Effect of Pilates Training on People With Fibromyalgia Syndrome: A Pilot Study


      Altan L, Korkmaz N, Bingol Ü, Gunay B. Effect of Pilates training on people with fibromyalgia syndrome: a pilot study.


      To investigate the effects of Pilates on pain, functional status, and quality of life in fibromyalgia, which is known to be a chronic musculoskeletal disorder.


      Randomized, prospective, controlled, and single-blind trial.


      Physical medicine and rehabilitation department.


      Women (N=50) who had a diagnosis of fibromyalgia syndrome (FMS) according to the American College of Rheumatology criteria.


      The participants were randomly assigned into 2 groups. In group 1, a Pilates exercise program of 1 hour was given by a certified trainer to 25 participants 3 times a week for 12 weeks. In group 2, which was designed as the control group, 25 participants were given a home exercise (relaxation/stretching) program. In both groups, pre- (week 0) and posttreatment (week 12 and week 24) evaluation was performed by one of the authors, who was blind to the group allocation.

      Main Outcome Measures

      Primary outcome measures were pain (visual analog scale) and Fibromyalgia Impact Questionnaire (FIQ). Exploratory outcome measures were number of tender points, algometric score, chair test, and Nottingham Health Profile.


      Twenty-five Pilates exercise and 24 relaxation/stretching exercise participants completed the study. In group 1, significant improvement was observed in both pain and FIQ at week 12 but only in FIQ at 24 weeks. In group 2, no significant improvement was obtained in pain and FIQ at week 12 and week 24. Comparison of the 2 groups showed significantly superior improvement in pain and FIQ in group 1 at week 12 but no difference between the 2 groups at week 24.


      We suggest Pilates as an effective and safe method for people with FMS. Our study is the first clinical study designed to investigate the role of the Pilates method in FMS treatment. We believe that further research with more participants and longer follow-up periods could help assess the therapeutic value of this popular physical exercise method.

      Key Words

      List of Abbreviations:

      FIQ (Fibromyalgia Impact Questionnaire), FMS (fibromyalgia syndrome), NHP (Nottingham Health Profile)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Carville S.F.
        • Arendt-Nielsen S.
        • Bliddal H.
        • et al.
        EULAR evidence-based recommendations for the management of fibromyalgia syndrome.
        Ann Rheum Dis. 2008; 67: 536-541
        • Henriksson K.G.
        Fibromyalgia—from syndrome to disease.
        J Rehab Med. 2003; 41: 89-94
        • Wolfe F.
        The fibromyalgia syndrome: a consensus report on fibromyalgia and disability.
        J Rheumatol. 1996; 23: 534-539
        • Crofford L.J.
        • Appleton B.E.
        The treatment of fibromyalgia: a review of clinical trials.
        Curr Rheumatol Rep. 2000; 2: 101-103
        • Meiworm L.
        • Jakop E.
        • Walker U.A.
        • Peter H.H.
        • Keul J.
        Patients with fibromyalgia benefit from aerobic endurance exercise.
        Clin Rheumatol. 2000; 19: 253-257
        • Martin L.
        • Nutting A.
        • Macintosh B.R.
        • Edworthy S.M.
        • Butterwick D.
        • Cook J.
        An exercise program in the treatment of fibromyalgia.
        J Rheumatol. 1996; 23: 1050-1053
        • Clark S.R.
        • Jones K.D.
        • Burckhardt C.S.
        • Bennet R.
        Exercise for participant with fibromyalgia: risks versus benefits.
        Curr Rheumatol Rep. 2001; 3: 135-146
        • Gowans S.E.
        • deHueck A.
        • Voss S.
        • Richardson M.
        A randomized, controlled trial of exercise and education for individuals with fibromyalgia.
        Arthritis Care Res. 1999; 12: 120-128
        • Jentoft E.S.
        • Kvalvik A.G.
        • Mengshoel A.M.
        Effects of pool-based and land-based aerobic exercise on women with fibromyalgia/chronic widespread muscle pain.
        Arthritis Rheum. 2001; 45: 42-47
        • Altan L.
        • Bingöl U.
        • Aykaç M.
        • Koç Z.
        • Yurtkuran M.
        Investigation of the effects of pool-based exercise on fibromyalgia syndrome.
        Rheumatol Int. 2004; 24: 272-277
        • Busch A.J.
        • Schachter C.L.
        • Overend T.J.
        • Peloso P.M.
        • Barber K.A.
        Exercise for fibromyalgia: a systematic review.
        J Rheumatol. 2008; 35: 1130-1144
        • Busch A.J.
        • Barber K.A.
        • Overend T.J.
        • Peloso P.M.
        • Schachter C.L.
        Exercise for treating fibromyalgia syndrome.
        Cochrane Database Syst Rev. 2007 Oct 17; (CD003786)
      1. Friedman P. Eisen G. The Pilates method of physical and mental conditioning. 10th ed. Penguin Books, London2005
        • Latey P.
        Updating the principles of the Pilates method.
        J Bodyw Mov Ther. 2002; 6: 94-101
        • Herrington L.
        • Davies R.
        The influence of Pilates training on the ability to contract the transversus abdominis muscle in asymptomatic individuals.
        J Bodyw Mov Ther. 2005; 9: 52-57
        • Levine B.
        • Kaplanek B.
        • Scafura D.
        • Jaffe W.L.
        Rehabilitation after total hip and knee arthroplasty: a new regimen using Pilates training.
        Bull NYU Hosp Jt Dis. 2007; 65: 120-125
        • Blum C.L.
        Chiropractic and Pilates therapy for the treatment of adult scoliosis.
        J Manipulative Physiol Ther. 2002; 25: E3
        • Donzelli S.
        • Di Domenica E.
        • Cova A.M.
        • Galletti R.
        • Giunta N.
        Two different techniques in the rehabilitation treatment of low back pain: a randomized controlled trial.
        Eura Medicophys. 2006; 42: 205-210
        • La Touche R.
        • Escalante K.
        • Linares M.T.
        Treating non-specific chronic low back pain through the Pilates Method.
        J Bodyw Mov Ther. 2008; 12: 364-370
        • Hamilton N.A.
        • Affleck G.
        • Tennen H.
        • et al.
        Fibromyalgia: the role of sleep in affect and in negative event reactivity and recovery.
        Health Psychol. 2008; 27: 490-497
        • Mitani Y.
        • Fukunaga M.
        • Kanbara K.
        • Takebayashi N.
        • Ishino S.
        • Nakai Y.
        Evaluation of psychophysiological asymmetry in patients with fibromyalgia syndrome.
        Appl Psychophysiol Biofeedback. 2006; 31: 217-225
        • Jones K.D.
        • Horak F.B.
        • Winters-Stone K.
        • Irvine J.M.
        • Bennett R.M.
        Fibromyalgia is associated with impaired balance and falls.
        J Clin Rheumatol. 2009; 15: 16-21
        • Johnson E.G.
        • Larsen A.
        • Ozawa H.
        • Wilson C.A.
        • Kennedy K.L.
        The effects of Pilates-based exercise on dynamic balance in healthy adults.
        J Bodyw Mov Ther. 2007; 11: 238-242
        • Muscolino J.E.
        • Cipriani S.
        Pilates the “powerhouse.”.
        FI. J Bodyw Mov Ther. 2004; 8: 15-24
        • Wolfe F.
        • Smythe H.A.
        • Yunus M.B.
        • et al.
        The American College of Rheumatology 1990 criteria for the classification of fibromyalgia.
        Arthritis Rheum. 1990; 33: 160-172
        • Ost L.
        Applied relaxation: description of a coping technique and review of controlled studies.
        Behav Res Ther. 1987; 25: 397-409
        • Alter M.J.
        Science of flexibility.
        Human Kinetics, Champaign1996
        • Burckhardt C.S.
        • Clark S.R.
        • Bennett R.M.
        The Fibromyalgia Impact Questionnaire: development and validation.
        J Rheumatol. 1991; 18: 728-733
        • Sarmer S.
        • Ergin S.
        • Yavuzer G.
        The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire.
        Rheumatol Int. 2000; 20: 9-12
        • Fisher A.A.
        Pressure threshold meter: its use for quantification of tender spots.
        Arch Phys Med Rehabil. 1986; 67: 836-838
        • Tunks E.
        • McCain G.A.
        • Hart L.E.
        • et al.
        The reliability of examination for tenderness in patients with myofascial pain, chronic fibromyalgia and controls.
        J Rheumatol. 1995; 22: 944-952
        • Hewett J.E.
        • Buckelew S.P.
        • Johnson J.C.
        • Shaw S.E.
        • Huyser B.
        • Fu Y.Z.
        Selection of measures suitable for evaluating change in fibromyalgia clinical trials.
        J Rheumatol. 1995; 22: 953-958
        • Mannerkorpi K.
        • Svantesson U.
        • Carlsson J.
        • Ekdahl C.
        Tests of functional limitations in fibromyalgia syndrome: a reliability study.
        Arthritis Care Res. 1999; 12: 193-199
        • Wiklund I.
        The Nottingham Health Profile–a measure of health-related quality of life.
        Scand J Prim Health Care. 1990; 1: 15-18
        • Küçükdeveci A.A.
        • McKenna S.P.
        • Kutlay S.
        • et al.
        The development and psychometric assessment of the Turkish version of the Nottingham Health Profile.
        Int J Rehabil Res. 2000; 23: 31-38
        • Segal N.A.
        • Hein J.
        • Basford J.R.
        The effects of Pilates training on flexibility and body composition: an observational study.
        Arch Phys Med Rehabil. 2004; 85: 1977-1981
        • Sekendiz B.
        • Altun O.
        • Korkusuz F.
        • Akın S.
        Effects of Pilates exercise on trunk strength, endurance and flexibility in sedentary adult females.
        J Bodyw Mov Ther. 2007; 11: 318-326
        • Jago R.
        • Jonker M.L.
        • Missaghian M.
        • Baranowski T.
        Effect of 4 weeks of Pilates on the body composition of young girls.
        Prev Med. 2006; 42: 177-180
        • Curnow D.
        • Cobbin D.
        • Wyndham J.
        • Boris Choy S.T.
        Altered motor control, posture and the Pilates method of exercise prescription.
        J Bodyw Mov Ther. 2009; 13: 104-111
        • Bernardo L.M.
        The effectiveness of Pilates training in healthy adults: an appraisal of the research literature.
        J Bodyw Mov Ther. 2007; 11: 106-110
        • Moldofsky H.
        • Scarisbrick P.
        Induction of neurasthenic musculoskeletal pain syndrome by selective sleep stage deprivation.
        Psychosom Med. 1976; 38: 35-44
        • Bennett R.M.
        • Clark S.
        • Goldberg L.
        • et al.
        Aerobic fitness in the fibrositis syndrome.
        Arthritis Rheum. 1989; 32: 454-460
        • Ramsay C.
        • Moreland J.
        • Ho M.
        • Joyce S.
        • Walker S.
        • Pullar T.
        An observer-blinded comparison of supervised and unsupervised aerobic exercise regimens in fibromyalgia.
        Rheumatology. 2000; 39: 501-505
        • Kjaer M.
        Regulation of hormonal and metabolic responses during exercise in humans.
        Exerc Sport Sci Rev. 1992; 20: 161-184
        • Koltyn K.F.
        Analgesia following exercise.
        Sports Med. 2000; 29: 85-98