Advertisement
Review article| Volume 96, ISSUE 12, P2231-2242, December 2015

Pilates Method for Women's Health: Systematic Review of Randomized Controlled Trials

Published:April 22, 2015DOI:https://doi.org/10.1016/j.apmr.2015.04.005

      Abstract

      Objective

      To critically analyze the benefits of Pilates on health outcomes in women.

      Data Sources

      CINAHL, MEDLINE, PubMed, Science Direct, SPORTDiscus, Physiotherapy Evidence Database (PEDro), Cochrane Central Register of Controlled Trials, and Web of Science.

      Study Selection

      Databases were searched using the terms Pilates and Pilates Method. Published randomized controlled trials (RCTs) were included if they comprised female participants with a health condition and a health outcome was measured, Pilates needed to be administered, and the article was published in English in a peer-reviewed journal from 1980 to July 2014.

      Data Extraction

      Two authors independently applied the inclusion criteria to potential studies. Methodological quality was assessed using the PEDro scale. A best-evidence grading system was used to determine the strength of the evidence.

      Data Synthesis

      Thirteen studies met the inclusion criteria. PEDro scale values ranged from 3 to 7 (mean, 4.5; median, 4.0), indicating a relatively low quality overall. In this sample, Pilates for breast cancer was most often trialed (n=2). The most frequent health outcomes investigated were pain (n=4), quality of life (n=4), and lower extremity endurance (n=2), with mixed results. Emerging evidence was found for reducing pain and improving quality of life and lower extremity endurance.

      Conclusions

      There is a paucity of evidence on Pilates for improving women's health during pregnancy or for conditions including breast cancer, obesity, or low back pain. Further high-quality RCTs are warranted to determine the effectiveness of Pilates for improving women's health outcomes.

      Keywords

      List of abbreviations:

      BES (best-evidence synthesis), PEDro (Physiotherapy Evidence Database), QOL (quality of life), RCT (randomized controlled trial), WHO (World Health Organization)
      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:

      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

      References

        • Lange C.
        • Unnithan V.B.
        • Larkam E.
        • Latta P.M.
        Maximizing the benefits of Pilates-inspired exercise for learning functional motor skills.
        J Bodyw Mov Ther. 2000; 4: 99-108
        • Pilates J.
        • Miller W.
        Return to life through contrology.
        Presentation Dynamics, Incline Village1945
        • Pilates J.H.
        Your health.
        Presentation Dynamics, Incline Village1934
        • Latey P.
        The Pilates method: history and philosophy.
        J Bodyw Mov Ther. 2001; 5: 275-282
        • Lessen D.
        The P.M.A. Pilates certification exam study guide.
        Pilates Method Alliance, Miami2014
        • Cruz-Ferreira A.
        • Fernandes J.
        • Laranjo L.
        • Bernardo L.M.
        • Silva A.
        A systematic review of the effects of Pilates method of exercise in healthy people.
        Arch Phys Med Rehabil. 2011; 92: 2071-2081
        • Anderson B.
        Fitting Pilates into a rehabilitation practice.
        Rehab Manag. 2010; 23: 26-27
        • Kloubec J.
        Pilates: how does it work and who needs it?.
        Muscles Ligaments Tendons J. 2011; 1: 61-66
        • Eyigor S.
        • Karapolat H.
        • Yesil H.
        • Uslu R.
        • Durmaz B.
        Effects of Pilates exercises on functional capacity, flexibility, fatigue, depression and quality of life in female breast cancer patients: a randomized controlled study.
        Eur J Phys Rehabil Med. 2010; 46: 481-487
        • Aladro-Gonzalvo A.R.
        • Machado-Díaz M.
        • Moncada-Jiménez J.
        • Hernández-Elizondo J.
        • Araya-Vargas G.
        The effect of Pilates exercises on body composition: a systematic review.
        J Bodyw Mov Ther. 2012; 16: 109-114
        • Stan D.L.
        • Collins N.M.
        • Olsen M.M.
        • Croghan I.
        • Pruthi S.
        The evolution of mindfulness-based physical interventions in breast cancer survivors.
        Evid Based Complementary Altern Med. 2012; 2012: 758641
        • Granacher U.
        • Gollhofer A.
        • Hortobagyi T.
        • Kressig R.W.
        • Muehlbauer T.
        The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review.
        Sports Med. 2013; 43: 627-641
        • Cancela J.M.
        • de Oliveira I.M.
        • Rodriguez F.G.
        Effects of Pilates in physical fitness on older adults. A systematic review.
        Eur Rev Aging Phys Act. 2014; 11: 81-94
        • Barker A.L.
        • Bird M.L.
        • Talevski J.
        Effect of Pilates exercise for improving balance in older adults: a systematic review with meta-analysis.
        Arch Phys Med Rehabil. 2015; 96: 715-723
        • Bo K.
        • Herbert R.D.
        There is not yet strong evidence that exercise regimens other than pelvic floor muscle training can reduce stress urinary incontinence in women: a systematic review.
        J Physiother. 2013; 59: 159-168
        • Sullivan A.B.
        • Scheman J.
        • Venesy D.
        • Davin S.
        The role of exercise and types of exercise in the rehabilitation of chronic pain: specific or nonspecific benefits.
        Curr Pain Headache Rep. 2012; 16: 153-161
        • 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
        • Posadzki P.
        • Lizis P.
        • Hagner-Derengowska M.
        Pilates for low back pain: a systematic review.
        Complement Ther Clin Pract. 2011; 17: 85-89
        • Lim E.C.
        • Poh R.L.
        • Low A.Y.
        • Wong W.P.
        Effects of Pilates-based exercises on pain and disability in individuals with persistent nonspecific low back pain: a systematic review with meta-analysis.
        J Orthop Sports Phys Ther. 2011; 41: 70-80
        • Pereira L.M.
        • Obara K.
        • Dias J.M.
        • et al.
        Comparing the Pilates method with no exercise or lumbar stabilization for pain and functionality in patients with chronic low back pain: systematic review and meta-analysis.
        Clin Rehabil. 2012; 26: 10-20
        • Aladro-Gonzalvo A.R.
        • Araya-Vargas G.A.
        • Machado-Díaz M.
        • Salazar-Rojas W.
        Pilates-based exercise for persistent, non-specific low back pain and associated functional disability: a meta-analysis with meta-regression.
        J Bodyw Mov Ther. 2013; 17: 125-136
        • Wells C.
        • Kolt G.S.
        • Marshall P.
        • Hill B.
        • Bialocerkowski A.
        Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews.
        BMC Med Res Methodol. 2013; 13: 7
        • Wells C.
        • Kolt G.S.
        • Marshall P.
        • Hill B.
        • Bialocerkowski A.
        The effectiveness of Pilates exercise in people with chronic low back pain: a systematic review.
        PLoS One. 2014; 9: e100402
        • Küçükçakır N.
        • Altan L.
        • Korkmaz N.
        Effects of Pilates exercises on pain, functional status and quality of life in women with postmenopausal osteoporosis.
        J Bodyw Mov Ther. 2013; 17: 204-211
        • Culligan P.J.
        • Scherer J.
        • Dyer K.
        • et al.
        A randomized clinical trial comparing pelvic floor muscle training to a Pilates exercise program for improving pelvic muscle strength.
        Int Urogynecol J. 2010; 21: 401-408
        • Irez G.B.
        • Ozdemir R.A.
        • Evin R.
        • Irez S.G.
        • Korkusuz F.
        Integrating Pilates exercise into an exercise program for 65+ year-old women to reduce falls.
        J Sports Sci Med. 2011; 10: 105-111
        • Bird M.L.
        • Hill K.D.
        • Fell J.W.
        A randomized controlled study investigating static and dynamic balance in older adults after training with Pilates.
        Arch Phys Med Rehabil. 2012; 93: 43-49
        • World Health Organization
        International Classification of Functioning, Disability and Health.
        WHO, Geneva2001
      1. World Health Organization. WHO International Statistical Classification of Diseases and Related Health Problems, 2010. Available at: http://apps.who.int/classifications/icd10/browse/2010/en. Accessed January 11, 2015.

        • World Health Organization
        Definition of an older or elderly person.
        WHO, Geneva2010 (Available at:) (Accessed January 11, 2015)
        • Mayer C.G.
        • Sherrington C.
        • Herbert R.D.
        • Moseley A.M.
        • Elkins M.
        Reliability of the PEDro scale for rating quality of randomized controlled trials.
        Phys Ther. 2003; 83: 713-721
        • Verhagen A.P.
        • de Vet H.C.
        • de Bie R.A.
        • et al.
        The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus.
        J Clin Epidemiol. 1998; 51: 1235-1241
        • de Morton N.A.
        The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study.
        Aust J Physiother. 2009; 55: 129-133
        • Olivo S.A.
        • Macedo L.G.
        • Gadotti I.C.
        • Fuentes J.
        • Stanton T.
        • Magee D.J.
        Scales to assess the quality of randomized controlled trials: a systematic review.
        Phys Ther. 2008; 88: 156-175
        • Slavin R.E.
        Best-evidence synthesis: an alternative to meta-analytic and traditional reviews.
        Educ Res. 1986; 15: 5-11
        • Slavin R.E.
        Best evidence synthesis: an intelligent alternative to meta-analysis.
        J Clin Epidemiol. 1995; 48: 9-18
        • Treadwell J.R.
        • Singh S.
        • Talati R.
        • McPheeters M.L.
        • Reston J.T.
        A framework for best evidence approaches can improve the transparency of systematic reviews.
        J Clin Epidemiol. 2012; 65: 1159-1162
        • Trinh K.
        Summaries and recommendations of the global impression method.
        J Acupunct Tuina Sci. 2009; 7: 296-302
        • Rodrigues B.G.
        • Cader S.A.
        • Torres N.V.
        • de Oliveira E.M.
        • Dantas E.H.
        Pilates method in personal autonomy, static balance and quality of life of elderly females.
        J Bodyw Mov Ther. 2010; 14: 195-202
        • Altan L.
        • Korkmaz N.
        • Bingol Ü.
        • Gunay B.
        Effect of Pilates training on people with fibromyalgia syndrome: a pilot study.
        Arch Phys Med Rehabil. 2009; 90: 1983-1988
        • Alves de Araujo M.E.
        • Bezerra da Silva E.
        • Bragade Mello D.
        • Cader S.A.
        • Shiguemi Inoue Salgado A.
        • Dantas E.H.
        The effectiveness of the Pilates method: reducing the degree of non-structural scoliosis, and improving flexibility and pain in female college students.
        J Bodyw Mov Ther. 2012; 16: 191-198
        • Cakmakci O.
        The effect of 8 week Pilates exercise on body composition in obese women.
        Coll Antropol. 2011; 35: 1045-1050
        • Marinda F.
        • Magda G.
        • Ina S.
        • Brandon S.
        • Abel T.
        • Ter Goon D.
        Effects of a mat Pilates program on cardiometabolic parameters in elderly women.
        Pak J Med Sci. 2013; 29: 500-504
        • Martin E.
        • Battaglini C.
        • Groff D.
        • Naumann F.
        Improving muscular endurance with the MVe Fitness Chair™ in breast cancer survivors: a feasibility and efficacy study.
        J Sci Med Sport. 2013; 16: 372-376
        • Plachy J.K.
        • Kovách M.V.
        • Bognár J.
        Improving flexibility and endurance of elderly women through a six-month training programme.
        Hum Mov. 2012; 13: 22-27
        • Fourie M.
        • Gildenhuys G.M.
        • Shaw I.
        • Shaw B.S.
        • Toriola A.L.
        • Goon D.T.
        Effects of a mat Pilates programme on body composition in elderly women.
        West Indian Med J. 2013; 62: 524-528
        • Ashrafinia F.
        • Mirmohammadali M.
        • Rajabi H.
        • et al.
        The effects of Pilates exercise on sleep quality in postpartum women.
        J Bodyw Mov Ther. 2014; 18: 190-199
        • Lee C.H.
        • Hyun J.
        • Kim S.G.
        Influence of Pilates mat and apparatus exercises on pain and balance of businesswomen with chronic low back pain.
        J Phys Ther Sci. 2014; 26: 475-477
        • Gildenhuys G.M.
        • Fourie M.
        • Shaw I.
        • Shaw B.S.
        • Toriola A.L.
        • Witthuhn J.
        Evaluation of Pilates training on agility, functional mobility and cardiorespiratory fitness in elderly women.
        Afr J Phys Health Educ Recreation Dance. 2013; 19: 505-512
        • Kaptchuk T.J.
        • Kelley J.M.
        • Conboy L.A.
        • et al.
        Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome.
        BMJ. 2008; 336: 999-1003
        • Horlings C.G.
        • van Engelen B.G.
        • Allum J.H.
        • Bloem B.R.
        A weak balance: the contribution of muscle weakness to postural instability and falls.
        Nat Clin Pract Neurol. 2008; 4: 504-515
        • Boguszewski D.
        • Monika
        • Adamczyk J.
        • Ochal A.
        The role of Pilates and aquafitness exercises in sustaining the health and fitness of elderly women.
        Sport Sci Rev. 2012; 21: 127-138
        • Fourie M.
        • Gildenhuys G.M.
        • Shaw I.
        • Shaw B.S.
        • Toriola A.L.
        • Goon D.T.
        Effects of mat Pilates programme on muscular strength and endurance in elderly women.
        Afr J Phys Health Educ Recreation Dance. 2012; 18: 299-307
        • Jakicic J.M.
        • Clark K.
        • Coleman E.
        • et al.
        American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults.
        Med Sci Sports Exerc. 2001; 33: 2145-2156
        • Sekendiz B.
        • Altun Ö.
        • Korkusuz F.
        • Akin S.
        Effects of Pilates exercise on trunk strength, endurance and flexibility in sedentary adult females.
        J Bodyw Mov Ther. 2007; 11: 318-326
        • Rogers K.
        • Gibson A.L.
        Eight-week traditional mat Pilates training-program effects on adult fitness characteristics.
        Res Q Exerc Sport. 2009; 80: 569-574
        • Kloubec J.A.
        Pilates for improvement of muscle endurance, flexibility, balance, and posture.
        J Strength Cond Res. 2010; 24: 661-667
        • Balogh A.
        Pilates and pregnancy.
        RCM Midwives. 2005; 8: 220-222
        • Robinson L.
        Pilates in pregnancy: the body control method.
        Pract Midwife. 2007; 10: 24-26
        • Pia S.D.
        Pilates and pregnancy: programming ideas and exercise guidelines.
        IDEA Fitness J. 2007; 4: 89-92
        • Artal R.
        • O'Toole M.
        Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period.
        Br J Sports Med. 2003; 37: 6-12
        • ACOG Committee opinion
        Number 267, January 2002: exercise during pregnancy and the postpartum period.
        Obstet Gynecol. 2002; 99: 171-173
        • Pate R.R.
        • Pratt M.
        • Blair S.N.
        • et al.
        A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine.
        JAMA. 1995; 273: 402-407