pilates exercise program in improving shoulder abduction and external rotation ROM. Statistically significant improvement in shoulder internal and external rotation in the affected UE was shown for the one participant with pre-existing metastatic disease. The improving baselines seen for pain, mood, and UE function data made it impossible to assess the effects of Pilates exercises on those outcomes. No adverse events were experienced. DISCUSSION AND CONCLUSION: Pilates exercises may be an effective and safe exercise option for women who are recovering from breast cancer treatments; however, further research is needed.

BACKGROUND AND PURPOSE:Decreased bone mineral density (BMD) is a common condition in postmenopausal women that can be managed with impact activities. Among the activities studied are the whole-body vibration (WBV) and muscle-strengthening exercises. The purpose of this study was to compare the effects of WBV versus Pilates exercise on BMD in postmenopausal women.

METHODS:In this study, 51 postmenopausal women were randomized into 3 groups: vibration (n = 17), Pilates (n = 17), and control (n = 17). Outcomes were the areal bone mineral density (aBMD) (lumbar spine, femoral neck, total hip, trochanter, intertrochanter, and ward's area) assessed by dual-energy x-ray absorptiometry at baseline and follow-up. The interventions were performed 3 times a week for 6 months, totaling 78 sessions. The analysis was performed with intention-to-treat and covariance analyses adjusted for baseline outcomes.

RESULTS:After 6 months, 96.1% of the participants completed the follow-up. The analyses demonstrated significant mean between-group differences in favor of the interventions: vibration versus control, for the aBMD of the lumbar spine (0.014 g/cm; 95% confidence interval [CI], 0.006-0.022; P= .018, d = 1.21) and trochanter (0.018 g/cm; 95% CI, 0.006-0.030; P = .012, d = 1.03); and Pilates versus control, for the aBMD of the lumbar spine (0.016 g/cm; 95% CI, 0.007-0.025; P = .008, d = 1.15) and trochanter (0.020 g/cm; 95% CI, 0.010-0.031; P = .005, d = 1.28).

CONCLUSION:In postmenopausal women, 3 weekly sessions of WBV or Pilates administered for 6 months provided an equal effect on BMD.

BACKGROUND AND PURPOSE:Decreased bone mineral density (BMD) is a common condition in postmenopausal women that can be managed with impact activities. Among the activities studied are the whole-body vibration (WBV) and muscle-strengthening exercises. The purpose of this study was to compare the effects of WBV versus Pilates exercise on BMD in postmenopausal women.

METHODS:In this study, 51 postmenopausal women were randomized into 3 groups: vibration (n = 17), Pilates (n = 17), and control (n = 17). Outcomes were the areal bone mineral density (aBMD) (lumbar spine, femoral neck, total hip, trochanter, intertrochanter, and ward's area) assessed by dual-energy x-ray absorptiometry at baseline and follow-up. The interventions were performed 3 times a week for 6 months, totaling 78 sessions. The analysis was performed with intention-to-treat and covariance analyses adjusted for baseline outcomes.

RESULTS:After 6 months, 96.1% of the participants completed the follow-up. The analyses demonstrated significant mean between-group differences in favor of the interventions: vibration versus control, for the aBMD of the lumbar spine (0.014 g/cm; 95% confidence interval [CI], 0.006-0.022; P= .018, d = 1.21) and trochanter (0.018 g/cm; 95% CI, 0.006-0.030; P = .012, d = 1.03); and Pilates versus control, for the aBMD of the lumbar spine (0.016 g/cm; 95% CI, 0.007-0.025; P = .008, d = 1.15) and trochanter (0.020 g/cm; 95% CI, 0.010-0.031; P = .005, d = 1.28).

CONCLUSION:In postmenopausal women, 3 weekly sessions of WBV or Pilates administered for 6 months provided an equal effect on BMD.

OBJECTIVES:Low back pain affects the person's ability to keep balance, especially in challenging conditions. The purpose of this study was to determine the immediate effects of Pilates exercises on postural sway and dynamic balance of young individuals with non-specific low back pain.

DESIGN:Controlled laboratory design.

SETTINGS AND MAIN OUTCOME MEASURES:Forty-six participants with non-specific low back pain were randomized to a Pilates (n=23, 10 males; age: 21.8±3.2years) and a control group (n=23, 9 males; age: 22.8±3.6years). Postural sway was assessed with a force platform and dynamic balance with the Star Excursion Balance Test, before and after the intervention or rest period. To assess postural sway, participants stood still on an unstable surfaceset on the force plate for 90s, with eyes closed.

INTERVENTION:The intervention lasted 20min and consisted on four Pilates exercises: single leg stretch (level 1), pelvic press (level 1), swimming (level 1) and kneeling opposite arm and leg reach.

RESULTS:At baseline, no differences were found between groups. The Pilates group improved in all the postural sway values (area of CoP: 11.5±3.4 to 9.7±2.7cm, p=0.002 and CoP velocity: 2.8±0.6 to 2.3±0.5cm/s, p<0.001) and in the Star Excursion Balance Test. Control group only improved in CoP velocity, however, this improvement was significantly inferior compared to the Pilates group.

CONCLUSIONS:Pilates exercises immediately improved postural sway and dynamic balance in young adults with non-specific low back pain.

[Purpose] This study was to observe the influence of Pilates training on the quality of life in chronic stoke patients. [Subjects and Methods] Forty chronic stroke patients participated in this study. They were divided into same number of experimental group (EG) and control group (CG). EG participated in a 60-min Pilates training program, twice a week for 12 weeks, while the CG did not participate in any exercise-related activities for the duration and participating in general occupational therapy without any exercise-related activities. Then the MMSE-K was performed before and after Pilates training to observe the influence of Pilates training on the quality of life in chronic stroke patients. [Results] Statistically significant improvement in the physical, social, and psychological domains was found in EG after the training. No statistically significant difference was found in all three quality of life domains for the CG. EG experienced a statistically significant improvement in all quality of life domains compared with that of CG. [Conclusion] Therefore, participation in Pilates training was found to effectively improve the quality of life in stroke patients. Pilates training involves low and intermediate intensity resistance and repetition that match the patient's physical ability and can be a remedial exercise program that can improve physical ability and influence quality of life.

OBJECTIVE: To evaluate the influence of pain on vertical ground-reaction force (VGRF) in patients with low back problems and the effect of the Pilates method on the gait of these patients. DESIGN: A single-blind randomized controlled trial. PARTICIPANTS: 28 individuals assigned to a control group (n = 11) and a low-back group (n = 17), the latter of which was subdivided into a Pilates group (n = 8) and a no-Pilates group (n = 9). INTERVENTION: The Pilates group undertook 15 sessions of Pilates. MAIN OUTCOME MEASURES: The VGRF parameters were recorded during preferred and faster walking speeds. The data were collected before and after the intervention. RESULTS: The weight-acceptance rate and push-off rate were significantly less in the right lower limb of low-back group than of the control group at preferred speed. Improvements were seen in the Pilates group postintervention, with increased middle-support force for the left lower limb at faster walking speed and decreased pain; this did not occur in the no-Pilates group. CONCLUSIONS: These results suggest that patients with low back pain use strategies to attenuate the amount of force imposed on their body. The Pilates method can improve weight discharge in gait and reduce pain compared with no intervention.