The effects of the Pilates method in the elderly: a systematic review

Função e atuação do serviço de atendimento domiciliar na perspectiva de profissionais da Atenção Primária à Saúde

Introdução: O Serviço de Atenção Domiciliar (SAD) é um serviço complementar aos cuidados realizados na atenção básica e urgência e visa fortalecer a integralidade da atenção à saúde, pois assume papel importante na formação de novas estratégias de cuidado na modalidade de atenção complementar e substitutiva. Objetivo: Caracterizar a função e atuação do SAD na perspectiva dos profissionais da Atenção Primária à Saúde (APS) em um município do extremo sul catarinense. Método: Trata-se de uma pesquisa de abordagem qualitativa, do tipo descritivo-exploratório, realizada com 14 profissionais que atuaram antes da implantação do SAD e continuam trabalhando em equipes de Saúde da Família do município de Araranguá/SC. O processo de análise ocorreu pela técnica de análise de conteúdo, com auxílio do software para análise de dados qualitativos Atlas.ti. Resultados: A atuação do SAD restringe-se à prestação do cuidado no domicílio; à realização de trabalho multiprofissional; a pacientes acamados como foco da assistência; à equipe de referência para prestação do cuidado. Com relação à função do SAD, ela associa-se ao apoio às equipes de Saúde da Família; ao auxílio para a efetivação da integralidade do cuidado; ao incentivo à desospitalização; à melhoria na qualidade de vida; e à ampliação do acesso ao serviço de saúde. Conclusão: A atuação do SAD representa um serviço mais próximo da população acamada e é realizado por equipe de referência multiprofissional. Sua função vincula-se à melhoria da assistência e à ampliação da garantia do direito à saúde.

Redox Status of Postmenopausal Women with Single or Multiple Cardiometabolic Diseases Has a Similar Response to Mat Pilates Training

Postmenopausal women have a high prevalence of cardiometabolic diseases and that may associate with higher oxidative stress. Exercise can contribute to the treatment of such diseases, but some modalities, such as Mat Pilates, need to be further studied in terms of their physiological responses. Our aim was to investigate the effects of 12 weeks of Mat Pilates on redox status in postmenopausal women with one or multiple comorbidities of cardiometabolic diseases. Forty-four postmenopausal women were divided into two groups: SINGLE, composed of women with one cardiometabolic disease (n = 20) and MULT, with multimorbidity (n = 24). Mat Pilates training was conducted three times a week for 12 weeks, and each session lasted 50 min. Plasma samples were collected before and after training to analyze the following redox markers: superoxide dismutase, catalase, glutathione peroxidase, total antioxidant capacity due to ferric-reducing antioxidant power (FRAP), reduced glutathione (GSH), uric acid, and carbonyl protein. ANCOVA showed interaction effects in FRAP (p = 0.014). Both groups had reduced levels of catalase (p = 0.240) and GSH (p = 0.309), and increased levels of carbonyl protein (p = 0.053) after intervention. In conclusion, the redox status of postmenopausal women shows no changes mediated by Mat Pilates training between SINGLE and MULT, except for greater reductions of FRAP in SINGLE.

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.

Effects of 12-week Pilates training program on cardiac autonomic modulation: a randomized controlled clinical trial

Aim: To evaluate the effects of 12-week Pilates training program on cardiac autonomic modulation. Materials & methods: A randomized controlled trial of a 12-week Pilates training program was conducted. A total of 54 men were randomly allocated to either a control or a Pilates group. Initially, the RR intervals were captured for 20 min for later analysis of heart rate variability (HRV). The training protocol was then initiated, in which the Pilates group performed 36 sessions of the Pilates method for approximately 60 min each session, three-times a week, totaling 12 weeks. The control group was instructed to maintain their normal activities during this period. One week after the end of the training, the final evaluations were performed with the capture of RR intervals in both the groups. Linear indices in the time (SDNN and rMSSD) and frequency (low frequency [LF] and high frequency [HF]) domains, and the Poincaré plot (SD1 and SD2) were used. Nonlinear indices were also analyzed (approximate entropy and detrended fluctuation analysis). Descriptive statistics and generalized mixed models were performed. Results: There was a group effect for LF (ms²) and a time effect for SD2. There was a training effect observed by the time*group interactions in which an increase in global HRV indices was found for the Pilates group after 12 weeks (SDNN: mean difference [MD] = 9.82; standard deviation [SD] = 18.52; ES = -0.514; LF [ms²]: MD = 334.23; SD = 669.43; ES = -0.547; SD2: MD = 14.58; SD = 24.28; ES = -0.693). Conclusion: A 12-week Pilates training program promotes significant improvement in global modulation of HRV in the Pilates group considering the significant increase in SDNN, LF (ms²) and SD2 indices. Trial registration number: NCT03232866.

Pilates Reducing Falls Risk Factors in Healthy Older Adults: A Systematic Review and Meta-Analysis

Background: The main theme of this systematic review and meta-analysis is to synthesize the evidence of randomized controlled trial of evidence of Pilates intervention, in comparison to control groups and other forms of exercise, for falls prevention in healthy older adults. Methods: The following electronic databases were searched up to October 2020; EMBASE, Scopus, Google Scholar, MEDLINE (Ovid), Science Direct, Cochrane, and CINAHL. The recommendations of the Preferred Reporting Items of Systematic Reviews and Meta-Analyses were followed. A PICOS approach was adopted as a framework to formulate the research question and set the inclusion and exclusion criteria. Participants were healthy older adults, defined as older adults who have maintained functional ability, including participants of both genders, those with a falls history, non-fallers, and individuals who were considered to be sedentary or active. Randomized controlled trials studies, written in the English language, from the decade, were included if they focused on specific outcome measures to decrease falls risk; functional mobility, mobility, fear of falling, gait, and postural stability. The PEDro scale was used to assess risk of bias. Results: There were included 12 studies. In total, 702 healthy older adults' participants were included. Pilates showed an effect in mediolateral directions in comparison to control groups (MD = -1.77, 95% CI, -2.84 to -0.70, p = 0.001, heterogeneity: I ² = 3%), mobility (MD = 9.23, 95% CI, 5.74 to 12.73, p < 0.00001, heterogeneity: I ² = 75%) and fear of falling (MD = -8.61, 95% CI, -10.16 to -7.07, p < 0.00001, heterogeneity: I ² = 88%). In relation to other exercises group, Pilates showed positive effects in functional mobility (MD = -1.21, 95% CI, -2.30 to -0.11, p = 0.03, heterogeneity: I ² = 80%), mobility (MD = 3.25, 95% CI, 1.46 to 5.04, p < 0.0004, heterogeneity: I ² = 0%). No evidence of an improvement was found between the groups for dynamic gait index (MD = 2.26, 95% CI, -0.05 to 4.56, p = 0.06, heterogeneity: I ² = 86%), anteroposterior directions of balance (MD = -1.58, 95% CI, -3.74 to -0.59, p = 0.15, heterogeneity: I ² = 51%) and functional mobility when compared to control groups (no exercise) (MD = -1.24, 95% CI, -2.48 to -0.00, p = 0.05, heterogeneity: I ² = 87%). Discussion: Pilates may be effective in decreasing the risk of falls in older adults. Pilates intervention was found to improve functional mobility, mobility, gait, fear of falling and postural stability and therefore there is some evidence to suggest that Pilates reduces certain risk factors for falls in healthy older adults. However, there is an absence of high-quality evidence in regards to the impact of Pilates on reducing falls and further robust RCTs are needed. Systematic Review Registration: [PROSPERO], identifier [CRD42021206134].

Interactive video games to reduce paediatric procedural pain and anxiety: a systematic review and meta-analysis

BACKGROUND

Procedural pain and anxiety in children can be poorly controlled, leading to significant short- and long-term sequelae, such as longer procedure times or future healthcare avoidance. Caregiver anxiety can exacerbate these effects. We aimed to evaluate the effect of interactive video game interventions on children's procedural pain and anxiety, including the effect of different types of video games on those outcomes.

METHODS

We conducted a systematic review and meta-analysis of the effectiveness of interactive video games compared with standard care in children (0-18 yr) undergoing painful procedures. We searched the databases MEDLINE, Embase, and PsycINFO. We conducted random-effects meta-analysis using 'R' of children's procedural pain and anxiety and caregivers' anxiety.

RESULTS

Of 2185 studies screened, 36 were eligible (n=3406 patients). Studies commonly involved venous access (33%) or day surgery (31%). Thirty-four studies were eligible for meta-analyses. Interactive video games appear to reduce children's procedural pain (standardised mean difference [SMD]=-0.43; 95% confidence interval [CI]: -0.67 to -0.20), anxiety (SMD=0.61; 95% CI: -0.88 to -0.34), and caregivers' procedural anxiety (SMD=-0.31; 95% CI: -0.58 to -0.04). We observed no difference between preparatory and distracting games, or between virtual reality and non-virtual reality games. We also observed no difference between interactive video games compared with standard care for most medical outcomes (e.g. procedure length), except a reduced need for restraint. Studies reported minimal adverse effects and typically had high intervention acceptability and satisfaction.

CONCLUSIONS

Our findings support introducing easily available video games, such as distraction-based conventional video games, into routine practice to minimise paediatric procedural pain and child/caregiver anxiety.

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.

A systematic review of the effectiveness of Pilates on pain, disability, physical function, and quality of life in older adults with chronic musculoskeletal conditions

OBJECTIVES

This systematic review aims to evaluate the effectiveness and delivery of Pilates to reduce pain and disability and to improve physical function and quality of life in middle-aged to older adults with a range of chronic musculoskeletal conditions.

METHODS

Searches were conducted using CENTRAL, CINAHL, SCOPUS, Pubmed, PsycInfo, Web of Science Core Collection and Google Scholar. Inclusion criteria were controlled trials and observational studies, population mean age 50 years and over with chronic musculoskeletal conditions, using mat-based Pilates exercise. Outcomes included pain, disability, physical function and quality of life.

RESULTS

Seven studies were included, with a combined total sample of 397 participants (73% female). Pilates was significantly effective (p ≤ 0.05) for reducing back pain, neck pain and pain associated with knee osteoarthritis and osteoporosis. Additional significant disability, physical functioning and quality of life effects were found for back pain, osteoporosis, and knee OA. Overall Pilates was as effective as other exercise. Adherence to group exercise was good, but poor for home exercise. No significant adverse effects were reported.

CONCLUSION

Pilates is a safe and effective exercise intervention for adults over 50 with a diverse range of musculoskeletal conditions which may otherwise put them at risk of becoming sedentary. Although no overall significant superiority was found over other exercise, participants reported psychosocial benefits particular to the Pilates group exercise, with enjoyment a possible positive factor in adherence. Further research on Pilates exercises for various pathologies could inform teaching and improve engagement with older adults, including those with chronic conditions.

Effects of applied swan pilates motions on upper body muscle activities

BACKGROUND

There have been very few studies involving swan motion during pilates exercises, and there is also insufficient scientific evidence to support the fact that Pilates swan motion strengthens specific muscles.

OBJECTIVES

Firstly, the purpose of this study was to evaluate the effect of 5 types Pilates swan motion (swan basic (SB), swan push-up (SP), swan holding posture (SH), form roller-based swan (SF), and circle-based swan (SC)) on muscle activity of deltoideus p. acromialis (DA), infraspinatus (IP), trapezius (TP), latissimus dorsi (LD), and erector spinae (ES). Secondly, the purpose of this study was to suggest an effective Pilates swan motion for strengthening muscle strength of each targeted muscle.

METHODS

Twenty-four healthy men in their 20s participated and all participants were measured muscle activity in DA, IP, TP, LD, and ES muscles by electromyography (EMG) during 5 Pilates swan motions (SB, SP, SH, SF, & SC). The measured values were expressed as relative voluntary contraction (%RVC) values based on the SB.

RESULTS

The %RVC values representing the muscle activity of DA and TP were significantly higher in SH and SP than in SC, SF, and SB (p < .001). The %RVC values of IP and LD were significantly higher in SH and SC than in SF, SP, and SB (p < .001). The %RVC value of ES was were significantly higher in SH than in SP, SC, SF, and SB (p < .001).

CONCLUSION

The application of SP, SC, and SH Pilates swan motion is an effective method to activate the back muscles of the trunk.

Hemodynamic and creatine kinase changes after a 12-week equipment-based Pilates training program in hypertensive women

Exercise therapy is a conservative strategy to manage hypertension. The aim of this study was to investigate the effects of a 12-week equipment-based Pilates training program on the hemodynamics of medication-controlled hypertensive women. Forty-five women were classified into two groups: medication-controlled hypertensive (n = 30) or control (n = 15). To be eligible for the hypertensive group, participants had to have a clinical diagnosis of hypertension, be taking medication to control their blood pressure and not to have done any exercise activity in the previous three months. In the control group, the participants needed to have normal blood pressure levels and not to have done any exercise activity in the previous three months. All women participated in a 12-week equipment-based Pilates training program (2 × 60min sessions per week). Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR) and creatine kinase levels (CK) were assessed before and after the program. SBP, DBP and heart rate were also assessed before and after each session. There was no statistically significant difference after Pilates training for systolic (normotensive MD 4.1, 95%CI -9.2 to 17.5, hypertensive MD 3.8, 95%CI -5.3 to 13.1) and diastolic (normotensive MD 5.8, 95%CI -2.0 to 13.7, hypertensive MD 4.0, 95%CI -4.3 to 12.4) blood pressure. Heart rate was reduced after Pilates training in both normotensive (MD 4.5, 95%CI 1.1 to 7.8) and medication-controlled hypertensive (MD 7.9, 95%CI 4.4 to 11.4) women. Creatine kinase activity was reduced after Pilates training in medication-controlled hypertensive women (p = 0.019). Blood pressure was not altered, but heart rate and creatinine kinase activity were reduced following 12 weeks of Equipment-based Pilates training.

Efficacy of the Pilates versus general exercises versus educational workshops on neuromuscular parameters: A randomized controlled trial

INTRODUCTION

Muscle strength, flexibility and changes in muscle recruitment patterns are usually associated to low back pain (LBP). Physical exercises can reverse the adverse changes associated to LBP.

OBJECTIVES

Compare Pilates, general exercises and educational workshop on muscle flexibility, strength and recruitment of the trunk extensor muscles in women with LBP.

METHODS

Forty-six women were randomly divided into Pilates group (PG, n = 16), general exercise group (GEG, n = 15), and educational group (EG, n = 15). This study sought to determine flexibility, muscle strength, and muscle recruitment of right (RIL), left (LIL) iliocostalis lumbar; right (RMU) and left (LMU) lumbar multifidus muscles. Both PG and GEG performed 16 exercise sessions, while EG attended 4 workshops. Statistical analysis used data sample from Shapiro-Wilk test, Pearson's correlation, multivariate analysis, mixed variance analysis, and Cohen's index.

RESULTS

Flexibility showed no differences (p > 0.05). Muscle strength increased in the intragroup analysis for PG (p = 0.003) and GEG (p = 0.002); however, the intergroup analysis presented no difference. Intergroup showed statistically significant differences for the recruitment of RMU in PG (p < 0.001). Intragroup analysis presented differences after interventions in PG for RIL (p = 0.001); in GEG for LIL (p = 0.005); and in EG for RIL (p = 0.007), LIL (p = 0.002) and RMU (p < 0.001).

CONCLUSIONS

None of the groups showed flexibility improvements. PG and GEG increased muscle strength through intragroup analysis. Intergroup analysis showed an increase in recruitment of the RMU muscle in PG and all groups demonstrated significant improvements in the intragroup analysis.

The effect of Pilates exercise on the happiness and depression of elderly women: a clinical trial study

BACKGROUND

The available approaches for reducing mental problems, particularly for elderlies, include physical activities and exercise. Pilates is a sport that has received much attention during the past few years. The present study was conducted to explore the influence of Pilates on depression and happiness levels of elderly women.

METHODS

This randomized trial work was conducted on 60 elderly women referred to the health center of Rafsanjan city, southern Iran. The participants were randomly assigned into two intervention (Pilates) and control groups, each with 30 members. In the intervention group, participants did Pilates three sessions each week for 8 weeks. The control group did not receive any intervention similar to the intervention group. The happiness level of the participants was measured using the Oxford Happiness Inventory (OHI) and their depression was measured using the Beck Depression Inventory (BDI) before, one month after, and two months after the intervention. A mixed ANOVA was applied for data analysis.

RESULTS

The majority of the participants were married housewives with primary education and age range of above 62 years. Based on the findings of this study, the mean happiness and depression scores of the participants at the end of months one and two in the intervention groups increased significantly compared to those of the control group.

CONCLUSIONS

Doing Pilates for 8 weeks may positively affect the depression and happiness levels of the elderly. Thus, it is recommended as a healthy exercise for elderlies.

Effect of different forms of physical activity on balance in older women

The aim of this study was to analyze the effect of two types of physical activity, dance, and general exercises, on balance in older women. Study participants comprised two groups of women. The participants attended 45-min DMT (n = 20) or GRE sessions (n = 19) three times per week for 12 weeks. Before and after the training, the participants underwent the Postural Stability Test, the Limits of Stability Test, and the Fall Risk Test. Improvement of the balance was confirmed for only one test both for the dance group and the general exercises group.

Effects of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain: a protocol of a systematic review

BACKGROUND

Chronic musculoskeletal pain affects the quality of life of older adults by interfering in their ability to perform activities of daily living. Aerobic exercise programs have been used in the treatment of various health conditions, including musculoskeletal disorders. However, there is still little evidence on the effects of aerobic exercise for the treatment of older adults with chronic musculoskeletal pain. Thus, the objective of this study is to assess the effects of aerobic exercise in improving pain and function of older adults with chronic pain as a consequence of different chronic musculoskeletal conditions.

METHODS

The databases to be used in the search are PubMed, EMBASE, CINAHL, PEDro, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomized controlled trials that used aerobic exercise in the treatment of older adults with chronic musculoskeletal pain will be included. Primary outcomes will be pain and function. We will use the PEDro scale to evaluate the methodological quality and statistical description of each included study, and the strength of the recommendations will be summarized using GRADE.

DISCUSSION

The results of this systematic review will provide a synthesis of the current evidence on the effects of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain. In addition, this information can help health professionals in decision-making about the use of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain.

ETHICS AND DISSEMINATION

This systematic review was recorded prospectively, and the results will be part of a doctoral thesis to be published in a peer-reviewed international journal and possibly presented at international conferences.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO, CRD42019118903.