“Mat Pilates probably improves balance and strength in older adults” – CSP

In recent research conducted by de Souza and colleagues there was a consensus that mat based pilates can improved balance and strength in older adults.

In this article shared from the Chartered Society of Physiotherapy we share some information on this research…

(Image/Amelie Beniost/BSIP/Science Photo Libary)

Why was this study needed?

In the UK, 11.8 million people are aged 65 or older, with numbers increasing each year. Maintaining physical fitness in this age group is of paramount importance for the prevention of falls and cardiovascular disease but also to ensure mental wellbeing.

Mat Pilates is a form of exercise that only requires a mat or minimal equipment, such as rubber bands and Swiss balls. It aims to strengthen the core muscles. It also focuses on increased flexibility and balance. Pilates has been gaining popularity, and the 2005 UK national standard for Pilates ensures teachers are sufficiently skilled. Pilates teachers must have at least Level 3 to be on the UK Register of Exercise Professionals.

Though, in theory, Pilates should be beneficial for older adults, there has been limited objective evidence.

What did this study do?

This systematic review included nine randomised controlled trials comparing mat Pilates with no exercise. Studies included 415 adults aged over 60 years with no recorded health concerns. Pilates sessions ranged from 50 to 60 minutes, two to four times per week, for four to 24 weeks. The studies were conducted in Brazil, Israel, Turkey and South Africa.

Each study used different scales to measure each element of fitness. Therefore, results were converted into a standardised mean difference (SMD). They defined a difference of 0.2 as a small effect, 0.2 to 0.8 a moderate effect, and over 0.8 a large effect.

DoH guidelines recommend that over 65’s have at least 150 mins moderate activity each week

Five studies were assessed as high quality and four low quality. However, most study personnel were aware which group participants were in, either at the time of allocation or assessment, which could have biased results in favour of Pilates.

What did it find?

Mat Pilates gave a large improvement in all the following elements compared to no exercise:

  • Dynamic balance (SMD 1.10, 95% confidence interval [CI] 0.29 to 1.90; three trials, 156 participants).
  • Lower limb muscle strength (SMD 1.13, 95% CI 0.30 to 1.96; five trials, 217 participants).
  • Lower body flexibility (SMD 1.22, 95% CI 0.39 to 2.04; three trials, 147 participants).
  • Cardiorespiratory fitness (SMD 1.48, 95% CI 0.42 to 2.54; three trials, 127 participants).

What does current guidance say on this issue?

Department of Health 2011 guidelines recommend adults aged 65 or more to be active daily, adding up to at least 150 minutes of moderate activity per week. They also recommend strength training on at least two days a week.  If at risk of falls, balance training, such as tai chi or yoga, should be incorporated. There is no guidance on Pilates for older people.

NICE 2008 guidelines on mental wellbeing in the over 65s recommends tailored physical activity programmes, delivered by physiotherapists, fitness instructors and the voluntary sector. This includes strength, resistance, toning and stretching exercises, dancing, walking and swimming.

What are the implications?

It does not seem so surprising that Pilates should be better than no exercise for strength, balance and flexibility. The evidence has quality limitations but this is a difficult area to research without bias, and the apparent beneficial effect is substantial and consistent across outcomes.

Exercise referral schemes are only funded for inactive people who have existing health conditions or are at increased risk of ill health. However, mat Pilates is often available outside this service from trained instructors at gyms, for example.

Here at Complete Physiotherapy we offer a ‘Complete Core Conditioning’ class which focuses on engaging key trunk muscles to improve posture and reduce pain.

Classes are on Wednesday at 12:30pm and Friday at 3:30pm and are lead by our Physiotherapist Noelia Mendoza who has expertise for Woman’s Health. The class costs £8 and is limited to 6 people to ensure you get the attention you need. Call today on 01189462299 to book your space.