Is Pilates beneficial and where is the greatest evidence?

Pilates is a popular exercise method that emphasizes controlled movements, stretching, and breathing. It has been increasingly used not only for physical fitness but also as a rehabilitation tool for various medical conditions. This synthesis aims to identify the medical conditions for which Pilates has the most evidence supporting its effectiveness as a treatment.


​Key Insights
  • Chronic Low Back Pain (CLBP): Pilates is effective in reducing pain and improving functional ability in patients with chronic low back pain, showing greater improvements compared to usual care and physical activity in the short term. 4, 5, 10 
 
  • Multiple Sclerosis (MS): Pilates improves physical function, balance, gait, and core stability in people with multiple sclerosis. It also helps reduce self-perceived fatigue and has high adherence rates. 2, 3
 
  • Non-Communicable Diseases (NCDs): Pilates shows strong evidence for improving exercise tolerance and moderate evidence for improving symptoms, muscle strength, and health-related quality of life in patients with various non-communicable diseases, including breast cancer, diabetes, chronic stroke, chronic obstructive pulmonary disease, cystic fibrosis, heart failure, and arterial hypertension. 1
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  • Fibromyalgia: Pilates is effective in reducing pain, improving quality of life, psychological status, and functional capacity in women with fibromyalgia. It shows better results compared to aerobic exercises like walking. 8
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  • Parkinson’s Disease (PD): Pilates has beneficial effects on fitness, balance, and functional autonomy in people with Parkinson’s disease. It is more effective than traditional training programs in improving lower limb function. 7
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  • Women’s Health: Pilates shows emerging evidence for reducing pain and improving quality of life and lower extremity endurance in women, particularly those with breast cancer and low back pain. 9

Conclusion

Pilates is supported by substantial evidence as an effective treatment for chronic low back pain, multiple sclerosis, various non-communicable diseases, fibromyalgia, and Parkinson’s disease. It is particularly noted for its benefits in reducing pain, improving physical function, and enhancing quality of life. While Pilates is often as effective as other forms of exercise, its specific benefits and high adherence rates make it a valuable option in rehabilitation programs for these conditions.

References

1. Miranda, S., & Marques, A. (2018). Pilates in noncommunicable diseases: A systematic review of its effects.. Complementary therapies in medicine, 39, 114-130 . https://doi.org/10.1016/j.ctim.2018.05.018.
Pilates has strong evidence for improving exercise tolerance in patients with non-communicable diseases like chronic cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes.

2. Sanchez-Lastra, M., Martínez-Aldao, D., Molina, A., & Ayán, C. (2019). Pilates for people with multiple sclerosis: A systematic review and meta-analysis.. Multiple sclerosis and related disorders, 28, 199-212 . https://doi.org/10.1016/j.msard.2019.01.006.
Pilates is a feasible therapy for people with multiple sclerosis that can lead to improvements in physical function and reduce self-perceived fatigue.

3. Rodríguez-Fuentes, G., Silveira-Pereira, L., Ferradáns-Rodríguez, P., & Campo-Prieto, P. (2022). Therapeutic Effects of the Pilates Method in Patients with Multiple Sclerosis: A Systematic Review. Journal of Clinical Medicine, 11. https://doi.org/10.3390/jcm11030683.
Pilates improves balance, gait, physical-functional conditions, and cognitive functions in patients with multiple sclerosis.

4. Yamato, T., Maher, C., Saragiotto, B., Hancock, M., Ostelo, R., Cabral, C., Costa, L., & Costa, L. (2015). Pilates for low back pain.. The Cochrane database of systematic reviews, 7, CD010265 . https://doi.org/10.1002/14651858.CD010265.pub2.
Pilates is more effective than minimal intervention for pain and disability.

5. Yu, Z., Yin, Y., Wang, J., Zhang, X., Cai, H., & Peng, F. (2023). Efficacy of Pilates on Pain, Functional Disorders and Quality of Life in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 20. https://doi.org/10.3390/ijerph20042850.
Pilates may have positive efficacy for pain relief and the improvement of functional disorders in chronic low back pain patients.

6. Byrnes, K., Wu, P., & Whillier, S. (2018). Is Pilates an effective rehabilitation tool? A systematic review.. Journal of bodywork and movement therapies, 22 1, 192-202 . https://doi.org/10.1016/j.jbmt.2017.04.008.
Pilates is effective in reducing pain and disability in conditions like low back pain, ankylosing spondylitis, multiple sclerosis, post-menopausal osteoporosis, non-structural scoliosis, hypertension, and chronic neck pain.

7. Suárez-Iglesias, D., Miller, K., Seijo-Martínez, M., & Ayán, C. (2019). Benefits of Pilates in Parkinson’s Disease: A Systematic Review and Meta-Analysis. Medicina, 55. https://doi.org/10.3390/medicina55080476.
Pilates is beneficial for people with mild-to-moderate Parkinson's disease, improving fitness, balance, and physical function, with superior benefits on lower-body function compared to other conventional exercises.

8. Cazotti, L., Natour, J., Carvalho, F., Pereira, D., & Jones, A. (2023). OP0089-HPR PILATES IS BETTER THAN WALKING FOR PATIENTS WITH FIBROMYALGIA: A RANDOMIZED CONTROLLED TRIAL. Annals of the Rheumatic Diseases. https://doi.org/10.1136/annrheumdis-2023-eular.3961.
Pilates is effective in treating fibromyalgia, improving pain, quality of life, psychological status, and reducing analgesic consumption compared to walking.

9. Mazzarino, M., Kerr, D., Wajswelner, H., & Morris, M. (2015). Pilates Method for Women's Health: Systematic Review of Randomized Controlled Trials.. Archives of physical medicine and rehabilitation, 96 12, 2231-42 . https://doi.org/10.1016/j.apmr.2015.04.005.
There is emerging evidence for reducing pain and improving quality of life and lower extremity endurance in women using Pilates.

10. Wells, C., Kolt, G., Marshall, P., Hill, B., & Bialocerkowski, A. (2014). The Effectiveness of Pilates Exercise in People with Chronic Low Back Pain: A Systematic Review. PLoS ONE, 9. https://doi.org/10.1371/journal.pone.0100402.
Pilates exercise offers greater improvements in pain and functional ability compared to usual care and physical activity in the short term for chronic low back pain.
Is Pilates beneficial for:
Explaining the process

It is difficult to analyse all of the research on Pilates, so we have started using AI.

At this stage, AI is not perfect, but it gives a good start. The process we go through:

1. Have the AI identify research around a particular topic. The application we are using only currently reviews 10 research papers, but they are generally from peer-reviewed, reputable journals.

2. If there are sufficient papers, it will generate a consensus meter like the one below.

There is a note with each reference as to the AI assessment of the research. It will say "Assessment" and then either:
  • Positive (green)
  • Possibly beneficial (amber)
  • Negative (red)
  • Unknown
3. We review the information that has been generated and edit, delete and add research as needed. If we do not agree with the AI assessment, there will be a note. For example: Assessment: Positive (green) (Amber in AI). This means the AI rated it as amber but on reviewing the article, it is clearly positive and so it has been changed.

Please note:
  • the consensus meter is based on the original AI assessment. At this stage, we have not modified it based on our reviews.
  • ​the assessment makes no evaluation of the quality of the research. If it is positive and included 10 subjects, it willl have the same rating as a positive study with 10,000 subjects.

4. For each article, there is a note regarding how influential the Journal is where the article was published. This will be a rating from 1 star to 4 stars, with 4 stars being the highest ranking. The measure used is the Scimago Journal Rank.

If a journal has a four star rating, the research can be given more weight than research appearing in a one star journal.

5. Each reference includes a brief summary of that particular article.

​Future enhancements

The aim is to get as many conditions on to the website as quickly as possible and then work to enhance the information. We will be advising on social media when a new summary is added to the site.

We are also working on a scoring system for the research as a systematic review should carry more weight than a pilot study.

​Stay tuned!
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