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

Effects of Pilates exercises on postural balance and reduced risk of falls in older adults: A systematic review and meta-analysis

BACKGROUND

and Purpose: Pilates exercises have been recommended to improve postural balance and reduce the risk of falls in older adults. However, the certainty of these recommendations remains unclear. In this sense, our objective was to update the literature and verify the effects of Pilates on postural balance and the risk of falls in this population.

METHODS

A systematic search was conducted across multiple databases, including PubMed, EMBASE, CENTRAL, CINAHL, Web of Science, SPORTDiscus, LILACS, and PEDro, on April 17, 2023. The methodological quality of the studies was assessed using the PEDro scale, and the certainty of evidence was evaluated using the GRADE system. Meta-analysis calculations were performed by standardized mean difference (SMD).

RESULTS

A total of 39 studies, involving 1770 participants, were included in the systematic review. Only 14 studies exhibited satisfactory methodological quality. Evidence with very low to moderate certainty showed that Pilates was significantly superior to control groups on indicators of dynamic postural balance (SMD = 1.60 to 0.72), static postural balance (SMD = 0.37 to 0.25), and general state of balance (SMD = 0.76), but not to reduce the number and fear of falls. Furthermore, Pilates was comparable to other forms of exercise for these outcomes.

CONCLUSIONS

Pilates can be recommended to enhance static and dynamic postural balance in older adults, but not to reduce the number of falls or the fear of falling. Given that no outcomes showed high certainty of evidence, future studies may alter these findings.

Effect of the 'Pilates stance' and Pilates-based matwork training on measurements of height, waist circumference, and interscapular distance

BACKGROUND

Standardised guidelines for stance are used to improve interobserver reliability in anthropometric measurements in clinical practice. A key feature of the stance in Pilates is the 'drawing in and up' of the abdomen. The aim of this study was to study the impact of the Pilates stance on height, waist circumference and interscapular distance, compared to that recommended in clinical practice.

METHODS

48 healthy females (median age 60 years) were assessed before and after 10-week Pilates-based matwork training. One Pilates expert and one novice took independent measurements of weight, height, waist circumference and interscapular distance (ISD).

RESULTS

Pilates stance, compared to Normal, increased height by up to 2.7 cm and decreased waist up to 5.2 cm (each P < 0.001, repeated measures ANOVA). ISD decreased up to 14 mm (P < 0.001) and this decrease was greater after training (P < 0.001). After controlling for age and length of time learning Pilates, greater baseline ISD predicted a greater change in ISD after the intervention. Effect of Pilates stance was greater when the expert took the measurements (each P ≤ 0.001).

CONCLUSIONS

Activation of trunk muscles in the Pilates stance increases height and decreases waist circumference, compared to the stance recommended in UK healthcare settings. A decrease in ISD was observed, which was greater after a Pilates-based matwork programme. There are significant inter-observer differences, therefore current clinical guidelines for stance are recommended for repeated anthropometry. The value of the Pilates stance in improving posture and the role of ISD as a marker, should be further studied in various contexts, including clinical settings.

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 Mat Pilates Training on Blood Pressure, Inflammatory, and Oxidative Profiles in Hypertensive Elderly

To determine the effects of mat Pilates training on blood pressure, inflammatory, and antioxidative markers in hypertensive elderly people, 34 hypertensive subjects aged 60-75 years were randomly divided into a control group (CON; n = 17) and a mat Pilates training group (MP; n = 17). The CON participants conducted normal daily activities and participated in neither organized exercises nor sports training, while those in the MP group received mat Pilates training for 60 min three times/week for 12 weeks. Parameters including blood pressure, cardiovascular function, nitric oxide (NO), tumor necrotic factor-alpha (TNF-α), superoxide dismutase (SOD), and malonaldehyde (MDA) were collected at baseline and the end of 12 weeks. The MP group had significantly decreased blood pressure, improved cardiovascular variables, decreased MDA and TNF-α, and increased NO and SOD compared with the CON group and the pre-training period (p < 0.05). In conclusion, these findings demonstrate the positive effects of 12 weeks of mat Pilates training in terms of reducing blood pressure and increasing blood flow related to improvements in anti-inflammatory and antioxidative markers in hypertensive elderly people. Mat Pilates training might be integrated as an alternative therapeutic exercise modality in clinical practice for hypertensive elderly individuals.

Investigation of the Approaches to Optimal Exercise Interventions Based on Dementia Type: A Theoretical Review

The aim of this study is to enhance comprehension of the different types and features of dementia, including their symptoms, diagnosis and medical treatment, and to propose various evidence-based exercise interventions and their clinical applications tailored to each specific type of dementia. The theoretical review includes the analysis of publications in the scientific databases PubMed/Medline, Ebsco, Scielo, and Google. A total of 177 articles were found, of which 84 were studied in depth. With the prevalence of all forms of dementia projected to increase from 57.4 million in 2019 to 152.8 million in 2050, personalized treatment strategies are needed. This review discusses various forms of dementia, including their pathologies, diagnostic criteria, and prevalence rates. The importance of accurate diagnosis and tailored care is emphasized, as well as the effectiveness of physical exercise in improving cognitive function in dementia patients. For Alzheimer's, a combination of drug therapies and exercises is recommended to enhance cerebral blood flow and neurotransmitter activity. To improve cognitive and motor functions in Lewy body dementia, a combination of pharmacological and physical therapies is recommended. For managing frontotemporal dementia, a mix of medication and exercises aimed at emotion regulation, including aerobic exercises, and a unified protocol, is suggested. For mild cognitive impairment, aerobic and functional exercises are important in delaying cognitive decline and enhancing cognitive performance. In conclusion, individualized care and treatment plans tailored to the specific characteristics of each disease type can improve the quality of life for individuals with this condition and effectively manage this growing global health issue.

Comparison of Intervention Programs to Improve Trunk Stability for Active Females

Background

Current literature illustrates a disparity in trunk stability push up performance (TSPU), as measured by the Functional Movement Screen (FMSTM), in females throughout the lifespan when compared to their male counterparts.

Hypothesis/Purpose

The purpose of this study was to evaluate the effectiveness of a novel exercise approach to a trunk stability (NEATS) program compared to a standard Pilates program on TSPU performance in active females aged 18-45 years. It was hypothesized that subjects in the NEATS program would have greater improvements on outcomes related to trunk stability than subjects in the Pilates program.

Study Design

Randomized controlled trial.

Methods

All subjects were tested at baseline on Beighton criteria, the FMSTM, Y-Balance Test Upper Quarter and Lower Quarter, and grip strength by an evaluator blinded to group allocation. Subjects were randomized into the NEATS (n=17) or the Pilates group (n=19). The intervention period lasted eight weeks, with exercise progression at weeks two, four, and six.

Results

The main outcome was between-group pass rates on the TSPU. At posttest, 41% (n=7) of the NEATS group and 42% (n=8) of the Pilates group passed the TSPU, though there was no difference between groups (p=0.97). Significant differences were noted on the TSPU (Pilates, NEATS p=0.01) and composite scores (Pilates p=0.01; NEATS p=0.03). No within-group improvements were noted on the individual scores of the FMSTM (p=0.05-0.66). Within-group differences were noted on the posterolateral reach on the Y-Balance Test Lower Quarter (p=0.03) in the Pilates group. Between-group posttest continuous measures were not significantly different (p=0.17-0.96).

Conclusion

Improvements in trunk stability were comparable between the multi-planar NEATS program and a standard Pilates program suggesting that both can be used to improve trunk stability performance in active females.

Level of Evidence

2.

Effect of 12 Weeks Core Training on Core Muscle Performance in Rhythmic Gymnastics

BACKGROUND

Rhythmic gymnastics performance is characterized by technical elements involving flexibility, aerobic capacity and strength. Increased core strength in rhythmic gymnastics could lead to improved sporting performance.

OBJECTIVE

The aim of this study was to analyze the effect of 12 weeks of core muscle training on core muscle performance in rhythmic gymnasts.

METHODS

A randomized controlled study involving 24 rhythmic gymnastics was conducted. Participants were randomly assigned to a control group (CG; n = 12; age 13.50 ± 3.17 years) or a training group (TG; n = 12; age 14.41 ± 2.35 years). Body composition, isometric strength of trunk, core endurance and core muscle electromyographic activity were measured (EMG) after 12 weeks of core training. Independent sample t-tests were carried out to compare baseline values between groups. A two-way repeated-measures analysis of variance (ANOVA) (time × group) was applied.

RESULTS

The TG improved body composition, trunk lean mass (mean differences MD = -0.31; p = 0.040), lean mass (MD = 0.43; p = 0.037) and bone mass (MD = -0.06; p < 0.001) after training. Core training increased isometric strength of trunk, flexion test (MD = -21.53; p = 0.019) and extension test (MD = 22.7; p = 0.049), as well as the prone bridge core endurance test (MD = -11.27; p = 0.040). The EMG values also increased in the TG in prone bridge for front trunk (MD = -58.58; p = 0.026).

CONCLUSIONS

Core strength training leads to improvements in body composition, as well as improvements in trunk strength and increases in muscle electromyographic activity. These improvements could therefore improve performance during competitive rhythmic gymnastics exercises.

Effects of pilates on physical-functional performance, quality of life and mood in older adults: Systematic review and meta-analysis of randomized clinical trials

OBJECTIVE

To systematically review the effects of pilates on physical-functional aspects and quality of life of older adults.

METHODS

We included randomized clinical trials whose participants were older adults, whose intervention was pilates exercises and that used a control group for comparison. The primary outcomes were balance, muscle strength, quality of life. Secondary outcomes were mood, autonomy, and flexibility. The searches were performed in the electronic databases Pubmed, Web of Science, LILACS, Cochrane Library and EMBASE, using terms from MeSH: Aged, elderly, Pilates-Based Exercises, Pilates Training, Pilates, Mat Pilates, Equipment-based Pilates, and synonyms, in May 2020. The meta-analysis, when possible, was performed using the mean and standard deviation values of the groups after the intervention period using the random effects model.

RESULTS

The search rendered 1639 studies, of which 28 articles corresponding to 24 ECRs (897 individuals) were included, most of the studies involved a female population. A meta-analysis was performed only in the balance variable, through the Berg Scale (three RCTs), where there were no significant differences between the intervention and control groups (2.06-95% CI: 1.31, 5.44, I²: 91%), and it was evaluated by the TUG (six RCTs), which showed a reduction of 0.92 seconds in the protocol execution (95% CI: 1.67, -0.17, I²: 62%).

CONCLUSION

This review demonstrate that the practice of pilates by older adults may have positive effects on some of the outcomes evaluated, these results should be interpreted with caution (methodological heterogeneity and a part present high risk of bias).

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 Circuit Resistance Training on Body Composition, Strength, and Cardiorespiratory Fitness in Middle-Aged and Older Women: A Systematic Review and Meta-Analysis

A systematic review with meta-analysis was conducted to evaluate the effects of circuit resistance training (CRT) on cardiorespiratory fitness, strength, and body composition in middle-aged and older women. Sixteen studies were included in the meta-analysis. The CRT interventions led to a significant decrease in weight, body mass index, and fat mass along with an increase in muscle mass. Significant differences were found in the fat mass and a trend to develop muscle mass when compared with the control group. CRT led to a significant increase in VO2max, walking endurance, and time to exhaustion; likewise, significant differences were observed when compared with the control group. CRT had a moderate and large favorable effect on arm, trunk, and lower limb strength. Furthermore, the increases in strength observed in the CRT were significantly greater than the changes observed in the control group. In middle-aged and older women, CRT improved cardiorespiratory fitness and strength and optimized body composition.