Journal of Bodywork and Movement Therapies (2009) 13, 155–163
COMPARATIVE CONTROLLED STUDY
Effect of Pilates and taiji quan training on
self-efﬁcacy, sleep quality, mood, and physical
performance of college students
Karen Caldwell, Ph.D.
, Mandy Harrison, Ph.D.
Marianne Adams, MFA
, N. Travis Triplett, Ph.D.
Department of Human Development and Psychological Counseling, Appalachian State University,
Boone, NC, USA
Department of Health, Leisure and Exercise Science, Appalachian State University, Boone, NC, USA
Department of Theatre and Dance, Appalachian State University, Boone, NC, USA
Received 3 September 2007; received in revised form 29 November 2007; accepted 4 December 2007
Summary Methods of exercise such as Pilates and taiji quan, which have been shown
to have beneﬁcial effects on physical and mental characteristics, have been studied
more often in samples of older participants. The purpose of this investigation was to
examine the effects of a semester of either Pilates or taiji quan training on perceived
self-efﬁcacy, sleep quality and mood, as well as strength and balance in college-age
individuals. Self-efﬁcacy was found to be improved in the Pilates and taiji quan groups
and there was a trend towards improvement in sleep quality. Mood was found to be
improved signiﬁcantly in the Pilates group while the taiji group showed a trend towards
improvement. There were no changes or group differences in the strength or balance
measures. Pilates and taiji quan are effective exercise modes to improve mental
parameters in college-age individuals.
&2008 Elsevier Ltd. All rights reserved.
In developing his method, Joseph Pilates ‘‘com-
bined the mental focus of and speciﬁc breathing of
yoga with the physicality of gymnastics and other
sports’’ (Ungaro, 2002, p. 8) for the ideal of
attaining a complete coordination of body, mind,
and spirit (Gallagher and Kryzanowska, 2000).
The mind–body approach is further elucidated by
the principles (CCCPFB) that Pilates founded his
method on: centering,concentration,control,
precision,ﬂow,and breath (Adamany and Loigerot,
2004;Adams and Quin, 2007;Gallagher and
Kryzanowska, 1999;Siler, 2000;Ungaro, 2004).
ARTICLE IN PRESS
1360-8592/$ - see front matter &2008 Elsevier Ltd. All rights reserved.
Corresponding author. Tel.: +1 828 262 6045;
fax: +1 828 262 2128.
E-mail address: email@example.com (K. Caldwell).
Anecdotal evidence suggests that as the Pilates
method increases core strength, the natural ﬂex-
ibility of the spine and limbs returns. However,
there has been little research on the effectiveness
of Pilates exercise and any studies found have been
poorly controlled (Herrington and Davies, 2005).
A recent review of literature identiﬁed only three
published clinical trials investigating the effective-
ness of Pilates training in healthy adults (Bernardo,
Another mind–body method is taiji quan (also
transliterated as tai chi chuan), an ancient Chinese
martial art characterized by slow circular move-
ments, breath regulation, and concentration or
mindfulness. It is a low-impact, moderate-intensity
aerobic exercise (Lan et al., 2004). Most studies of
the effect of taiji quan practice have focused on
middle-aged to older adults and have documented
improvements in health parameters such as im-
mune function, balance, and strength.
Perceived self-efﬁcacy is related to mainte-
nance, effort, and performance of various speciﬁc
behaviors, including health-promotion activities
(Bandura, 1997;Noble and Robertson, 1996).
Perceived self-efﬁcacy is one’s judgment of his/
her ability to perform a speciﬁc activity. This
judgment is based on four sources of information:
(1) mastery experiences that serve as indicators of
capability; (2) vicarious experiences [observations
of others] that alter efﬁcacy beliefs through
transmission of competencies and comparison with
the attainments of others [if she can do it, I can do
it]; (3) verbal persuasion and social inﬂuences that
one possesses certain capabilities [you can dance
very well]; and (4) physiological and affective
states from which people partly judge their
capableness, strength, and vulnerability to dys-
function [my stomach is in knots, I feel exhausted]
Research reviewed by Bandura (1997) across a
wide variety of activities shows that, controlling for
ability, one’s reported perceived self-efﬁcacy re-
garding a speciﬁc task remains a signiﬁcant
contributor to performance accomplishment. Using
pre- and post-exercise program self-efﬁcacy and
physical ﬁtness measures, McAuley et al. (1991)
investigated the inﬂuence of both short- and long-
term exercise programs on physical activity self-
efﬁcacy, adherence to exercise self-efﬁcacy and
physiological function of middle-aged, previously
inactive adults. Both short- and long-term groups
showed signiﬁcant gains in physical activity and
adherence self-efﬁcacy as well as signiﬁcant gains
in physiological functioning.
An additional important health indicator is sleep
quality. Epidemiologic studies have consistently
shown an association between self-reports of
exercise and better sleep, and exercise is often
recommended as an important sleep aid (Hublin
et al., 2001). However, experimental studies
demonstrate that there is no single effect of
exercise on sleep (O’Connor and Youngstedt,
1995;Youngstedt et al., 2003). King et al. (1997)
found a regular moderate-intensity exercise pro-
gram to be effective in improving sleep complaints
of older adults, and Li et al. (2004) found improved
sleep quality in older practitioners of taiji quan.
In addition to the effects of exercise on self-
efﬁcacy and sleep quality, the differential effects
of various types of moderate physical exercise on
mood enhancement are still a question of interest.
A number of studies have shown that changes in
mood and anxiety through physical exercise may be
related to the form of the exercise (Berger and
Owen, 1988, 1992;Jin, 1989, 1992). Taiji quan
practice, with its emphasis on physical and mental
training, has been found to have a positive impact
on mood in a number of these studies, but most of
these are focused on middle-aged to older adults.
The few studies that include college-aged stu-
dents (aged 18–30) have generally found positive
effects of taiji quan on the self-assessed physical
and mental health of college students. Jin’s (1989)
study of 33 beginning (average age: 33.279 years)
and 33 experienced (average age: 37.7714.3
years) taiji quan practitioners found that the
practice of taiji quan raised heart rate, increased
noradrenaline excretion in urine, and decreased
salivary cortisol concentration at levels comparable
to those found with moderate exercise. The
subjects also reported improvements in mood and
fatigue. A second study by Jin (1992) focused on the
efﬁcacy of taiji, brisk walking, meditation, and
reading in reducing mental and emotional stress
(n¼96). Mood states were improved and salivary
cortisol levels dropped signiﬁcantly for all treat-
ments. However, the adrenaline level after taiji
quan exercise dropped more in comparison with
that after meditation, and the noradrenaline level
was higher after taiji quan than after reading. Taiji
participants also reported greater reduction of
state anxiety and enhancement of vigor as com-
pared to the reading control group, but this
discrepancy disappeared when expectancy regard-
ing the outcome of treatments was used as a
covariate. Szabo et al. (1998) compared aerobic
dance, weight training, martial arts, taiji quan,
yoga and music appreciation and found the com-
bined taiji and yoga group reported higher levels of
tranquility than all other exercise groups. This
group also reported lower psychological distress,
fatigue, and exhaustion than participants in the
ARTICLE IN PRESS
K. Caldwell et al.156
martial arts group. Wang et al. (2004) reported on a
3-month intervention of taiji quan in 30 college
students (mean age: 24.2372.74 years). Using a
pre- and post-test design comparing scores on the
multidimensional SF-36v2 health survey question-
naire, general health and bodily pain were sig-
niﬁcantly improved as were the mental health
measures of vitality, role function, and perceptions
of mental health.
Balance plays a critical role in any activity. Static
balance involves minimizing postural sway in a
motionless stance, i.e., sitting or standing while
dynamic balance involves the ability to maintain
control of the center of gravity while moving it over
the base of support, i.e., walking, climbing stairs,
and getting up from a chair. A variety of exercises
have been shown to have a positive effect on
balance especially in older adults. Johnson et al.
(2007) found a signiﬁcant change in dynamic
balance in healthy adults after completing 10
Pilates-based exercise sessions, and Kaesler et al.
(2007) found improvement in some components of
static and dynamic postural sway in their sample of
older adults. Similar improvements in balance in
older adults have been found in studies of taiji quan
(Busing, 2005;Yuhua et al., 2007).
Therefore, the purpose of this study was to
better understand the effect of Pilates and taiji
quan training in healthy young adults on perceived
self-efﬁcacy, sleep quality, mood, strength, and
balance. Studies of other modes of exercise have
included these variables, but at this point no
studies have documented effects of Pilates or taiji
participation on these variables in the college-age
Study participants were recruited from ﬁve physi-
cal education classes (three Pilates mat classes and
two taiji quan classes), and two recreation classes
(an outdoor leadership class and a special recrea-
tion class) served as a control group. Subjects were
students at a moderately sized state university in
the fall and spring semesters of one academic year.
The Pilates classes met twice a week for 75 min
each class period or three times per week for
50 min each class period for a 15-week semester.
The instructors was comprehensively trained and
certiﬁed in the Pilates method. The Chen style
taiji quan classes met twice a week for 50 min
each session for 15 weeks and followed principles
outlined by Yang (2005). Participants in the
recreation classes were actively involved in their
own preferred forms of exercise outside of class,
but the class content was theoretical. During the
ﬁrst week of class, at mid-term and at the end of
the semester, students were asked to complete in
class a survey instrument containing self-regulatory
efﬁcacy scales, sleep quality indexes, mood scales,
and demographic questions. At the beginning
and end of the semester, students in ﬁve of the
classes (three Pilates, one taiji quan, and one
special recreation) were assessed for balance and
A four-item self-regulatory efﬁcacy instrument
(Harrison and McGuire, 2008) was used as well as
a self-efﬁcacy measurement speciﬁc to either
Pilates or taiji quan because self-efﬁcacy measures
must be speciﬁc to the activity being measured
(Bandura, 1997). Since no measurement tools of
Pilates self-efﬁcacy (PSE) were found, a 14-item,
seven-point Likert-type scale on widely accepted
principles of the Pilates method was developed
(Table 1). Other experienced Pilates practitioners
reviewed the instrument to establish face validity
of the scale, and initial testing resulted in high
inter-item reliability (Cronbach’s alpha ¼.935).
Scores on the PSE scale potentially ranged from
14 to 98 with higher scores indicating greater self-
efﬁcacy. A 12-item Taiji Quan Self-Regulatory
Efﬁcacy Scale (TSE) was also developed and
reviewed by experienced practitioners. Initial
testing resulted in high inter-item reliability (Cron-
bach’s alpha ¼.897). Scores potentially ranged
from 12 to 84 with higher scores indicating greater
The Pittsburgh Sleep Quality Index (PSQI; Buysse
et al., 1989) was chosen for this investigation and
consists of 19 self-rated questions related to
normal sleep habits. The possible range of scores
is 0–21 points with lower scores indicating better
sleep quality. The Pilates group completed the PSQI
at beginning and end of the semester, but the other
groups completed an abbreviated form addressing
only daytime dysfunction and subjective sleep
quality. A PSQI global score 45 has served as a
marker to distinguish sleep disturbances in insom-
nia patients versus controls (Backhaus et al., 2002).
ARTICLE IN PRESS
Effect of Pilates and taiji quan on performance of college students 157
The Four Dimensional Mood Scale (Huelsman et al.,
1998) was utilized in this investigation and is a 20-
item adjective checklist using a ﬁve-point Likert
format (1 ¼not at all, 5 ¼extremely). Scores on
the four scales are the mean response to the items
on the scale: positive energy (six items), tiredness
(seven items), negative arousal (seven items), and
relaxation (nine items). There is evidence for
generally good internal consistency of the scales
as well as concurrent and discriminant validity
(Huelsman et al., 2003).
Strength and balance
A subset of participants (n¼67) were assessed for
lower body back and leg strength through the use of
a back and leg dynamometer. Subjects were asked
to exert three maximal effort isometric pulls while
standing on the dynamometer platform. The
strength reading was obtained from the dynam-
ometer dial and the highest reading used for
This smaller group of participants was also
assessed for balance ability when standing on
a force platform on the dominant leg with the
eyes closed. Postural sway was measured during
this postural control test. The test was con-
ducted on a specialized balance platform with a
computer and software package (AMTI Balance
Clinic, Boston, MA, USA) used to record and analyze
Statistical analyses were conducted using the
Statistical Packages for Social Sciences (SPSS),
version 14 (SPSS Inc., Chicago, IL, USA). A total of
127 students participated in the study (Pilates
n¼51, taiji quan n¼35, special recreation
n¼41), but data was available at all three points
in time for only 98 participants (Pilates n¼41,
taiji quan n¼29, special recreation n¼28).
A Chi-square on possible differences in gender and
independent t-tests on possible differences in age,
and hours of weekly exercise were non-signiﬁcant
when the complete data group was compared with
the group eliminated from the study. Participants
included in the study ranged in age from 18 to
32 years of age (mean ¼21.27, S.D. ¼2.24).
Groups differed signiﬁcantly by gender distribution:
Pilates ¼37 female and 4 male; taiji quan ¼4
female and 25 male; special recreation ¼9 female
and 19 male. An additional initial difference
between the groups was that the special recreation
group reported signiﬁcantly higher levels of weekly
exercise (mean ¼10.50, S.D. ¼6.72) compared to
the Pilates (mean ¼5.03, S.D. ¼2.89) and taiji
quan groups (mean ¼6.03, S.D. ¼3.90). The fol-
lowing comparisons in the groups across time were
calculated using linear mixed model statistical
analyses using a Toeplitz residual covariance stru-
cture. Mixed model analyses provide a framework
for analyzing data with dependent observations
ARTICLE IN PRESS
Table 1 Items from Pilates self-efﬁcacy (PSE) instrument based on six principles of Pilates.
Principle Item from PSE
Centering—the ability to focus attention on one small
I can move from my core strength. I can maintain
Concentration—ability to focus one’s attention as the
mind wills the body into action, or the mind/body
I can feel the articulation of my spinal column. I can
visualize myself doing the exercises correctly. I can
sense how I am doing the exercises by using an internal
focus. I can modify the exercises as needed.
Control—promotes injury prevention and is
empowering, mindfulness helps to produce
I can coordinate smooth movements of my arms and
legs. I can move with a sense of control in movement. I
can lower myself to the ﬂoor with control.
Precision—the ability to avoid sloppy, mindless
movements, increases the likelihood of producing the
I can move with a sense of precision in movement. I
can release unnecessary muscle tension.
Flow—transitional ability, the ease from which one
moves from one experience or exercise to the next.
I can smoothly transition from one movement to
Breath—awareness and control of the breath can lead
to increased lung capacity, efﬁciency, coordination of
physical functioning and optimal muscular patterning
in everyday tasks.
I can focus completely on coordinating my breath with
body movements. I am aware of using my breath
K. Caldwell et al.158
using an iterative process of calculating a residual
covariance structure. This results in estimates of
the degrees of freedom for the F-statistics.
Self-efﬁcacy speciﬁc to Pilates as measured by the
PSE increased signiﬁcantly over the course of the
semester from an initial mean of 64.6 to a ﬁnal
mean of 88.9 (paired t-test, t(40) ¼13.05,
p¼.0005). Self-efﬁcacy speciﬁc to taiji quan as
measured by the TSE also increased over the course
of the semester from an initial mean of 57.6 to a
ﬁnal mean of 63.2 (t(28) ¼4.504, p¼.0005).
Participants perceived themselves as being more
able to control their movements mindfully at the
end of the semester than at the beginning. Initial
PSE scores and initial self-regulatory efﬁcacy scores
were signiﬁcantly correlated (r(39) ¼.36, p¼.02),
and TSE scores and initial self-regulatory efﬁcacy
scores correlated at a similar level (r(27) ¼.32,
A mixed model analysis of self-regulatory
efﬁcacy scores found a signiﬁcant group effect
(F(2, 99.95) ¼5.135, p¼.008), time effect
(F(2, 117.02) ¼3.201, p¼.044), and group by
time interaction (F(4, 116.92) ¼3.212, p¼.015).
The Pilates group rated their self-regulatory efﬁ-
cacy higher than the special recreation group at the
beginning of the semester, and the Pilates group
scores were signiﬁcantly higher at the end of
the semester than at the beginning of the class
(Figure 1). Self-regulatory efﬁcacy scores for the
other two groups were essentially unchanged from
the beginning to the end of the semester.
In the Pilates group sleep quality as measured by
the PSQI showed some improvement from beginning
(n¼40, mean ¼6.22, S.D. ¼3.12) to end of the
semester (mean ¼5.37, S.D. ¼3.58) (t(39) ¼1.891,
p¼.066). Pilates participants were sorted using
the PSQI scores into groups that scored the same as
insomniacs (PSQI45) and normal sleepers. At the
beginning of the semester 52.5% of the Pilates
participants (n¼21) scored in the same range as
insomniacs, but that number had reduced signiﬁ-
cantly by the end of the semester to 35% (n¼14) of
the Pilates participants (w
(1, n¼40) ¼9.528,
Using the abbreviated sleep quality scale (three
items, Cronbach’s alpha ¼.757), a mixed model
analysis of the Pilates classes, taiji quan classes
and only one special recreation class (n¼81) found
no statistically signiﬁcant differences although the
groupeffectbarelymissedsigniﬁcance(F(2, 78.61) ¼
2.749, p¼.07) (Figure 2). One special recreation
class was dropped from this analysis because data
was not available for the three-item sleep quality
items at the end of the semester. The Pilates and
taiji quan groups demonstrated a trend towards
improved sleep quality over the course of the
semester while the special recreation class demon-
strated improved sleep mid-semester and an end of
semester worsening of sleep quality.
A mixed model analysis of positive mood scores
(positive energy) found signiﬁcant differences
ARTICLE IN PRESS
Pre Mid Post
Sleep quality score
Tai j i
Figure 2 Sleep quality scores. Values expressed as
mean7S.E.: , signiﬁcant difference from pre-test
value; #, signiﬁcant difference from special recreation
Tai j i
Figure 1 Self-efﬁcacy scores. Values expressed as
mean7S.E.: , signiﬁcant difference from pre-test
value; ], signiﬁcant difference from special recreation
Effect of Pilates and taiji quan on performance of college students 159
across time (F(2, 129.58) ¼5.155, p¼.007) and
group by time (F(4, 129.59) ¼2.463, p¼.048).
Initially, the special recreation group positive mood
scores were higher than the Pilates group, but by
the end of the semester, the Pilates positive mood
scores had increased to the same level as the
special recreation group, which remained essen-
tially the same as the beginning of the semester.
The taiji quan group scores trended upward from
the beginning to the end of the semester but not as
much as the Pilates group (Figure 3).
A mixed model analysis of tired mood scores
found no signiﬁcant differences across group or
time, and the group by time interaction barely
missed statistical signiﬁcance (F(4, 135.86) ¼2.345,
p¼.058). Using a similar analysis of relaxed mood
scores, signiﬁcant group (F(2, 95.09) ¼6.442,
p¼.002) and time (F(2, 129.60) ¼6.814, p¼
.002) effects were found. Using estimated marginal
means, the taiji group reported signiﬁcantly higher
relaxation scores than the Pilates group, and
the Pilates scores at the end of the semester
were signiﬁcantly higher than at the beginning
A mixed model analysis of negative mood scores
found a signiﬁcant group by time interaction
(F(4, 136.54) ¼3.840, p¼.005). The Pilates and
taiji groups experienced a decrease in negative
mood mid-semester and returned to beginning
semester levels by the end of the semester, while
the special recreation group experienced a spike in
negative mood scores which reduced by the end of
the semester to levels similar to their scores at the
beginning of the semester (Figure 5). In other
words, the difference in groups occurred mid-
semester, and the negative mood scores were
similar at the end of the semester by group as they
had been at the beginning of the semester. Strength and balance
Initial dynamometer measures were correlated to
the age of participants (r¼.24) and the number of
hours participants reported exercising weekly at
the beginning of the semester (r¼.41). Strength
varies by gender, so gender was used as a factor in a
mixed model analysis of the 67 individuals for
whom strength measures were available at both
the beginning and end of the semester. An effect
was found only for gender (F(1, 61) ¼59.773,
p¼.001). When the effects of gender were
considered, there were no differences between
the groups from the beginning to the end of the
semester in terms of leg and back strength as
measured by the dynamometer. Regarding balance,
a mixed model analysis using the 61 individuals
for whom beginning and end of semester mea-
sures were available yielded no group or time
ARTICLE IN PRESS
Pre Mid Post
Positive mood score
Tai j i
Figure 3 Positive mood scores. Values expressed as
mean7S.E.: , signiﬁcant difference from pre-test value
(Pilates group only).
Pre Mid Post
Relaxed mood score
Figure 4 Relaxed mood scores. Values expressed as
mean7S.E.: , signiﬁcant difference from pre- and
mid-test values (Pilates group only); y, signiﬁcant
difference from Pilates value.
Pre Mid Post
Negative mood score
Tai j i
Figure 5 Negative mood scores. Valued expressed as
mean7S.E.: y, signiﬁcant difference between Pilates and
special recreation group.
K. Caldwell et al.160
Overall, the results of this investigation were
similar to other studies performed in older popula-
tions and/or with similar exercise modes (Pilates,
taiji). Study results indicate that students who
participated in Pilates classes experienced signiﬁ-
cant improvements in self-efﬁcacy and positive
mood, with trends towards improved sleep quality
and a reduction in negative mood over the course
of a semester. The taiji group primarily showed
trends of improvement. As expected from previous
studies, there were complex interactions between
the health variables, type of exercise and time of
Research across a wide variety of activities shows
that, controlling for ability, self-efﬁcacy regarding
a speciﬁc task remains a signiﬁcant contributor to
performance accomplishment (Bandura, 1997). Our
ﬁndings regarding Pilates support those of McAuley
et al. (1991), as we found an increase in self-
regulatory self-efﬁcacy with exercise programs of
varying duration. Interestingly, the taiji group did
not show the same level of increase in self-
regulatory efﬁcacy, although there was an increase
in self-efﬁcacy speciﬁc to taiji movements. Li et al.
(2001) also found increases in self-efﬁcacy speciﬁc
to taiji movement in participants of a 6-month taiji
program for elderly participants
Rates of poor quality of sleep in college students
have varied from study to study depending on
sample and measures of sleep quality used. For
example, 44% of ﬁrst-year college students in a
study in Taiwan reported sleep problems (Yang
et al., 2003). Rates of poor sleep quality in medical
college students have ranged from 38% to 19% (Feng
et al., 2005;Medeiros et al., 2001). Some studies
have found that sleep quality improves over the
course of semester (Hawkins and Shaw, 1992;
Pilcher and Ott, 1998) while other studies found
the opposite (Brown et al., 2006). The results of
this investigation are in agreement with those
showing nearly half of college students exhibit
some problems with sleep quality. This investiga-
tion also supports the concept of exercise some-
what improving sleep quality overall in young
adults, although the results of this investigation
were not as dramatic as in studies with older
individuals (King et al., 1997;Li et al., 2004).
Many systems of the body interact in a holistic
manner together with positive and negative moods.
Thayer’s (1989) biopsychological mood theory
anticipates that activities such as exercise or
techniques involving control of thoughts would be
integrally related to mood improvement. Indeed,
the subjects in four studies reported by Thayer
et al. (1994) identiﬁed exercise as the most
effective mood-regulating behavior. The greatest
improvement in positive mood was seen in the
Pilates group. However, the participants in this
study had no change in negative or tired mood from
the beginning to the end of the study. The Pilates
and taiji quan groups did show improvement in
negative mood at the mid-term timepoint while the
control group showed a worsening of negative mood
the same time.
Strength and balance
Strength and balance measures were unaffected by
Pilates and taiji training in this age group. There
are likely several reasons for these ﬁndings.
College-age individuals are at a peak regarding
strength and balance and highly focused training on
these variables is necessary to elicit any measur-
able change. In older individuals, where the largest
gains are often seen, the exerciser is already at a
physical deﬁcit and the exercise can result in
signiﬁcant improvements. Although both Pilates
and taiji have strength and balance as components,
the training is not as likely to elicit a measurable
change in this age group.
The results of this study indicate that students who
participated in Pilates classes experienced the
largest improvements in self-regulatory self-efﬁ-
cacy, positive mood, and sleep quality over the
course of a semester. The lack of improvement in
strength and balance measures may be due to the
methods used for measuring these characteristics.
Our results must be interpreted with caution
because of the lack of random assignment to groups
and the uneven gender representation in the
Special thanks to Rebecca Quin for participating as
a Pilates instructor and Karen Callahan for assis-
tance in the statistical analyses.
ARTICLE IN PRESS
Effect of Pilates and taiji quan on performance of college students 161
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