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A six-week pilates exercise protocol for improving physical and mental health-related parameters

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Main Problem: Pilates, as a body-mind exercise method has an increasing popularity in recent years especially among young women. But there is not enough evidence whether this exercise method contributes to the physical or/and psychological condition of individuals. The aim of this study was to investigate the effectiveness of an original six-week Pilates Exercise Protocol on young females’ health-related parameters including anthropometric features, emotional state, fatigue, and quality of life. Methods: Fifty-one sedentary females aged between 18 and 25 were randomly assigned to Pilates Exercise Group (n=25), and Control Group (n=26). Pilates Exercise Group performed a six-week Pilates exercise protocol whereas Control Group did not participate any regular physical activity during six weeks. Anthropometric features, anxiety, depression, fatigue, and quality of life of the subjects were assessed at the baseline and after six weeks. Results: Weight (p=0.005), body mass index (p=0.005), waist (p<0.001), hip (p=0.002), and thigh circumferences (p<0.001), severity of anxiety (p=0.001), depression (p=0.001), and fatigue (p<0.001) significantly decreased in Pilates Exercise Group after six weeks besides vitality (p=0.005), and mental health (p=0.021) domains of quality of life increased. There were no significant differences in Control Group (p>0.005) after six weeks except of anxiety (p=0.010), and fatigue (p=0.032). Conclusions: The current Pilates exercise protocol contribute to the physical, and psycological well being of young females in terms of anthropometric features, emotional state, fatigue, and some domains of quality of life.
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Malaysian Journal of Movement, Health & Exercise, 7(2), 65-79, 2018
65
A SIX-WEEK PILATES EXERCISE PROTOCOL FOR IMPROVING
PHYSICAL AND MENTAL HEALTH-RELATED PARAMETERS
Eda Akbaş* and Banu Ünver
Bülent Ecevit University, Faculty of Health Sciences, Department of Physiotherapy and
Rehabilitation 67600 Zonguldak/TURKEY
*Email: akbas.pt@gmail.com
(Received 1 April 2018; accepted 28 May 2018; published online 3 July 2018)
To cite this article: Akbaş, E. & Ünver, B. (2018). A six-week pilates exercise protocol for
improving physical and mental health-related parameters. Malaysian Journal of Movement,
Health & Exercise, 7(2), 65-79. https://doi.org/10.15282/mohe.v7i2.239
Link to this article: https://doi.org/10.15282/mohe.v7i2.239
Abstract
Main Problem: Pilates, a body-mind exercise method, has experienced
increasing popularity in recent years, especially among young women. But
there is not enough evidence whether this exercise method contributes to the
physical or/and psychological condition of individuals. The aim of this study
was to investigate the effectiveness of an original six-week Pilates mat
exercise protocol on young females’ health-related parameters including
anthropometric features, emotional state, fatigue, and quality of life.
Methods: Fifty-one sedentary females aged between 18 and 25 were
randomly assigned to Pilates Exercise Group (n=25), and Control Group
(n=26). Pilates Exercise Group performed a six-week Pilates mat exercise
protocol whereas Control Group did not participate in any regular physical
activity f[r six weeks. Anthropometric features, anxiety, depression, fatigue,
and quality of life of the subjects were assessed at the baseline and after six
weeks. Results: Weight (p=0.005), body mass index (p=0.005), waist
(p<0.001), hip (p=0.002), and thigh circumferences (p<0.001), severity of
anxiety (p=0.001), depression (p=0.001), and fatigue (p<0.001) significantly
decreased in the Pilates Exercise Group after six weeks and vitality
(p=0.005), and mental health (p=0.021) domains of quality of life increased.
There were no significant differences in Control Group (p>0.005) after six
weeks except anxiety (p=0.010), and fatigue (p=0.032). Conclusions: The
current Pilates mat exercise protocol contribute to the physical, and
psychological well-being of young females in terms of anthropometric
features, emotional state, fatigue, and some domains of quality of life.
Keywords: Depression, exercise, Pilates, quality of life
A sıx-week pılates exercıse protocol
66
Introduction
The World Health Organization defines health as “A state of complete, physical, mental,
and social well-being, not merely the absence of disease or infirmity (Callahan, 1973).
The modern era and lifestyle, unfortunately, worsen well-being of the individuals and
cause inactive lifestyle contrary to human biomechanics. In today's society, especially
young population suffer from the consequences of inactivity (Furnham, Badmin, &
Sneade, 2002; Runfola et al., 2013). Worsening of body composition and fitness levels due
to an inactive lifestyle may impair the physical and psychological health of the young
population (von Sperling de Souza & Brum Vieira, 2006).
There is consensus in the literature that physical activity/exercise is a correct, and healthy
way to improve well-being (Kelley, Kelley, Hootman, & Jones, 2010; Sjøgaard et al.,
2016; Standage & Ryan, 2012; Vancampfort et al., 2011; Wang et al., 2010). Physical
activity regulates the energy balance of the body, providing weight control, and
determining body composition. Also, mood and anxiety can be altered depending on the
intensity and type of the physical activity.
Pilates supposed that the balance between body and mind is an important factor in
achieving health, and happiness. Pilates also holds that contrology stimulates the mind and
decreases mental strain (Pilates & Miller, 1945). Pilates training minimizes unnecessary
muscle recruitment by maintaining a neutral spine position and core stabilization. Pilates
exercises improve general body flexibility and health by improving strength, posture, and
the coordination of movements. The control of large group muscles with coordination, and
focusing on breathing may increase aerobic capacity (Caldwell, Harrison, Adams, &
Triplett, 2009), and further improve mental health (Kucuk & Livanelioglu, 2015).
Heretofore, some researchers have also reported that the holistic approach of Pilates based
training may offer physical and psychological improvements for human health (Akbas &
Erdem, 2016; Bernardo, 2007; Cruz-Ferreira et al., 2011; Karaman, Yuksel, Kinikli, &
Caglar, 2017; Kucuk & Livanelioglu, 2015), and various intensities benefit quality of life,
mental health, fatigue, physical fitness levels, and body types in diverse rates (Anderson
& Spector, 2000; Arslan, Çakmakçi, Taşkin, Çakmakçi, & Ismet, 2012; Ashrafinia et al.,
2015; Caldwell et al., 2009; Campos de Oliveira, Gonçalves de Oliveira, & Pires-Oliveira,
2015; Cruz-Ferreira et al., 2011; Frank, Edwards, & Larimore, 2017; Ginsberg et al., 2016;
Hassan & Amin, 2011; Kucuk & Livanelioglu, 2015; Leopoldino et al., 2013; McGrath,
O'Malley, & Hendrix, 2011; Memmedova, 2015; Miller & Mesa, 2013; Pourvaghar,
Bahram, Sharif, & Sayyah, 2014; Rogers & Gibson, 2009; Roh, 2016; Segal, Hein, &
Basford, 2004; Shanazari, Marandi, & Minasian, 2013; Soysal Tomruk, Uz, Kara, &
Idiman, 2016; Stan et al., 2012; Şavkın, 2014; Vieira, Faria, Wittmann, Teixeira, &
Nogueira, 2013). The method is recommended by health professionals, both as
rehabilitative for the people who have diseases, and preventive for undiagnosed or healthy
individuals (Herrera-Gutiérrez, Olmos-Soria, & Brocal-Pérez, 2015). However, only a few
clinical trials have investigated the effectiveness of Pilates training in healthy young
females (Bavli & Koybasi, 2016; Caldwell et al., 2009; Kucuk & Livanelioglu, 2015;
Parikh & Arora, 2016; Tolnai, Szabo, Koteles, & Szabo, 2016). Previous studies could not
demonstrate the influences of Pilates-based training on psychological variables (Cruz-
Malaysian Journal of Movement, Health & Exercise, 7(2), 65-79, 2018
67
Ferreira et al., 2011). Although there have been many studies describing the benefits of
Pilates-based training, these studies vary in terms of duration, intensity and/or the exercises
they contain and diverse periods, and intensities of Pilates training programs had different
effects on health-related parameters. Furthermore, since exercise protocols have not been
clearly reported in such studies, they cannot provide realistic proposals for clinics and
society in order to improve the individuals’ health.
The Pilates method has seen increasing popularity in last decades particularly among
young women in order to avoid the physical and psychological consequences of sedentary
lifestyle (Littleton & Ollendick, 2003), but evidence-based studies in this field remain
limited in the context of this population. Previous studies promised certain contributions
to improve health-related parameters but could not offer any clear exercise program for
individuals and their outcomes were contradictory. We aimed to create a standardized
protocol to improve the physical and mental health of young females with this study. The
question addressed was whether our original Pilates exercise protocol would contribute to
improving their anthropometric features, emotional state, fatigue, and quality of life. Our
hypothesis was that the current six-week program could provide physical and
psychological benefits to young females.
Materials and Methods
Participants
Subjects were recruited from female volunteers between the ages of 18, and 25. Written
informed consent was obtained from all participants, and they signed in the form approved
by Bulent Ecevit University Clinical Research Ethics Committee (2017-74-09/08) prior to
participation in the study.
Pregnancy, participation in regular physical training such as exercise classes or sport for
more than one hour at least once a week during the previous year, taking medications
affecting the emotional state, exercise contraindications due to cardiovascular or
neurological disorders, inability to cooperate for assessments and insufficient attendance
at least 80% of exercise sessions were exclusion criteria.
To estimate sample size, a preliminary power analysis was applied. Per a previous study
(Kucuk & Livanelioglu, 2015), we used 8.48 as the standard deviation values, and 8.19 as
the difference in mean of the BDI. Consequently, we needed 19 individuals in each group
to have 80% power with 5% type I error level. Anticipating 7 dropouts in each group, the
sample size was determined as 26 participants for each group. Eligible participants were
randomly assigned to Pilates Exercise Group (PEG) (n=26), and Control Group (CG)
(n=26). One participant of the PEG excluded from the study owing to insufficient
attendance. Thus, 25 subjects in the PEG and 26 in the CG completed the study (Figure I).
The control group was asked to maintain their normal sedentary activities including daily
living activities, and not to participate in regular physical activity during the study.
Endpoint assessments were conducted after verbal confirmation that participants had not
participated in regular physical activity within the past six weeks.
A sıx-week pılates exercıse protocol
68
Figure 1: Flow diagram
Assessments
This prospective, single-blind, randomized-controlled study involved pre and post-
measurement tests. Assessments were conducted at the baseline and after six week period.
The dependent variables including weight, waist, hip and thigh circumferences, the
severity of anxiety, depression and fatigue and quality of life were assessed in all subjects.
Weight was assessed while subjects were barefoot and wearing light clothes, and Body
Mass Index (BMI) was calculated as weight divided by height squared (kg/m2). Waist
circumference was measured at the mid-level between the lowest rib margin and the iliac
crest. Hip circumference was measured at the widest level on great trochanters. The thigh
circumference was measured 1 cm below the gluteal fold level perpendicular to the long
axis of the thigh (Norton K, 1996; Snijder et al., 2003).
Beck Anxiety Inventory (BAI) was used to evaluate the anxiety symptoms. BAI is a 21-
item self-report questionnaire for assessing the severity of anxiety (Ulusoy, 1998). For the
assessment of depression, the Beck Depression Inventory (BDI) was used. This index
evaluates the grade of depression using 21 questions similarly to BAI (Hisli, 1989). A
higher score indicates more severe anxiety and depression according to the scales.
The severity of fatigue was assessed with the Fatigue Severity Scale (FSS). FSS is a self-
report questionnaire investigating the severity of fatigue with 9 items. Grading of each
item ranges from 1 to 7. One indicates fully disagreement where 7 indicates full agreement.
The final score is calculated of the mean value of these items (Armutlu et al., 2007;
Michalos, 2014).
Malaysian Journal of Movement, Health & Exercise, 7(2), 65-79, 2018
69
Short Form Health Survey (SF-36) which is a multidimensional test was used to assess the
quality of life of the subjects. SF-36 is comprised of Functional Capacity, Physical
Aspects, Bodily Pain, General Health, Vitality, Social Aspect, Emotional Aspect, and
Mental Health domains. A higher score indicates a better quality of life (Kocyigit, 1999).
Pilates Mat Exercise Protocol
The Pilates exercise group followed an original six-week Pilates mat exercise protocol
created by the researchers of this study (Table I). According to previous reports, 6 to 8
weeks of Pilates training has positive effects on physical and psychological health (Bavli
& Koybasi, 2016; Pourvaghar, Bahram, Sharif, & Sayyah, 2014; Rogers & Gibson, 2009).
We preferred the 6-week protocol to demonstrate efficacy as soon as possible in this study.
Sessions were conducted twice a week and duration of each session was 40-50 minutes in
average including 5 minutes of warming up and 5 minutes of cooling down. Exercises
were performed as group training and supervised by a physical therapist, taking into
account the potential benefits of group interaction on motivation and coordination. The
protocol was predominantly composed of training for the abdomen, hip and lower limbs
in order to improve body image by the way of reducing body weight, waist, hip and thigh
circumferences. All exercises were performed focusing on the alignment, and awareness
of the core, and breathing correctly. Current protocol comprised of progressive three
phases. Phase-1 contained simple movements such as hundreds, crunches, rolling and
some simple training series for back and hip during the first two weeks. All Phase-1
exercises were part of the program of the following phases. At the beginning of the third
week, a few more complicated exercises were added to the program. Phase-3, which was
performed during last two weeks period of the protocol, was composed of the most
complicated and difficult exercises in addition to the previous ones. Figure II contains
detailed information about the current protocol. Individual limitations were respected
while training, and exercises were modified according to the subjects’ abilities. The trainer
demonstrated each activity using verbal and visual instructions to facilitate the correct
position and movement. All exercises were coordinated in the group. There was a 10
seconds rest interval between each exercise.
A sıx-week pılates exercıse protocol
70
Table 1: Pilates Mat Exercise Protocol
* min: minutes
Statistical Analysis
Data were analyzed using SPSS 15.0 for Windows. Level of 5% was used to determine
significant differences. Normality tests indicated that quantities data were not normally
distributed. Descriptive statistics were used for demographic data, while the Wilcoxon
signed-rank test was used for comparing intra-group, and the Mann-Whitney U test was
used for inter-group analysis.
Results
Demographic features and the baseline outcomes of the participants are shown in Table 2.
At baseline, no significant differences were found between the PEG, and CG in age (years),
height (cm), thigh circumference (cm), and the scores of BDI, BAI, FSS, and SF-36
(p>0.05). Weight (Kg), BMI (kg/m2) waist circumference (cm), and hip circumference
(cm) were significantly higher in the PEG at the baseline (p<0.05) (Table 2).
Phase 1
(1&2 Weeks)
Phase 2
(3&4 Weeks)
Phase 3
(5&6 Weeks)
Frequency
Warm up (5 min)
Warm up (5 min)
Warm up (5 min)
2
times/week
Hundreds
Hundreds
Hundreds
Crunches/extended legs
and arms
Crunches/extended
legs and arms
Crunches/extended legs
and arms
Bent knee crunch
Bent knee crunch
Bent knee crunch
Rolling like a ball
Rolling like a ball
Rolling like a ball
Bent knee raise in
crawling position
Bent knee raise in
crawling position
Bent knee raise in
crawling position
Fire hydrant
Bent knee cross in
crawling position
Bent knee cross in
crawling position
Hip isometrics
Fire hydrant
Fire hydrant
Bridging
Hip isometrics
Hip isometrics
Knee Swim
Bridging
Bridging
Side leg series
Knee Swim
Knee Swim
Cool down (5 min)
Hip abduction/in
bridging
Hip abduction/in
bridging
Cross bridging
Cross bridging
Cat and cow
Straight leg raise/in
bridging
Side leg series
Cat and cow
Cool down (5 min)
Straight leg raise/in
crawling
Leg raise with bent
knee/in crawling
Side leg series
Cool down (5 min)
Malaysian Journal of Movement, Health & Exercise, 7(2), 65-79, 2018
71
Table 2: Demographic Features and Initial Outcomes of the Participants
PEG (n=25)
CG (n=26)
p
21.44±1.35
21.26±1.51
0.549
1.61±0.51
1.63±0.49
0.163
57.00±4.78
54.65±6.41
0.025*
21.88±1.68
20.44±2.05
0.001*
70.56±4.37
66.00±5.62
<0.001*
96.68±4.36
92.57±6.24
0.001*
54.00±4.05
51.00±4.87
0.054
15.88±1.07
17.57±8.48
0.336
13.32±7.72
13.38±7.83
0.917
4.69±1.04
4.81±1.24
0.450
88.00±9.78
86.34±1.17
0.788
69.00±34.06
65.38±36.79
0.795
70.28±2.00
70.26±2.24
0.970
58.52±16.39
61.30±16.20
0.550
55.80±14.69
48.46±21.94
0.198
71.68±2.28
66.50±2.58
0.263
54.52±35.75
55.30±37.57
0.954
60.00±1.36
54.92±2.10
0.460
Mann-Whitney U test * p<0.05
m: meter; kg: kilogram; cm: centimeter; BMI: Body Mass Index; BAI: Beck Anxiety Inventory;
BDI: Beck Depression Inventory; FSS: Fatigue Severity Scale; SF36: Short Form Health Survey
Intragroup analysis revealed a significant reduction in weight, BMI, waist circumference,
hip circumference, and thigh circumference (p<0.05) in the PEG while there was no
significant difference in CG after six weeks (p>0.05) (Table III).
Six weeks after the baseline, BAI scores significantly decreased in both groups (Table III)
nevertheless inter-groups analysis indicated that the reduction in the anxiety was
significantly in favor of PEG (p=0.017). There was also a significant reduction in BDI
score (p<0.05) in the PEG, while it did not change in CG after six weeks (p>0.05) (Table
III).
FSS scores significantly decreased in the both of the groups compared to baseline
outcomes (p<0.05) (Table III) moreover reduction in fatigue was significantly over in the
PEG (p=0.007).
Analysis revealed that vitality and mental health domains significantly increased after six
weeks in the PEG (p<0.05) while no significant differences were identified for the
functional capacity, physical aspects, bodily pain, general health, social aspect or
emotional aspect items (p>0.05) (Table III). Quality of life did not change in CG in terms
of emotional or physical components after six weeks (p>0.05) (Table III).
A sıx-week pılates exercıse protocol
72
Table 3: Intra-group Analysis of the Outcomes
Wilcoxon signed-rank test * p<0.05
m: meter; kg: kilogram; cm: centimeter; BMI: Body Mass Index; BAI: Beck Anxiety Inventory;
BDI: Beck Depression Inventory; FSS: Fatigue Severity Scale; SF36: Short Form Health Survey
Discussion
This study investigated the effectiveness of an original Pilates mat exercise protocol on
weight, BMI, anthropometric features, emotional state, fatigue, and quality of life among
young females. Our findings revealed that the six weeks Pilates mat Exercise Protocol
contribute to decrease weight, BMI, waist circumference, hip circumference, thigh
circumference, anxiety, depression, fatigue, and improve some domains of quality of life
of young females.
Physical exercise is one of the most common weight control and slimming methods
worldwide and is frequently preferred by females (von Sperling de Souza & Brum Vieira,
2006). Among exercise methods, Pilates-based training has seen increasing popularity in
recent years. However, results of the studies investigating the effect of Pilates on
anthropometric features and body mass are conflicting (Arslan, Çakmakçi, Taşkin,
Çakmakçi, & Ismet, 2012; Kucuk & Livanelioglu, 2015; Rogers & Gibson, 2009; Segal,
Hein, & Basford, 2004; Şavkın, 2014). Trials have shown that different periods and
intensities of Pilates training programs have different effects on these parameters. In the
current study, a six-week Pilates mat exercise protocol provided a reduction in weight,
BMI, waist, hip, and thigh circumferences compared to baseline outcomes of the
participants. This study confirms the findings of some previous ones, however, contradicts
to the report of Segal et al, who indicated 6 months of Pilates training did not change
weight, or other body composition parameters in adults (Segal et al., 2004). Segal et al.
explained this absence of changes in body composition with the low intensity of Pilates
exercise program (one hour per week). Although the intensity of the program conducted
in that study was lower than ours, the duration was higher. We think that the difference
between the outcomes of our study and previous one might be related to the differences in
content rather than the length of the training programs. Rogers and Gibson (2009) and
PEG (n=25)
CG (n=26)
Before
After
p
Before
After
p
Weight (kg)
57.00±4.78
56.28±4.80
0.005*
54.65±6.41
54.53±5.88
0.617
BMI (kg/m2)
21.88±1.68
21.61±1.69
0.005*
20.44±2.05
20.41±1.93
0.649
Waist Circumference (cm)
70.56±4.37
68.20±4.84
<0.001*
66.00±5.62
66.19±6.01
0.352
Hip Circumference (cm)
96.68±4.36
95.12±4.62
0.002*
92.57±6.24
92.76±6.20
0.375
Thigh Circumference (cm)
54.00±4.05
51.64±3.62
<0.001*
51.00±4.87
51.69±5.27
0.552
BAI
15.88±1.07
8.80±7.99
0.001*
17.57±8.48
13.07±8.79
0.010*
BDI
13.32±7.72
6.92±5.09
0.001*
13.38±7.83
9.88±9.48
0.067
FSS
4.69±1.04
3.30±1.03
<0.001*
4.81±1.24
4.29±1.39
0.032*
SF36-Functional Capacity
88.00±9.78
88.00±13.69
0.655
86.34±1.17
83.46±14.47
0.346
SF36-Physical Aspects
69.00±34.06
80.00±25.00
0.162
65.38±36.79
65.38±36.10
0.937
SF36-Bodily Pain
70.28±2.00
75.16±25.29
0.159
70.26±2.24
72.07±15.07
0.414
SF36-General Health
58.52±16.39
63.52±16.97
0.129
61.30±16.20
54.23±12.46
0.060
SF36-Vitality
55.80±14.69
66.68±15.72
0.005*
48.46±21.94
52.88±18.71
0.385
SF36-Social Aspect
71.68±2.28
76.20±19.31
0.233
66.50±2.58
63.38±20.15
0.936
SF36-Emotional Aspect
54.52±35.75
59.92±31.75
0.531
55.30±37.57
59.11±35.58
0.573
SF36-Mental Health
60.00±1.36
68.72±14.72
0.021*
54.92±2.10
58.92±16.95
0.389
Malaysian Journal of Movement, Health & Exercise, 7(2), 65-79, 2018
73
Şavkın (2014) both reported that 8 weeks Pilates training was sufficient in slimming the
participants in the waist and other regions of the body except thigh circumference. Unlike
these studies, a more intensive use of lower extremity exercises in our study might have
resulted in the reduction in thigh circumference. It is not possible to comment on this issue
since the authors did not provide detailed information about their exercise protocols.
In today's society, body image problems are unfortunately becoming widespread, and
unhealthy methods are taken depending on these perceptions especially of young girls.
Many studies have found high levels of subjective, and extreme body image dissatisfaction
about a person's physical appearance (Runfola et al., 2013). Weight control and slimness
may contribute women to improve their satisfaction with body image, and physical health.
According to our findings, the current Pilates mat exercise protocol promises to achieve
this in a correct and healthy way.
Present study also indicated that the severity of anxiety and depression of young females
who participated in Pilates training decreased compared to baseline. These findings are
inconsistent with previous reports in this subject (Cruz-Ferreira et al., 2011; Hassan &
Amin, 2011; Memmedova, 2015; Miller & Mesa, 2013; Roh, 2016). In a case report,
Miller and Mesa (2013) declared that “Pilates can help in the present moment releasing
anxiety, and stress but depending on the severity of anxiety it can add to the levels once
the client leaves, and goes back into the world.” This emphasizes the importance of
consistency for the effectiveness of the exercise. Simple, practical, feasible and
entertaining programs may help individuals to incorporate exercise into their lifestyle and
provide permanence of the positive effects. Heretofore, many opinions have been
developed about the effective mechanisms of Pilates exercises on the emotional health.
Memmedova (2015) summarized the mechanisms of Pilates on reducing anxiety through
the increase of body energy, sleep quality, attention, concentration, blood circulation, and
oxygen flow to the brain owing to blood circulation increment, relaxing of muscles, and
whole body, and breathing effect. The Pilates method has often been shown to be effective
in the increased release of serotonin from the brain. Increased levels of serotonin can be
helpful in the reduction of the symptoms associated with depressive symptoms and poor
or pessimistic attitudes (Ginsberg et al., 2016; Hassan & Amin, 2011). Further, breathing
as an integral aspect of Pilates has been found to have a positive effect on the vagus nerve,
which can influence emotional states such as anxiety and depression (Frank, Edwards, &
Larimore, 2017). Additionally, we think that group training might contribute to the
emotional state in terms of anxiety, and depression of the subjects through promoting
social interaction which helps the individuals to get rid of their daily stress.
There have been very few trials examining the effects of Pilates exercises on fatigue in the
literature (Ashrafinia et al., 2015; Shanazari, Marandi, & Minasian, 2013; Soysal Tomruk,
Uz, Kara, & Idiman, 2016; Stan et al., 2012). Our finding is consistent with the previous
researchers in terms of reduction in fatigue but none of them were conducted in healthy
populations. Our study is unique at this point. Authors reported that Pilates exercises might
reduce fatigue by the way of reducing redundant muscle activity and activate needful
muscles for functionality (Anderson & Spector, 2000). When people learn to contract their
muscles correctly in training sessions, they may use their muscles more effectively during
their daily activities. Further, the acceleration of physical activity might increase the
A sıx-week pılates exercıse protocol
74
fatigue threshold by improving endurance. Another possible mechanism might be the
deep, and relaxing respiration associated with the Pilates. Increasing airflow and lung
capacity might easier to perform any activity. In the current study, body mass reduction
might be another factor which helped fatigue reduction in the participants.
Our findings confirmed the past knowledge in terms of improving vitality, and mental
health domains of SF-36. The positive effects of Pilates training in quality of life in the
sedentary population were previously reported (Campos de Oliveira, Gonçalves de
Oliveira, & Pires-Oliveira, 2015; Leopoldino et al., 2013; McGrath, O'Malley, & Hendrix,
2011; Vieira, Faria, Wittmann, Teixeira, & Nogueira, 2013). However, frequency,
duration or intensity of training were all incomparable with our study. Pilates thought the
contrology stimulates the mind and decreases mental strain (Cruz-Ferreira et al., 2011;
Pilates & Miller, 1945). By allowing the brain to relax, it is possible for Pilates to increase
focus and concentration. Additionally, the control of muscles with coordination and
focusing on breathing might increase aerobic capacity, and further improve mental health
(Caldwell et al., 2009; Kucuk & Livanelioglu, 2015). We think that a longer and more
intensive program may be more effective to improve the quality of life of practitioners.
According to the present study, it is possible to report that the current Pilates mat exercise
protocol has positive effects on the health-related physical and psychological parameters
of young females. But as a limitation, it is not possible to reveal the mechanisms of effects
through this study. We could only guess, and comment on possible effect mechanisms.
The baseline outcomes of weight, BMI, waist and hip circumferences of PEG and CG were
significantly different despite randomization. We were unable to achieve homogeneity
between the two groups at the baseline. Relatively small sample size might be the possible
reason for this limitation. Besides, we did not perform normality test amongst the groups
prior to the intervention. More accurate results could be obtained from normally
distributed data obtained from a larger number of participants. Heretofore several studies
investigated the possible effects of Pilates exercises on undiseased or diseased populations,
but our study was different from previous ones in terms of offering an original six-week
Pilates exercise protocol which is effective at weight loss, slimming, emotional state,
fatigue and some domains of quality of life. This evidence-based study is significant in
terms of presenting a clear, reliable, basic, and effective protocol to the literature in order
to improve the physical, and psychological well-being of young females.
Conclusion
In conclusion, an original 6-week (twice a week for a total of 12 sessions) Pilates mat
exercise protocol contributes to the physical, and psychological well-being of young
females in terms of body mass, slimness, anxiety, depression, fatigue, and quality of life.
However, there is still need for long-term and larger sample sized future studies to clarify
the possible effect mechanisms of Pilates exercises and evidence based on this subject.
Malaysian Journal of Movement, Health & Exercise, 7(2), 65-79, 2018
75
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... Concerning the impact of exercise on fatigue, balance, and physical disability, further studies were performed in various areas. For example, six weeks of Pilates exercises mitigated fatigue and depression and subsequently improved the quality of life in the experimental group, compared with the control group [18]. Also, Baquet et al. indicated that short-term aerobic exercises did not significantly impact the quality of life and fatigue, in MS patients [19]. ...
... The Berg balance scale is a measurement of performance based on static and dynamic balance. It consists of 14 items; the total score varies from 0 to 56 (ie, the maximum score, showing a better balance) [18]. Also, each item includes five options scored from 0 to 4. Kashani et al. [23] verified the validity and reliability of the Persian version of this scale. ...
... Consistent with the results of Akbas as well as Salehi et al. [18,34], the eight-week Pilates training program significantly decreased the frequency of fatigue in the experimental group, compared with the control group. It also reduced the frequency of fatigue and improved the quality of life [18]. ...
Article
Background: Proinflammatory cytokines increasingly cause inflammation in patients with Multiple Sclerosis (MS). In this regard, the current study aimed to shed light on the effectiveness of an eight-week Pilates training program in the level of interleukin-18, the severity of fatigue, balance, and physical disability, in females with MS. Methods: This study was a quasi-experimental research with a pre-test-post-test design and a control group and conducted in Sirjan City, Iran. A total of 30 female MS patients (Mean±SD age: 30.15±6.97 years; 2≤ expanded disability status scale≤5.5) were selected using a purposeful sampling method and divided into control and experimental groups. The experimental group conducted the Pilates exercises for eight weeks, three sessions per week (lasting 45-60 minutes), while the control group had no regular physical activity. Before and after the training program, we evaluated fatigue, physical disability, and balance using the fatigue severity scale, the expanded disability status scale, and the Berg balance scale, respectively. Also, 5 mL of blood was taken from each participant to evaluate the interleukin-18 level. Then, the independent t-test was used to compare the pretest-posttest scores. Results: The findings indicated that the Pilates training program significantly decreased the level of interleukin-18, the severity of fatigue, and the score of physical disability (P≤0.05), and increased the balance (P≤0.05), in females with MS. Conclusion: Therefore, patients with MS can make the best use of such exercises to strengthen their immune systems and performances.
... Exercises can be done on mats or require the use of specialized equipment and the concepts of Pilates include centering that occurs by tightening of the body's muscle core between the ribcage and the pelvic floor throughout exercise, focus where cognitive focus needed to accomplish the activity, balance that needs the posture and movement control throughout the activity, precision that allows the accurateness of the technique of exercise, flow to get smooth movement changes within the course of exercise and most importantly, respiration that needs proper inhalation and exhalation of air from the lungs in combination with the exercise [7] . The Pilates mat training regimen results in young women's physical and psychological health in terms of body weight, slimming, anxiety, depressed mood, tiredness and quality of life [8] . Pilates helps to enhance both the mental and physical components in women during menopause [9] . ...
... The study's outcome measure is the Menopause Specific Quality of L ife [6] . females' physical and psychological well-being [8] . Rodriguez et al., ...
Article
Menopausal women shows common symptoms which includes night sweats and hot flushes, heart distress, disturbances in sleep, depression, irritability, anxiousness, weight changes, physical and mental fatigue, joint and muscle pain. This affects the Quality Of Life of the Menopausal women. Pilates Training has proven beneficial for enhancing QOL in menopausal women but there is paucity of evidence of effect of Progressive Muscle Relaxation Technique in Menopausal women on QOL. The research is an initiative study that focuses on the effectiveness of PMRT on the various aspects of Quality Of Life of the menopausal women and comparison of the Pilates training and PMRT in order to enhance the QOL of participants. Effect of Pilates training & Progressive Muscle Relaxation Technique on menopausal women’s QOL and comparison of both the technique. Methods: 42 participants aged >45 years will be randomly categorized in two groups: Group A (n= 21) and Group B (n=21). The study duration will be of 6 months. The pre and post Intervention will be taken from both the group and data will be analyzed with the help of main outcome measure which is Menopause specific Quality Of Life. Subject showed significant improvement in physical and psychosocial domain of MENQOL followed by both the intervention and Pilates Training has been seen more effective than PMRT. The study concluded that both the Pilates and Progressive Muscle Relaxation Therapy helped in improving the patients QOL.
... Pilates exercises have an increasing popularity among the general population in the last decades [13]. It has also been used by clinicians and researchers to improve the individuals' physical fitness, posture, muscle strength and functional performance. ...
... Previous research demonstrated that 6 to 8 weeks of Pilates training improves physical and psychological health [25,26]. Besides, six-week Pilates exercise protocol, which consists of two sessions per week, was revealed to contribute to physical and psychological well-being in healthy individuals [13]. Based on these results, we established the same protocol (twice per week for six weeks) in the current study. ...
Article
Full-text available
Objectives: Impairment in postural stability is prevalent in schizophrenia patients and this poses potential hazards. This study was planned to investigate whether the Pilates-based training improve the postural stability of patients with schizophrenia. Methods: Outpatients with schizophrenia were allocated to either Pilates exercise group (n=10), or control group (n=10) receiving no exercise. Pilates exercise group participated in supervised Pilates mat exercise program twice per week for six weeks, while the control group participated in no regular physical activity during study. Biodex Balance System was used to assess the participants’ postural stability at the baseline and after six weeks. Results: Statistical analysis revealed that Pilates exercise group showed significant improvement in terms of overall and medial/lateral postural stability scores in static condition (p<0.05). Also, overall and anterior/posterior index scores on left leg, overall and medial/lateral index scores on right leg decreased after training (p<0.05). Postural stability scores in dynamic condition, medial/lateral index score on left leg and anterior/posterior index score on right leg did not change in the Pilates exercise group (p>0.05). Conclusions: Our results showed that Pilates-based training benefit and suggest potential particular benefits in terms of postural stability in patients with schizophrenia. Pilates exercise can be added to the rehabilitation program of schizophrenia patients as a safe and effective method. Future research should include comparative exercise groups in order to determine any particular advantage to Pilates-based training in schizophrenia.
... Exercises may be mat based or require the use of specialized equipment and the concepts of Pilates include centering, focus, balance, precision flow and respiration [5]. Pilates seems to improve both the physical and psychological components in women during menopause [6]. ...
Article
Introduction: The concept of menopause is a complete cessation of ovarian function. Most common symptom of menopause include muscle and joint ache, poor memory, lower back pain and trouble sleeping. The vasomotor and emotional domains reported less often compared with the physical and psychological domains. Such adverse changes in physical and mental health may have a negative impact on Quality of Life (QOL). Pilates is a mind body exercise focusing on muscle strength, core stability, endurance, muscle control, posture, and respiration which seems to improve both the physical and psychological components in women during menopause. The given study helps to provide the effect of 6 weeks Pilates training protocol on menopausal women’s presenting complaints as well as on her QOL. Complaints and clinical finding: Patient’s main concern were low back ache without any cause night sweats, fatigue, disturbed sleep wake cycle which lead to difficulties in performing activities of daily living which hampered the QOL of the patient. Physical findings revealed decrement in lower back and lower limb muscle strength along with some tightness. Scales helped to reveal that patient is having fatigue and tiredness and mat-exercise treatment protocol were formed. Therapeutic Intervention: 6 weeks Pilates training. Conclusion: As there are minimal to no evidence present in reference to this study, it helps us to provide new and proper treatment protocol and it is helpful to know the effect of the same. It showed significant improvement in the muscular strength as well as reduction in stress level and helped in enhancing the QOL of the patient.
... Gruplararası kıyaslamada ise, istatistiksel açıdan anlamlı bir sonuç elde edileyemeyişi iki grubun son test puanlarının birbirine oldukça yakın olmasından kaynaklı olabilir. Araştırmada elde edilen bulgu alanyazındaki çalışmalarla da paralellik göstermektedir (Vancini ve ark., 2017;Yucel & Uysal, 2016, Akbaş & Ünver, 2018. ...
... Akbaş y Ünver (38) investigaron la efectividad de un programa de Pilates sobre parámetros relacionados con la salud de mujeres jóvenes (características antropométricas, estado emocional, fatiga y calidad de vida). Mujeres sedentarias de entre 18 y 25 años fueron asignadas al azar a un grupo de ejercicios de Pilates (n=25) y a un grupo control (n=26). ...
Article
Full-text available
Pilates is an alternative form of physical therapy of low-to-moderate intensity, predominantly performed on the floor and which focuses on addressing stability, muscle strength, flexibility, breathing and posture. There is evidence supporting its usefulness in physical health. In contrast, the evidence is still limited in terms of its effectiveness in improving mental health. The objective of this review article was to highlight the preliminary evidence that supports the usefulness of Pilates in the improvement of mental health and psychological variables of people. This was a non-systematic narrative review, focused on primary literature, selected from a search in PubMed and SciELO databases. The key terms used were: “Pilates and mental health”, “Pilates and mental disorders”, and “Pilates and psychiatry”. The results were supplemented with secondary literature (books and book chapters). The research was carried out in order to provide a general orientation that would serve psychiatrists and physiotherapists in the design of therapeutic plans that complement psychopharmaceuticals, psychotherapy and conventional physical exercise.
... Akbaş y Ünver (38) investigaron la efectividad de un programa de Pilates sobre parámetros relacionados con la salud de mujeres jóvenes (características antropométricas, estado emocional, fatiga y calidad de vida). Mujeres sedentarias de entre 18 y 25 años fueron asignadas al azar a un grupo de ejercicios de Pilates (n=25) y a un grupo control (n=26). ...
Article
Full-text available
Pilates is an alternative form of physical therapy of low-to-moderate intensity, predominantly performed on the floor and which focuses on addressing stability, muscle strength, flexibility, breathing and posture. There is evidence supporting its usefulness in physical health. In contrast, the evidence is still limited in terms of its effectiveness in improving mental health. The objective of this review article was to highlight the preliminary evidence that supports the usefulness of Pilates in the improvement of mental health and psychological variables of people. This was a non-systematic narrative review, focused on primary literature, selected from a search in PubMed and SciELO databases. The key terms used were: “Pilates and mental health”, “Pilates and mental disorders”, and “Pilates and psychiatry”. The results were supplemented with secondary literature (books and book chapters). The research was carried out in order to provide a general orientation that would serve psychiatrists and physiotherapists in the design of therapeutic plans that complement psychopharmaceuticals, psychotherapy and conventional physical exercise. [Full text available in Spanish]
Chapter
Full-text available
When I began thinking about writing this introduction, about what readers might want to know concerning the history, aims, scope and structure of the first ever Encyclopedia of Quality of Life and Well-Being Research (EQOLWR), it occurred to me almost immediately that I had never read the introduction of any encyclopedia.
Article
Full-text available
This study aims to examine the effect of a 16-week Pilates exercise program on the ego resiliency and depression in elderly women. Before participating in Pilates exercise programs, researcher explained the purpose and the intention of the research to elderly women who were willing to participate in this research. A total of 148 elderly women agreed to participate in the program and they filled in ego resiliency and depression questionnaires. Then, the elderly participated in the 16-week Pilates exercise program and completed the same questionnaires afterwards. Collected data was analyzed by the SPSS ver. 20.0 program and results of paired t-test were as follows; there were statistically significant differences in all subvariables of the ego resiliency such as self-confidence (t=7.770, P<0.001), communication efficiency (t=2.690, P<0.01), optimistic trait (t=1.996, P<0.05), and anger management (t=4.525, P<0.001) after elderly women participated in the 16-week Pilates exercise program, there was a statistically significant difference in depression of elderly women who participated in the 16-week Pilates exercise program (t=−6.506, P<0.001) which was statistically lower than before their participation in the program. Consequently, participating in the Pilates exercise program can help improve the ego-resiliency and alleviate depression of the elderly women.
Article
Full-text available
Aim: Aim of this study was to observe the possible effects of Clinical Pilates exercise programme on pain and disability level additional to conventional physiotherapy in patients with rotator cuff tendinopathy. Methods: A total of 19 RCT patients (control group n=10, mean age=50,60 ± 11,70 years) (Pilates group n=9, mean age=51,44 ± 9,88 years) participated in the study. All patients were treated with hot-pack therapy, ultrasound therapy and home exercise program five times a week, total of fifteen sessions (three weeks). Pilates group also trained with Clinic Pilates exercise program especially focused to shoulder complex supervised with expert. Pain intensity (at night, resting, flexion, abduction, internal rotation, external rotation) was assessed with Visual Analog Scale (VAS). Disability level was assessed with Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and Shoulder Pain and Disability Index (SPADI), general health level was assessed with Health Assesment Questionaire Disability Index (HAQ-DI), and anxiety level was assessed with Beck Anxiety Inventory (BAI). Results: Night pain, pain in internal rotation, external rotation, DASH and SPADI scores significantly got better in both groups after therapy (p<0,05). Resting pain, pain in flexion and abduction HAQ-DI and BAI scores did not advanced in control group while significantly improved in the Pilates Group (p<0,05). Conclusions: Pilates exercises are associated with better quality of life values, especially in the dimensions of physical functioning, general health and mental health. Our results indicated that well-designed Clinic Pilates programme customed to shoulder complex may be beneficial option additional to conventional therapies in RCT patients.
Article
Purpose: The aim of this prospective, randomized, controlled study was to investigate the effects of the addition of Pilates-based exercises to standard exercise programs performed after total knee arthroplasty on quality of life and balance. Method: Forty-six volunteers were divided into two groups. The control group (n = 17) was assigned a standard exercise program after discharge; the study group (n = 17) was assigned Pilates-based exercises along with the standard exercise program. We carried out clinical evaluations of all patients on the day of discharge and after the completion of the 6-week exercise program. We also recorded sociodemographic data, Berg Balance test scores, and Short Form-36 (SF-36) health-related quality of life measurements. Results: When we compared the differences between pre- and post-treatment balance scores of the groups, we found a significant change in favor of the Pilates-based exercise group (13.64 ± 1.45; p < 0.01). The changes in the pre- and post-treatment SF-36 scores of the Pilates-based exercises group were found to be significant in terms of physical function (p = 0.001), physical role restriction (p = 0.01), and physical component score (p = 0.001). Conclusions: Pilates-based exercises performed along with standard exercise programs were more effective for improving balance and quality of life than standard exercise programs alone.
Chapter
Multiple sclerosis (MS) is an immune-mediated disorder in which the body's immune system damages myelin in the central nervous system. The onset of this disorder typically occurs in early adulthood, and it is more frequently diagnosed in women. As of 2016, there is no cure, and the long-term disease progression makes symptomatic management critical for maintaining quality of life (QoL). Several pharmacotherapeutic agents are approved for treatment, but many patients seek complementary and alternative interventions. Here, we review the potential benefits of yoga or Pilates for individuals with MS and address the ability of yoga or Pilates in managing symptoms related to QoL including pain, mental health, fatigue, spasticity, balance, bladder control, and sexual function.
Article
Pilates exercises have several demonstrated physical and psychological benefits. To date, most research in this context was conducted with symptomatic or elderly people with few dependent measures. The current study examined the chronic or longitudinal effects of very low frequency, once a week, Pilates training on several physical and psychological measures, over a 10-week intervention, in young, healthy, and sedentary women. Further, the study gauged the acute effects of Pilates exercises on positive- and negative affect in 10 exercise sessions. Compared to a control group, the Pilates group exhibited significant improvements in skeletal muscle mass, flexibility, balance, core- and abdominal muscle strength, body awareness, and negative affect. This group also showed favorable changes in positive (22.5% increase) and negative affect (12.2% decrease) in nine out of ten exercise sessions. This work clearly demonstrates the acute and chronic benefits of Pilates training on both physical and psychological measures. It also reveals that even only once a week Pilates training is enough to trigger detectable benefits in young sedentary women. While this frequency is below the required levels of exercise for health, it may overcome the ‘lack of time’ excuse for not exercising and subsequently its tangible benefits may positively influence one's engagement in more physical activity.