Pilates increases isokinetic muscular strength of the elbow flexor and extensor muscles of older women: A randomized controlled clinical trial

Effects of pilates exercises on strength, endurance and muscle power in older adults: Systematic review and meta-analysis

INTRODUCTION

Pilates exercises have been used by the older adults and have shown potential to improve some components of physical fitness.

OBJECTIVE

To verify the effects of Pilates on strength, endurance and muscle power in older adults.

METHODS

The searches were performed in the databases: PubMed, EMBASE, CENTRAL, CINAHL, Web of Science, SPORTDiscus, LILACS and PEDro until September 2022, without filters that limited the date of publications or language. The studies included were: randomized clinical trials (RCTs); interventions that used Pilates; interventions with outcomes involving strength, endurance and/or muscle power; participants over 60 years old.

RESULTS

24 RCTs (1190 participants) were selected. There is low quality evidence that Pilates did not significantly improve muscle strength compared to the control group (Standardized Mean Difference (SMD) = 1.18 [95%CI -0.71, 3.08] I2 = 93%), and moderate quality compared to other exercises (SMD = 0.01 [CI95% -0.46, 0.48] I2 = 0%). Very low quality evidence shows that Pilates can improve muscular endurance of upper limbs compared to control group (Mean Difference (MD) = 4.87 [95%CI 2.38, 7.36] I2 = 88%) and lower limbs compared to other exercises (MD = 2.68 [CI95% 0.26, 5.10] I2 = 87%). It was not possible to perform muscle power analysis due to the reduced number of studies.

CONCLUSION

Currently, it is not feasible to recommend Pilates exercises as a means to improve strength, endurance and muscle power in the older adults. More RCTs covering this topic are needed given the low quality of evidence available at this time.

Effect of pilates performed during pregnancy on postpartum stress urinary incontinence in primipara women

INTRODUCTION

Stress urinary incontinence (SUI) constitutes the majority of urinary incontinence (UI) cases that occur due to anatomical and physiological changes during pregnancy and postpartum period. The objcetive of this study was to evaluate the effect of pilates in preventing the occurrence of SUI in the postpartum period.

METHODS

A retrospective case-control study was conducted in a private hospital. Participants consisted of patients who gave birth vaginally at the hospital and were admitted to the hospital for routine control at the postpartum 12th week. The women did pilates for two days a week from the 12th week of pregnancy until the birth were included in the case group. The women did not do pilates in the control group. Data was collected using the "Michigan Incontinence Symptom Index". To detect the presence of SUI, researchers asked women "Do you have urinary incontinence problems in your daily life?". STROBE research check-list was used for reporting the study.

RESULTS

The study was completed with a total of 142 women consisting of 71 women in each group. Of the women, postpartum SUI occurred in 39.4%. The severity score of women who did pilates were found to be statistically significantly lower than those who did not do pilates.

CONCLUSION

During pregnancy, women should be encouraged to do pilates about the prenatal period by health professionals.

Benefits of Pilates in the Elderly Population: A Systematic Review and Meta-Analysis

The aim of this systematic review is to collect and summarize the benefits of Pilates in the elderly population (>60 years old), within the current scientific production, assessing its contribution to Healthy Ageing (HA). We used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) to select, collect, and analyse this thematic. The methodological procedures were registered in the PROSPERO database. The main results of the studies analysed (n = 30) point to significant differences between the intervention and the control groups in dynamic balance, strength, mobility, functional capacity, risk of falling reduction, and mental and psychological health. Thus, the results showed that Pilates may be beneficial for the health of the elderly. The meta-analysis found statistical differences between means on the dynamic balance (mean difference (MD) = −0.0, 95% CI [−0.71, −0.50]; I2: 0%) and the aerobic capacity and aerobic resistance [(MD) = 38.29, 95% CI [6.82, 69.77]; I2: 0%). Thus, it is concluded that the efficacy of Pilates has been shown in various areas of HA and has proven to be affordable and safe for the majority of people, using just a mat on the floor. Future studies should focus on the analysis of the relationship between the cost and the benefit of a Pilates intervention in the elderly population, to better understand how health costs can be minimized and to contribute to a multidisciplinary and generalized HA. Pilates has practical application for the clinicians, therapists, and health professionals that work with the elderly population.

Effects of Pilates Training on Physiological and Psychological Health Parameters in Healthy Older Adults and in Older Adults With Clinical Conditions Over 55 Years: A Meta-Analytical Review

This meta-analytical review aimed at comparing the impact of Pilates interventions (PIs) on physiological and psychological health parameters in healthy older adults and older adults with a clinical condition aged 55 years and older. The literature search was conducted in three databases (PubMed, Web of Science, SPORTDiscus). Randomized controlled trials that aimed at improving physiological and psychological health parameters in adults aged 55 years and older using Pilates as an intervention were screened for eligibility. The included data was extracted and assigned based on participants' health condition (clinical vs. non-clinical), as well as the respective control condition used in the study [inactive (IC) vs. active control group (AC)]. Statistical analyses were computed using a random-effects inverse-variance model. Fifty-one studies with a total of 2,485 participants (mean age: 66.5 ± 4.9 years) were included. Moderate effects (SMD: 0.55; 0.68) were found for physiological health parameters (muscle strength, balance, endurance, flexibility, gait, and physical functioning) in both experimental (clinical and non-clinical) conditions when compared to ICs (p < 0.003; p = 0.0001), and small to moderate effects (SMD: 0.27; 0.50) when compared to ACs (p = 0.04; p = 0.01). Moderate to large effects (SMD: 0.62; 0.83) were documented for psychological health parameters (quality of life, depression, sleep quality, fear of falling, pain, and health perception) in both conditions when compared to ICs (p < 0.001, p < 0.001). PIs induce small to large effects in physiological and psychological health parameters in older adults, regardless of their health condition. The substantial heterogeneity within the included studies complicated standardized comparison of the training modalities between the two target groups. Nonetheless, Pilates seems to be a safe, adaptable, and promising exercise approach for a heterogenous population of older adults.

Pilates improves physical performance and decreases risk of falls in older adults: a systematic review and meta-analysis

BACKGROUND

Falls are the leading cause of injury-related deaths in older adults. Physical exercise is a suitable strategy to reduce the risk of falls, but there is little research on the effectiveness of specific exercise modalities.

OBJECTIVES

To estimate the effectiveness of Pilates compared to habitual or non-exercise on physical performance and the risk of falls in older adults.

DATA SOURCES

Five databases were searched through April 15, 2021.

STUDY SELECTION

Randomized controlled trial in people aged ≥60 years.

OUTCOMES

balance, strength, flexibility, functionality, and risk of falls.

DATA SYNTHESIS

Pooled standardized mean differences were calculated using a random-effects model. Subgroup analyses based on Pilates' modality, the existence of a detailed exercise protocol, supervision by a certified instructor, and overall risk of bias were performed.

RESULTS

Thirty-nine studies were included in the systematic review and meta-analyses. The meta-analyses indicated a moderate effect of Pilates on balance (ES=0.36; 95% CI=0.21 to 0.50), strength (ES=0.63; 95% CI=0.44 to 0.81), flexibility (ES=0.41; 95% CI=0.16 to 0.67), and functionality (ES=0.51; 95% CI=0.32 to 0.72) as well as a large effect on the risk of falls (ES=0.90; 95% CI=0.41 to 1.38) in older adults when compared with control groups. The level of certainty of the findings was low for balance, flexibility, and functionality and moderate for strength and falls.

CONCLUSION AND IMPLICATIONS OF KEY FINDINGS

Pilates may promote the autonomy of older people in their daily living activities. Systematic Review Registration Number PROSPERO CRD42018116452.

Physical exercise and prevention of falls. Effects of a Pilates training method compared with a general physical activity program: A randomized controlled trial

INTRODUCTION

Falls are the leading cause of injury-related mortality and morbidity in the elderly. Physical activity plays a key role in the prevention of falls and stimulates postural control. The aim of this study was to compare a general physical activity program for the elderly with a Pilates program to evaluate the effects on balance and on reducing the risk of falling.

MATERIALS AND METHODS

Forty-six subjects were enrolled in this study, but only 41 were included in the study. The subjects were divided into 2 groups: Pilates group (P-G) and a group following a nonspecific program of physical activity (Pa-G). Each subject underwent the hand grip test, Berg balance scale test, and posturographic analysis.

RESULTS

Spearman correlation coefficient showed correlations between the following parameters: BBS versus hand grip test (r = 0.68); BBS versus ellipse surface area (r = -0.75). There were significant differences between groups after the exercise program: both groups showed an improvement in performance but the P-G recorded significantly better results than the Pa-G.

DISCUSSION AND CONCLUSIONS

This study confirmed that physical activity improves both balance and strength. However, our data show that Pilates has a greater effect on these physical abilities than a general physical activity program.

Effect of Three Months Pilates Training on Balance and Fall Risk in Older Women

This study assessed the effect of Pilates exercises on balance and fall risk in older women. Participants comprised 50 older women aged over 60 years, divided randomly into two groups: the experimental group (n = 30), which took part in Pilates sessions two times per week for three months, and the control group (n = 20). The control group did not participate in such sessions but also did not participate in any other rehabilitation programs or additional physical activity except everyday activities. Before and after the training cycle, all women underwent an assessment using Timed Up and Go (TUG), the One Leg Stance Test (OLST), a test performed on a Freestep baropodometric platform, and the tests performed on a Biosway platform. After the training, significantly decreased values of the surface of the ellipse (p = 0.0037) and mean values of velocity (p = 0.0262) for the right foot in the experimental group were observed. The Limits of Stability (LoS) test (p = 0.005) and the Modified Clinical Test of Sensory Interaction on Balance (m-CTSIB) performed on an unstable surface with eyes closed (p = 0.0409) indicated statistically significant changes in the experimental group. None of the above changes were statistically significant in relation to the control group. Pilates training affected the participants' balance by improving LOS and reducing fall risk.

Effect of different Pilates workout endings on the kyphotic and lumbar lordotic angles

Abstract Introduction: There are no studies that investigate whether different workout endings of the Pilates method (PM), either prioritizing the activation of powerhouse muscles or the relaxation of muscles trained during the session, affects spinal curvature. Objective: Identify the immediate effect of a PM session that ends with soft tissue mobilization or wall exercises on the kyphotic and lumbar lordotic angles. Methods: A crossover clinical trial with 19 female Pilates practitioners that used a Flexicurve ruler to evaluate thoracic and lumbar spine curvature before and after a PM exercise protocol, and after endings that involved soft tissue mobilization using massage balls or wall exercises. The order of the different endings was chosen by random draw and the study volunteers participated in two interventions, with intervals of seven to ten days between them. Two two-way ANOVAs were performed (one for each postural variable), using the factors “assessment time” (pre-session; post-PE; post-ending) and “type of ending” (soft tissue or wall exercises). Results: There was no significant difference between the assessment times or endings for the kyphotic (p = 0.972; p = 0.747) and lumbar lordotic angles (p = 0.574; p = 0.627), respectively. Conclusion: Pilates instructors can opt for more relaxing or more active endings without affecting the kyphotic and lumbar lordotic angles.

Pilates versus resistance training on trunk strength and balance adaptations in older women: a randomized controlled trial

Background

The neuromuscular decline impact in the functional independence of older women is determining the necessity of implementing new strategies focused on core strength training and postural stability maintenance to promote healthy aging.

Objectives

To define whether Pilates or resistance training is better at improving (a) core isometric and isokinetic muscular strength, and (b) static and dynamic balance, in older women.

Methods

This was a cluster randomized controlled trial. Physically independent older women (60–80 years) from day centers were randomly allocated to Pilates, Muscular and Control Groups (PG, MG and CG) using a block randomization method. Only the research staff performing the assessment and statistical analysis were blinded. Exercise groups trained twice a week (1 h per session) for 18 weeks in a moderate-to-vigorous intensity. Core strength (primary outcome): trunk and hip isometric and hip isokinetic muscular strength (Biodex System III Pro Isokinetic Dynamometer), alongside one leg static balance (portable force platform Kistler 9286AA) and dynamic balance (timed up and go (TUG)) were assessed.

Results

A total of 60 participants were randomized (PG, n = 20; MG, n = 20; CG, n = 20) and 49 completed the trial (PG, n = 16; MG, n = 19; CG, n = 14). Regarding hip isometric extension strength, PG was statistically better than CG (P = 0.004). There were no differences between groups regarding isokinetic strength or balance. Intra-group comparisons showed significant improvements (P < 0.05) in the dynamic balance and trunk and hip isometric extension strength for PG and MG, whereas every hip isokinetic measurement was improved in MG. Exercise programs did not produce any adverse event.

Conclusions

The Pilates training program was more effective for improving isometric hip and trunk extension strength, while the Muscular training program generated greater benefits on trunk and hip isokinetic strength. Moreover, both training programs showed moderate effects for the TUG.

Clinical Trial Registration

The trial was registered at ClinicalTrials.gov (identifier: NCT02506491).

Evaluating the muscular strength, functional capacity, and risk of sarcopenia in elderly women who practice Mat Pilates

Abstract Introduction: Despite the importance of appropriate levels of muscular strength to maintain the functional capacity and a healthy life in old age, the current literature still lacks studies that investigate the profile of elderly women who practice Mat Pilates regarding these variables. Objective: This study aimed to analyze muscular strength, functional capacity, and risk of sarcopenia in elderly women who practiced Mat Pilates. Method: This is a cross-sectional study carried out with 50 elderly women who practice Mat Pilates in the city of Maringá, Paraná. Sociodemographic and health questionnaires were used, in addition to tests created by a Latin American development group for maturity called Grupo de Desenvolvimento Latino Americano para a Maturidade (GDLAM), sitting-rising test, arm curl test, and SARC-F questionnaire. For data analysis, Shapiro-Wilk and Mann-Whitney U tests, as well as Spearman’s Rank Correlation Coefficients, were used. The level of significance was p < 0.05. Results: The 70-79-year-old elderly women showed worse results in the functional capacity and muscular strength tests of the upper limbs and a higher risk of sarcopenia than the individuals who were under 70 years of age. Muscular strength was inversely related to the reduction of the risk of sarcopenia, and functional capacity was directly associated with this risk. Conclusion: A good functional capacity seems to be related to the reduction of the risk of sarcopenia. Age seems to be an intervening factor for reducing muscular strength levels and functional capacity and increasing the risk of sarcopenia.