BACKGROUND:Urinary incontinence (UI) is a distressing condition affecting at least 5 million women in England and Wales. Traditionally, physiotherapy for UI comprises pelvic floor muscle training, but although evidence suggests this can be effective it is also recognised that benefits are often compromised by patient motivation and commitment. In addition, there is increasing recognition that physical symptoms alone are poor indicators of the impact of incontinence on individuals' lives. Consequently, more holistic approaches to the treatment of UI, such as Modified Pilates (MP) have been recommended. This study aimed to provide preliminary findings about the effectiveness of a 6-week course of MP classes as an adjunct to standard physiotherapy care for UI, and to test the feasibility of a randomised controlled trial (RCT) design.

METHODS:The study design was a single centre pilot RCT, plus qualitative interviews. 73 women referred to Women's Health Physiotherapy Services for UI at Colchester Hospital University NHS Foundation Trust were randomly assigned to two groups: a 6-week course of MP classes in addition to standard physiotherapy care (intervention) or standard physiotherapy care only (control). Main outcome measures were self-reported UI, quality of life and self-esteem at baseline (T1), completion of treatment (T2), and 5 months after randomisation (T3). Qualitative interviews were conducted with a subgroup at T2 and T3. Due to the nature of the intervention blinding of participants, physiotherapists and researchers was not feasible.

RESULTS:Post-intervention data revealed a range of benefits for women who attended MP classes and who had lower symptom severity at baseline: improved self-esteem (p = 0.032), decreased social embarrassment (p = 0.026) and lower impact on normal daily activities (p = 0.025). In contrast, women with higher symptom severity showed improvement in their personal relationships (p = 0.017). Qualitative analysis supported these findings and also indicated that MP classes could positively influence attitudes to exercise, diet and wellbeing.

CONCLUSIONS:A definitive RCT is feasible but will require a large sample size to inform clinical practice.

TRIAL REGISTRATION:ISRCTN74075972 Registered 12/12/12 (Retrospectively registered).

OBJECTIVE:To compare the effects of Pilates and walking on quality of life, depression, and anxiety levels.

METHODS:Sixty-three overweight/obese participants were randomly divided into: control (n = 20), walking (n = 21), and Pilates (n = 22) groups. Pilates and walking groups attended eight weeks of 60-minute exercise sessions three times per week. Quality of life, depression, and state- and trait-anxiety levels were evaluated before and after eight weeks of training.

RESULTS:Scores of quality of life, depression, and trait-anxiety improved in the Pilates and walking groups. State-anxiety levels improved only in the walking group.

CONCLUSION:Pilates and walking positively impact quality of life, depression and anxiety. The Pilates method could be used as an alternative to improve mood disorders in overweight/obese individuals.

Many claims have been made about the effectiveness of Pilates exercise on the basic parameters of fitness. The purpose of this study was to determine the effects of Pilates exercise on abdominal endurance, hamstring flexibility, upper-body muscular endurance, posture, and balance. Fifty subjects were recruited to participate in a 12-week Pilates class, which met for 1 hour 2 times per week. Subjects were randomly assigned to either the experimental (n = 25) or control group (n = 25). Subjects performed the essential (basic) mat routine consisting of approximately 25 separate exercises focusing on muscular endurance and flexibility of the abdomen, low back, and hips each class session. At the end of the 12-week period, a 1-way analysis of covariance showed a significant level of improvement (p

INTRODUCTION:Pilates has been shown to be effective for increasing muscle strength in older adults, however, some variables have not yet been explored.

OBJECTIVE:Investigate the effects of Pilates on the isokinetic muscular strength of the knee extensors and flexors at 60°/s, in elderly women.

METHOD:Thirty-two women were randomized into two groups: control group (CG, n = 16, age = 64.2 ± 0.8 years; BMI = 25.0 ± 1.2 kg/m), and experimental group (EG, n = 16, age = 63.6 ± 1.0 years, BMI = 24.7 ± 1.3 kg/m). Isokinetic evaluation of the knee extensor and flexor muscles was performed at 60°/s, pre- and post-intervention, considering the peak torque (N.m) and total work (J) for the right and left lower limbs. The CG participated in static stretching and the EG in Pilates sessions, twice a week for 12 weeks.

RESULTS:The results demonstrated that the EG presented a significant improvement (p < 0.01) in all tests performed, when comparing the pre- and post-intervention (intragroup), with an effect size (Cohen's d) reaching 2.03 and 1.33 for the knee flexor and extensor muscles respectively. Comparing the CG and EG (intergroup), post-intervention, a significant improvement was observed (p ≤ 0.01) in favor of the EG for all variables, with an effect size (Cohen's d) reaching 1.59 and 1.15 for the knee flexor and extensor muscles respectively.

CONCLUSION:The results indicated that 12 weeks of Pilates increases the isokinetic muscular strength of the knee extensors and flexors in elderly women and can be considered for this purpose when prescribing physical exercise programs.

OBJECTIVE: The aim of this study was to evaluate the effects of the Pilates method on the personal autonomy, static balance and quality of life in healthy elderly females. METHOD: Fifty-two elderly females were selected and submitted to evaluation protocols to assess functional autonomy (GDLAM), static balance (Tinetti) and quality of life (WHOQOL-OLD). The Pilates group (PG: n=27) participated in Pilates exercises twice weekly for eight weeks. Descriptive statistics were compiled using the Shapiro-Wilk test. The level of significance was considered to be p

OBJECTIVE:This study aims to evaluate the effects of Pilates exercises for a decreasing pain in pregnant women.

METHODS:A total of 40 pregnant women were divided into two groups, a control group (followed a standard pregnancy exercise regimen) and a Pilates group (completed a Pilates exercise regimen). A pain assessment was carried out after exercise, using a visual analog scale. The Pilates group workout program lasted 70-80 min per day, once a week, for 8 weeks.

RESULTS:The reduction in the level of pain was found to be significantly greater in the group of pregnant women who completed the Pilates workout (p < 0.05).

CONCLUSIONS:The results of this study indicated that Pilates is an effective, healthy, and feasible method of reducing pain in pregnancy, and is therefore a beneficial alternative workout for the suppression of pain in the third trimester of pregnancy.

STUDY DESIGN: A randomized controlled trial, prestest-posttest design, with a 3-, 6-, and 12-month follow-up. OBJECTIVES: To investigate the efficacy of a therapeutic exercise approach in a population with chronic low back pain (LBP). BACKGROUND: Therapeutic approaches developed from the Pilates method are becoming increasingly popular; however, there have been no reports on their efficacy. METHODS AND MEASURES: Thirty-nine physically active subjects between 20 and 55 years old with chronic LBP were randomly assigned to 1 of 2 groups. The specific-exercise-training group participated in a 4-week program consisting of training on specialized (Pilates) exercise equipment, while the control group received the usual care, defined as consultation with a physician and other specialists and healthcare professionals, as necessary. Treatment sessions were designed to train the activation of specific muscles thought to stabilize the lumbar-pelvic region. Functional disability outcomes were measured with The Roland Morris Disability Questionnaire (RMQ/RMDQ-HK) and average pain intensity using a 101-point numerical rating scale. RESULTS: There was a significantly lower level of functional disability (P = .023) and average pain intensity (P = .002) in the specific-exercise-training group than in the control group following the treatment intervention period. The posttest adjusted mean in functional disability level in the specific-exercise-training group was 2.0 (95% CI, 1.3 to 2.7) RMQ/RMDQ-HK points compared to a posttest adjusted mean in the control group of 3.2 (95% CI, 2.5 to 4.0) RMQ/RMDQ-HK points. The posttest adjusted mean in pain intensity in the specific-exercise-training group was 18.3 (95% CI, 11.8 to 24.8), as compared to 33.9 (95% CI, 26.9 to 41.0) in the control group. Improved disability scores in the specific-exercise-training group were maintained for up to 12 months following treatment intervention. CONCLUSIONS: The individuals in the specific-exercise-training group reported a significant decrease in LBP and disability, which was maintained over a 12-month follow-up period. Treatment with a modified Pilates-based approach was more efficacious than usual care in a population with chronic, unresolved LBP.

STUDY DESIGN: Longitudinal, repeated-measures study. OBJECTIVE: The aim of this study was to determine changes in sagittal spinal posture in older adults during standing and sitting after a Pilates-based exercise program. SUMMARY OF BACKGROUND DATA: Pilates exercise is purported to improve posture, however, few peer-reviewed articles are available to provide scientific support. Most previous studies were conducted in young dancers, and the effect of Pilates exercise on spinal posture in older adults remained unclear. METHODS: Thirty-four healthy older adults aged over 60 years volunteered for this study. A two-dimensional PEAK Motus motion analysis system was used to measure sagittal spinal angles. Participants were tested on 2 occasions before the exercise program to establish a baseline measure, and undertook a supervised Pilates-based exercise program twice weekly for 10 weeks. Participants were tested on another 2 occasions, immediately after the exercise program, and after a short-term follow-up. RESULTS: Baseline measures in both standing and sitting postures remained unchanged except for the lumbar spine angle in sitting. Immediately after the Pilates-based exercise program, older adults stood with slightly decreased thoracic flexion and sat with slightly increased lumbar extension. No significant differences were found during the follow-up period. CONCLUSION: The individually designed Pilates-based exercise program was feasible for healthy older adults, and the high attendance rate supports the suitability of the exercise program over a long period. Considering the variability of the baseline measure, small improvement was only observed in the thoracic kyphosis during standing. The long-term effect of Pilates exercise requires further investigation.

The aim of the study was to evaluate the effect of Mat Pilates on the functional capacity (FC) of elderly women before and after six weeks of intervention. Eighteen women aged 62.28 (±2.34) participated in the study. Timed Up and Go test, Timed Up Stairs, Timed Down Stairs, 30-s Chair Stand, Chair Sit-and-Reach and Back Scratch tests were assessed. The results showed significant improvements in all FC tests after six weeks of the Mat Pilates intervention. Summarizing, only sixweeks of Mat Pilates training of 60 min per session, three times a week, three series beginning with six repetitions and eight repetitions at the last two weeks of intervention, were enough to improve FC in elderly women. Furthermore, the exercises difficulty increased from beginners to intermediate.

BACKGROUND: Shoulder biomechanics and spine alignment have been found to be related to occasional and/or chronic neck-shoulder pain. Pilates is a physical training approach that focuses on posture, flexibility, segmental alignment and core control, through posture and movement exercises. The objectives of this study were to determine the effect of a Pilates training program on arm-trunk posture, strength, flexibility and biomechanical patterns during a functional shoulder flexion task. METHODS: Nineteen subjects (9 controls, 10 experimental) were assessed twice, 12 weeks apart, during which the experimental group was submitted to a Pilates training program (two 1-h sessions per week). The assessment consisted of trials of seated posture, abdominal strength, shoulder range of motion, and maximal shoulder flexion, during which neck, shoulder and trunk kinematics and the activity of 16 muscles were recorded. FINDINGS: After training, subjects showed smaller static thoracic kyphosis during quiet sitting and greater abdominal strength. The experimental group also showed reduced posterior and mediolateral scapular displacements, upper thoracic extension and lumbar lateral flexion, as well as higher activity of the ipsilateral cervical erector spinae, contralateral rhomboid muscles and lower activity of the ipsilateral lumbar erector spinae during the shoulder flexion task. INTERPRETATION: The Pilates training program was effective in improving abdominal strength and upper spine posture as well as in stabilizing core posture as shoulder flexion movements were performed. Since deficits in these functional aspects have previously been associated with symptoms in the neck-shoulder region, our results support the use of Pilates in the prevention of neck-shoulder disorders.

AIM:The purpose of this study was to determine the effect of Clinical Pilates exercises on patients with shoulder pain.

MATERIAL AND METHODS:Thirty-three patients, experiencing shoulder pain continuously for at least four weeks were selected as study subjects. The patients were randomly divided into two groups, namely Clinical Pilates exercise (n = 17) group and conventional exercise (n = 16) group. The patients were treated for five days a week, the total treatment being carried out for 10 days. The assessment of pain and disability amongst the patients were done at the baseline and at the end of the treatment sessions, using Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI).

RESULTS:The clinical Pilates exercise group showed a significant improvement in all scores used for assessment (p < 0.05), while the conventional exercise group demonstrated a significant improvement only in the SPADI total score (p < 0.05). A comparison of scores for the VAS, SPADI-Pain and SPADI-Total between the two groups, revealed a significant improvement in the Clinical Pilates exercise group (p < 0.05).

CONCLUSION:It was demonstrated by the study that Clinical Pilates exercise is an efficient technique for patients experiencing shoulder pain, as it helps reduce pain and disability among them.

BACKGROUND:Pilates is an exercise method which increases strength and endurance of core muscles and improves flexibility, dynamic postural control and balance.

OBJECTIVE:To analyze and compare the effects of Mat and Reformer Pilates methods in Patients with Multiple Sclerosis (MS).

METHODS:Thirty-eight patients with MS were included in the study. Participants were randomly divided into 3 groups as Mat Pilates, Reformer Pilates and control groups. The subjects in the Pilates groups did Mat or Reformer Pilates for 8 weeks, 2 days a week. The control group did breathing and relaxation exercises at home. Balance, functional mobility, core stability, fatigue severity and quality of life were evaluated.

RESULTS:Balance, functional mobility, core stability, fatigue severity and quality of life improved after Pilates in Mat and Reformer Pilates groups (p < 0.05). On the other hand, we could not find any changing in the control group (p > 0.05). When the gain obtained in the Pilates groups is compared, it has been observed that progress has been more in trunk flexor muscle strength in the Reformer Pilates group (p < 0.05) and that the gain has been similar in the other parameters (p > 0.05).

CONCLUSIONS:As a result, patients with MS have seen similar benefits in Reformer Pilates and Mat Pilates methods.

AIM: The Back School is a widely accepted and effective method for treating low back pain, whereas no scientific evidence exists about the effects of the Pilates CovaTech method. With this study we wanted to evaluate the efficacy of this new method in patients with low back pain. METHODS: Fifty-three patients with at least 3 months of nonspecific low back pain were entered into a Pilates therapy or a Back School treatment group, 43 of which completed the study. Small exercise groups of 7 patients each followed a daily kinesitherapy protocol for 10 days. Evaluations were performed at the start of the study and then at 1, 3 and 6 months after the beginning of treatment. We used the Oswestry Low Back Pain Disability Scale (OLBPDQ) to assess disability and the visual analog scale (VAS) to evaluate pain. RESULTS: Demographic and baseline clinical characteristics were similar for both groups. A significant reduction in pain intensity and disability was observed across the entire sample. The Pilates method group showed better compliance and subjective response to treatment. CONCLUSIONS: The results obtained with the Pilates method were comparable to those achieved with the Back School method, suggesting its use as an alternative approach to the treatment of non specific low back pain.