Effect of 9-month Pilates program on sagittal spinal curvatures and hamstring extensibility in adolescents: randomised controlled trial

The Effectiveness of Exercise Programs in Adolescents with Thoracic Kyphosis: A Narrative Review

Thoracic kyphosis is a common postural problem affecting over 20% of adolescents. This condition can contribute to various spinal problems, leading to a decreased ability to perform daily activities, reduced quality of life, and impaired pulmonary function. This review aimed to investigate the effectiveness of exercise programs in adolescents with thoracic kyphosis. We systematically searched the PubMed, Embase, Cochrane Library, and Scopus databases for articles relevant to adolescents with thoracic kyphosis that had been published up to 14 May 2024. Our inclusion criteria focused on studies investigating the effects of exercise on improving thoracic kyphosis. A total of 1883 articles was identified using the search terms. After the titles and abstracts had been screened, 1868 articles were found not to meet our inclusion criteria and were excluded. The remaining 15 articles were then assessed for eligibility. Finally, only seven studies were included in this systematic review. Exercises targeting the entire spinal curvature demonstrated efficacy in enhancing the strength and function of the cervical, thoracic, lumbar, and pelvic muscles, resulting in a corrective effect on thoracic kyphosis in adolescents. Consequently, exercise programs have emerged as potentially beneficial treatment approaches to improve poor posture and reduce adolescent thoracic kyphosis.

Efficacy of Different Exercises on Mild to Moderate Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-analysis

PURPOSE

The aims of this study are to evaluate the effectiveness of different exercise interventions on patients with adolescent idiopathic scoliosis and to provide evidence-based exercise prescriptions for this population.

METHODS

The PubMed, Embase, Cochrane Library, Web of Science, CNKI, Chinese Biomedical Literature Database (CBM), VIP, and Wanfang Data Knowledge Service Platform were searched until January 2023. The data were pooled and a meta-analysis was conducted.

RESULTS

A total of 19 studies were conducted with 778 participants. The Schroth exercises group (mean difference = -3.48, 95% confidence interval = -4.73 to -2.23, P < 0.00001) and strength training group (mean difference = -3.43, 95% confidence interval = -4.06 to -2.80, P < 0.00001) had better recovery of the Cobb angle than the other groups. The Cobb angle rehabilitation effect was good in the time of less than 60-min group. In addition, there was no significant difference found between the different intervention periods groups ( P > 0.05).

CONCLUSIONS

Schroth exercise and strength training significantly improved Cobb angle of adolescent idiopathic scoliosis patients; exercising for less than 60 mins is effective for Cobb angle rehabilitation, but prolonging exercise time cannot improve training effectiveness; 12 wks of exercise significantly improved Cobb angle, but prolonged training periods did not have a significant impact.

Sagittal spinal curvatures of young adults in the context of their self-reported physical activity and somatic parameters

The objective of this study was to assess the thoracic kyphosis (ThKA) and lumbar lordosis (LLA) in healthy young adults and to investigate potential relationships between spinal curvatures, self-reported physical activity (PA), and somatic parameters. The study included 380 female students and 211 male students aged 20.7 ± 1.5 years. The ThKA and LLA were measured using a Plurimeter-V gravity inclinometer. The level of PA was estimated using the International Physical Activity Questionnaire. ThKA was lower in women compared to men, while LLA was higher in women than in men (p < 0.0001). Female students reported lower PA than male students (p < 0.001). Female students with ThKA within normal values reported a significantly higher amount of low-intensity PA compared to those with ThKA below or above the norm. A correlation was found between ThKA and body mass index (BMI), body adiposity index (BAI), WC, and fat percentage (rho < 0.2), whereas LLA showed correlations with BMI, BAI, waist circumference, and fat percentage (rho < 0.2). Among male students, a correlation was found between LLA and BMI as well as WC (rho < 0.2). Maintaining a healthy body composition may be instrumental in mitigating the risk of developing spinal curvature abnormalities.

Effect of Eutony, Holistic Gymnastics and Pilates on hamstring flexibility and back pain in pre-adolescent girls: Randomized clinical trial

OBJECTIVE

This study aimed to evaluate the effects of Eutony, Holistic Gymnastics, and Pilates on hamstring flexibility and back pain in pre-adolescent girls.

METHODS

This randomized prospective quantitative clinical trial compared the effects of Eutony, Holistic Gymnastics, and Pilates on hamstring flexibility and back pain. The sample consisted of 80 pre-adolescent girls aged 10-13 years and divided into three groups: Eutony, with 26 girls; Holistic Gymnastics, 27 girls; and Pilates, 27 girls. The participants underwent ten 1-h weekly interventions. Hamstring flexibility was evaluated using fingertip-to-floor, sit-and-reach, and hip angle tests; back pain was evaluated using the Body Posture Evaluation Instrument questionnaire and the way they carried their backpack by the Layout for Assessing Dynamic Posture. Descriptive statistical analysis, analysis of variance, and Kruskal-Wallis test were performed at a 5 % significance level (p < 0.05).

RESULTS

The three body practices increased hamstring flexibility in all fingertip-to-floor (7.77 cm), hip angle (5.58°), and sit-and-reach evaluations (9.07 cm). Before the intervention, 66.25 % of participants complained of back pain. After the intervention, only 37.50 % continued with the complaint. Moreover, 25 % of pre-adolescent girls started to carry their school backpack correctly.

CONCLUSION

Eutony, Holistic Gymnastics, and Pilates increased hamstring flexibility, reduced back pain complaints, and incentivized the girls to carry the school backpack correctly.

REGISTRY OF CLINICAL TRIALS

Brazilian Registry of Clinical Trials ReBEC (RBR-25w6kk).

Effects of Pilates exercises on spine deformities and posture: a systematic review

BACKGROUND

Pilates is becoming increasingly popular amongst a wide range of people and is gaining more attention. It is also an effective means of physical rehabilitation. The aim of this systematic review is to explore the effects of Pilates on spinal deformity and posture.

METHOD

This systematic review was conducted using four recognised academic and scientific databases (Scopus, Web of Science, PubMed and Cochrane) to identify articles that met the inclusion criteria. The secondary search used the Google Scholar and the Science Direct search engines. The search for articles for this review began in July 06, 2023 and was concluded on February 01, 2024. The search process for this study was documented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020). The PEDro scale was used to assess the internal validity and data statistics of the studies included in this systematic review and to evaluate the quality of the studies.

RESULTS

The systematic review included nine studies that met the inclusion criteria from the 651 studies retrieved, involving a total of 643 participants. The PEDro scale scores of the studies included in this systematic review ranged from 3 to 8. The intervention was in the form of Pilates or Pilates combined exercises. The studies included in this review used outcome measures of Cobb angle, angle of trunk rotation (ATR), range of motion (ROM), chest expansion, Scoliosis Research Society Questionnaire (SRS-22r) and postural assessment. Research has shown that Pilates is effective in correcting spinal deformities and posture, as well as improving quality of life, pain relief, function and fitness.

CONCLUSIONS

This systematic review provide substantial evidence that Pilates has a positive impact on improving spinal deformity and posture. However, more research is needed to validate whether Pilates can be used effectively as a physical therapy for spinal deformity rehabilitation. Pilates has considerable potential for public health interventions.

The impact of Pilates exercise for depression symptoms in female patients: A systematic review and meta-analysis

BACKGROUND

The Pilates exercise has recently become an increasingly popular way of exercise in female patients since it is an attractive and low-cost physical exercise modality. Pilates may be a beneficial method of exercise for female patients with depression and anxiety symptoms. However, to date, there has been no attempt to collate this literature. This review aims to systematically assess and meta-analyze the efficacy of Pilates exercise for female patients with depression and anxiety symptoms and inform evidence-based guidelines for exercise prescription.

METHODS

Five electronic databases (Scopus, MEDLINE/PubMed, Embase, Web of Science, and the Cochrane Library) were systematically searched up to January 2023 to examine randomized controlled trials (RCTs) focused on the effects of Pilates exercise for female patients with depressive disorders and individuals with elevated levels of depression were included. The primary outcomes were the severity of depression, and the secondary outcomes were anxiety. Statistical analyses were performed using Stata version 15.1 software with a 95% confidence interval (Registration number: CRD42023426522), and the PEDRO Scale was used to evaluate the risk of bias for RCT.

RESULTS

18 RCTs with 827 female patients were included. The methodological quality of the RCTs was considered an A level in 4 studies, B level in 13, studies, and C level in 1 study investigation. The meta-analysis showed that there was moderate evidence for the Pilates exercise significantly improved the severity of depression symptoms (SMD = -0.73; 95% CI -0.86 to -0.59; P < .01) and anxiety symptoms (SMD = -0.62; 95% CI -0.79 to -0.46; P < .01).

CONCLUSIONS

Pilates exercise could reduce levels of depression and anxiety in female patients with depression and anxiety symptoms. Pilates exercise can be used as a potential ancillary program to improve depression and anxiety symptoms for female patients.

Effects of Pilates on Pain, Physical Function, Sleep Quality, and Psychological Factors in Young Women with Dysmenorrhea: A Preliminary Randomized Controlled Study

The effect of Pilates on dysmenorrhea has been little studied. The purpose of this study was to evaluate the effect of Pilates on menstrual pain and symptoms, premenstrual syndrome, and risk factors of dysmenorrhea. Thirty young women with primary dysmenorrhea were randomly assigned into a Pilates group (PG; n = 15) and a waitlist control group (CG; n = 15). The Pilates was performed twice a week for 12 weeks. Menstrual pain and symptoms were measured by visual analogue scale (VAS) and the Cox menstrual symptom scale (CMSS), respectively. Premenstrual syndrome was assessed using the premenstrual symptoms screening tool (PSST). Additionally, back flexibility, hip muscle strength, sleep duration and quality, perceived stress, state-trait anxiety, and depression were evaluated. The VAS, CMSS severity and frequency, and PSST symptoms and functional impairments decreased in the PG compared to the CG (p < 0.001 or p < 0.01) with large effect sizes. Back flexibility and the strength of hip flexors, hip extensors, and hip abductors significantly increased in the PG compared to the CG (all p < 0.01) with large effect sizes. Sleep quality (p < 0.01) and stress (p < 0.05) improved in the PG. Sleep duration, anxiety, and depression did not change in either group. In conclusion, the 12-week Pilates intervention ameliorates dysmenorrhea, partly mediated by improved physical function and sleep quality.

Effects of Pilates in children and adolescents - A systematic review and meta-analysis

BACKGROUND

Pilates can be performed by children as a form of exercise to promote healthy growth and development. The increasing use of Pilates as a type of exercise for children or as an adjunct tool in pediatric rehabilitation should be supported by evidence of its benefits. The aim of this systematic review and meta-analysis was to assess the effects of Pilates as an exercise prescription for children and adolescents.

METHODS

Five electronic databases were searched to identify trials (randomized controlled clinical trials or quasi-experimental studies) with a population of children or adolescents in which Pilates (mat or equipment) was performed as a form of exercise. Studies that investigated outcomes related to health and physical performance was analyzed. Individual trial effects were extracted and pooled for meta-analysis whenever possible. To evaluate the external and internal validity of the studies, we assessed their risk of bias.

RESULTS

Fifteen studies (from 945 records), including 1235 participants, met the eligibility criteria, and were included. The reported outcomes were heterogeneous, so only the effect on flexibility could be included in the meta-analysis (n = 4 studies). A significant positive trend toward improved flexibility for the control group compared with the Pilates group was found (Std. mean difference, 0.54; 95%CI: 0,18, 0.91; p = 0.003).

CONCLUSION

Few studies have assessed the effect of Pilates on children and adolescents. The lack of appropriate methodological descriptions/controls made it impossible to determine if all of the included studies were of good quality.

Mandatory after-school use of step tracker apps improves physical activity, body composition and fitness of adolescents

Previous scientific research on the use of mobile applications to increase physical activity level and improve health among adolescents does not provide conclusive results, one of the main reasons being the lack of adherence to the intervention after the first weeks. For this reason, the main objectives of the research were to determine the changes produced by a compulsory ten-week period of after-school intervention with mobile step-tracking applications on adolescents' health; and the final objective to compare the benefits obtained by each of the mobile applications. To meet the objectives, a longitudinal study with non-probability convenience sampling was proposed. The sample consisted of 400 adolescents from two public compulsory secondary schools in the Region of Murcia, Spain, whose body composition, level of physical activity, adherence to the Mediterranean diet, and physical fitness were measured. The SPSS statistical software was used for statistical analysis. The results showed that adolescents in the experimental group showed a higher level of physical activity and better body composition and physical fitness variables after the intervention compared to the control group, with differences between the different applications used. In conclusion, this research shows the usefulness of mobile applications if they are used in a compulsory way after school hours. The relevance of these results for policymakers lies in the fact that they provide statistical data on the usefulness of mobile applications as an educational resource, being an option to make up for the lack of sufficient physical education teaching hours to meet global physical activity recommendations.

Effect of Eutonia, Holistic Gymnastics, and Pilates on body posture for pre-adolescent girls: Randomized clinical trial

INTRODUCTION

Postural changes frequently occur in pre-adolescent girls, with sedentary lifestyle with reduced physical activity level as one of the risk factors.

OBJECTIVE

To investigate the effects of Eutonia, Holistic Gymnastics, and Pilates on body posture in pre-adolescent girls.

METHODS

A randomized prospective quantitative clinical trial was conducted. The study included girls aged 10-13 years and compared the effects of Eutonia, Holistic Gymnastics, and Pilates on body posture. The sample comprised 80 girls divided into three intervention groups as follows: Eutonia group, 26 girls; Holistic Gymnastics group, 27 girls; and Pilates group, 27 girls. Ten sessions of 1 h each were conducted on a weekly basis. Static posture was analyzed using the Postural Analysis Software SAPO; dynamic posture, using the modified Layout for Assessing Dynamic Posture LADy; and lifestyle, using the Body Posture Evaluation Instrument Back PEI questionnaire. The data were statistically analyzed using the analysis of variance (ANOVA) by Kruskal-Wallis' averages test at 5% significance level (p < 0,05).

RESULTS

The results showed that the three body movement practices improved the head inclination in the frontal plane (1,49°) and pelvic anteversion in the right (1,9°) and left profiles (2,09°). In addition, 25% of pre-teens started to carry their school bag correctly, improving their posture.

CONCLUSION

The body movement practices of Eutonia, Holistic Gymnastics, and Pilates improved head inclination, pelvic anteversion, and the correctness rate of carrying the schoolbag.

Spinal curvatures of yoga practitioners compared to control participants-a cross-sectional study

Purpose

The angles of thoracic kyphosis and lumbar lordosis determine the spinal alignment in the sagittal plane. The aim of this study was to compare the thoracic kyphosis and lumbar lordosis of male and female yoga practitioners with non-practicing participants and to determine the possible dependencies between sagittal spinal curvatures and somatic parameters, time spent on yoga exercise, and undertaking other physical activities in yoga practitioners.

Methods

The study involved 576 women and 91 men ages 18–68 years (mean = 38.5 ± 9) who were practicing yoga, and 402 women and 176 men ages 18–30 years (mean = 20.2 ± 1.3) as a control group. The angles of thoracic kyphosis and lumbar lordosis were measured using a Plurimeter-V gravity inclinometer.

Results

The two-way ANOVA demonstrated the influence of group (p < .0001) and sex (p = .03) on the angle of thoracic kyphosis, as well as the influence of group (p < .0001) and sex (p < .0001) on the angle of lumbar lordosis. It was noted that yoga practitioners had less pronounced thoracic kyphosis and lumbar lordosis and were more often characterized by normal or smaller thoracic kyphosis and lumbar lordosis than students from the control group. In yoga practitioners, the angle of thoracic kyphosis was positively correlated with age, body mass, BMI, and undertaking other forms of physical activity. The angle of lumbar lordosis was negatively correlated with body height and body mass.

Conclusions

The results suggest that yoga exercises can affect the shape of the anterior-posterior curves of the spine and may be an efficient training method for shaping proper posture in adults.

Comparative analysis of core muscle activation according to the use of props and the different knee angle during the modified Pilates Hundred

BACKGROUND

There are not so many Pilates studies related to muscle activation. Since the effectiveness and efficiency of the Pilates Hundred to muscle activation has recently emerged, it is necessary to investigate the effects of the Pilates Hundred on core muscles.

OBJECTIVES

The purpose of this study was to determine what difference occurs in the muscle activity, during the Pilates Hundred, to suggest the optimal props for muscle function improvement and then to provide data for the efficient exercise program.

METHODS

Twenty-eight men in their twenties who were able to fully conduct Pilates Hundred. According to the difference between the small tool application (no prop: NP, soft ball mini: SB, Pilates ring: PR) and the knee joint angle (90° and 180°), muscle activations of rectus abdominis (RA), external oblique (EO), rectus femoris (RF), lateral muscle (vastus lateralis: VL), medial muscle (vastus medialis: VM), biceps femoris (BF), and semitendinosus (ST) were measured by the using surface electromyography (EMG) while different exercise conditions.

RESULTS

During Pilates Hundred, the use of tools was found to be more effective in activating the core muscle (NP < SB < PR). During Pilates Hundred, 180° of knee angle had more influence on core muscle activation than 90°, and knee angle and props use showed an interaction for activating core muscles.

CONCLUSION

The Pilates Hundred with PR and 180° knee angle intervention can increase core muscle activation, and this leads to effective Pilates exercise program for those who need to enhance core muscle volume and function and to rehabilitate core muscles.

Lumbopelvic sagittal standing posture associations with anthropometry, physical activity levels and trunk muscle endurance in healthy adults

Background

Various factors, inherited and acquired, are associated with habitual spinal postures.

Objective

The purpose of this study was to identify the relationships between trunk muscle endurance, anthropometry and physical activity/inactivity and the sagittal standing lumbopelvic posture in pain-free young participants.

Methods

In this study, 112 healthy young adults (66 females), with median (IQR) age of 20 years (18.2-22 years), without low back pain, injury or trauma were included. Lumbar curve (LC) and sacral slope (SS) angles were measured in standing with a mobile phone application (iHandy level). Anthropometric, physical activity/inactivity levels (leisure-time sport involvement and sitting hours/day) and abdominal (plank prone bridge test) and paraspinal (Sorensen test) isometric muscle endurance measures were collected.

Results

LC and SS angles correlated significantly ( r = 0 . 80 , p < 0 . 001 ). Statistically significant differences for both LC ( p = 0 . 023 ) and SS ( p = 0 . 013 ) angles were identified between the male and female participants. A significant negative correlation was identified between the abdominal endurance time and LC ( r =- 0 . 27 , p = 0 . 004 ); however, the power of this result (56%) was not sufficiently high. The correlation between abdominal endurance and SS was non-significant ( r =- 0 . 17 , p = 0 . 08 ). In addition, no significant associations were identified between either of the sagittal lumbopelvic angles (LC-SS) in standing and the participants' body mass index (BMI), paraspinal endurance, leisure-time sport involvement or sitting hours/day.

Conclusion

The potential role of preventive exercise in controlling lumbar lordosis via enhancement of the abdominal muscle endurance characteristics requires further confirmation. A subsequent study, performed in a larger population of more diverse occupational involvement and leisure-time physical activity levels, is proposed.

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.

How does the Execution of the Pilates Method and Therapeutic Exercise Influence Back Pain and Postural Alignment in Children Who Play String Instruments? A Randomized Controlled Pilot Study

BACKGROUND

Inappropriate posture in children while playing some string instruments can cause back pain and alterations of the spine. To date, there is no research on the effect of exercise on children who play a musical instrument, although it is known that transversus abdominis muscle control through the Pilates method has shown pain reduction and posture improvement in this population.

OBJECTIVE

To assess the effectiveness of the Pilates method combined with therapeutic exercise with respect to therapeutic exercise exclusively in reducing pain and improving postural alignment in children playing string instruments applying a protocol of low dose to increase children's adherence to training.

METHODS

A randomized controlled pilot study was designed with two parallel intervention groups. Twenty-five children (10-14 years old) were randomized in two intervention groups: Pilates method with therapeutic exercise (experimental) and therapeutic exercise (control) for 4 weeks (50 min per day, one day per week). Two assessments were performed (before and after treatment) to assess back pain and shoulders and hips alignment using a visual analog scale and the Kinovea program.

RESULTS

Statistically significant differences were obtained for pain reduction before (p = 0.04) and after (p = 0.01) playing the instrument in the experimental group. There were no significant changes in alignment improvement in any of the two groups.

CONCLUSION

The application of a low dose of the Pilates method combined with therapeutic exercise could be a beneficial intervention for pain reduction before and after musical practice in children who play string instruments.

Back Pain Related with Age, Anthropometric Variables, Sagittal Spinal Curvatures, Hamstring Extensibility, Physical Activity and Health Related Quality of Life in Male and Female High School Students

Spinal pain (SP) is widely extended among adolescents. The origin of SP can be multifactorial; thus, the present study aimed to estimate the prevalence and risk of SP in high school students and to determine the differences in sagittal spinal curvatures and pelvic tilt, hamstring extensibility, age, anthropometric variables and healthy lifestyle habits dependent on SP between sexes. Two hundred seventy-three teenagers took part in this cross-sectional study. Age, sagittal spinal curvatures, hamstring extensibility, physical activity, sedentary lifestyle, anthropometric variables and health related quality of life (HRQL) were recorded. SP was reported by 16.12% of adolescents. Differences were observed in the HRQL according to SP (p < 0.05). Participants without SP were less sedentary (22.12%) and younger (13.10 years old) than participants with SP (40.91% and 13.66, respectively) (p < 0.05). A logistic regression model showed that both variables were significantly collinear (VIF = 1.01; Durbin-Watson = 2.10). Subjects with low back pain (LBP) had a higher weight, body max index, and hip girth than subjects without pain (p < 0.05). A misalignment in the lumbar spine was associated with LBP for males (Cramer’s V = 0.204, p = 0.022). In conclusion, adolescents with SP were older and had a lower HRQL in all dimensions. SP could be predicted according to age and sedentary habits.