Pilates is a promising way to improve balance in older adults

Barker, A.L., Bird, M. & Talevski, J. Effects of pilates exercise for improving balance in older adults: A systematic review with meta-analysis Archives of Physical Medicine and Rehabilitation. 2015;96:715-723.

Review question

Does Pilates improve balance and lower risk of falls among older adults?

Background

Older adults are more prone to falls than the rest of the general public.  The consequences of falls can also be more serious than in younger people and can affect independence and increase risk of serious injury or even death. Previous research has shown that exercises that improve balance can lower the risk of falls. Pilates is a balance exercise that focuses on strength, stability, flexibility, posture, and breathing. This review looked at whether Pilates helps improve balance and prevent falls in older adults. 

How the review was done

Six studies were included in this well done systematic review: five were randomized controlled trials, one was a controlled clinical trial. All studies included an exercise described as “Pilates,” a control group who did not do any exercise or “usual activity”, and all measured the impacts on falls and/or balance.  The average age of participants was over 60 years and the number of participants in the studies varied from 32 to 60. Over 75% of the participants were women. Five studies included adults living in the community, one study included participants in a residential care facility and all programs included at least 2hrs of Pilates exercise each week. The Pilates sessions were all group sessions 1hr in length and held three times a week.  The lengths of programs ranged from 5 to 24 weeks.

What the researchers found

The studies show that Pilates helps to improve balance in older adults. Pilates was also found to lower the number of falls but this outcome was only measured in one study.  Many of the exercises in the included studies were done while participants were seated or lying down, which suggests that even non-standing Pilates exercises may help people improve their balance.  The authors do note that standing exercises may provide more of a balance challenge and could provide greater benefits in improving balance.  While these results suggest Pilates can improve balance, because the quality of the included studies was low more studies of higher  quality need to be conducted to say with confidence that participating in Pilates will result in  improved balance and lower risk of  falls.

Conclusion

Pilates is a promising way to improve balance in older adults, and may lower the risk of falls. More high quality research is needed to confirm these conclusions.