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Pilates may improve muscle strength and balance in older adults

Bullo V, Bergamin M, Gobbo S, et al. The effects of pilates exercise training on physical fitness and wellbeing in the elderly: A systematic review for future exercise prescription Preventative Medicine. 2015;75:1-11.

Review question

What are the effects of Pilates on physical fitness, strength, balance, number of falls, mood, quality of life and the ability to independently complete daily tasks in older adults?


As people age, they tend to lose the amount of muscle they have. This can cause changes in one’s ability to function physically and make daily activities more difficult to complete. Because of this, strategies that help to improve or stop the decline in function are important for quality of life in older adults. Pilates is a type of physical activity made up of movements from different exercises such as dance, martial arts, gymnastics, and yoga. It emphasizes flowing movement, breathing, control, concentration, focusing on the centre of the body, and performing the movements properly. A previous systematic review showed that Pilates has a positive effect on muscle endurance, flexibility, and dynamic balance in young and middle-aged people, but how helpful it may be for older adults is not known.  

How the review was done

This is a systematic review and meta-analysis of 10 studies, most of which were randomized controlled trials. The studies were published between 2009 and 2013 and included a total of 349 participants. Key features of the studies:

  • The participants generally ranged in age from 60-80 years old. Some participants were healthy and others had a stable long-term illness.
  • The types of Pilates exercises varied, and included standing, sitting, and laying down exercises, floor mat exercises, and exercises using equipment such as weights, wobble boards, balls, elastic bands, reformers, and chairs. Generally, Pilates sessions lasted between 60-75 minutes and were done 1-3 times a week. Participants took part in these programs for 5 weeks to 12 months.
  • Researchers measured: muscle strength, walking performance (e.g., steps walked within a 5 m distance and walking speed), static balance, dynamic balance, flexibility, independence in completing daily activities (e.g., getting dressed/undressed), mood, and quality of life.
  • Some studies compared the results to people in control groups, older adults who did not do any Pilates exercise.  

What the researchers found

Pilates may have a large effect on improving muscle strength, a moderate effect on improving dynamic balance, and a small effect on improving static balance in older adults. Although improved balance may help to prevent falls, the data from this review does not yet support Pilates’ role in preventing falls. The review did not find enough data in the included studies to understand the impact of Pilates on walking and walking speed, flexibility, the ability to accomplish daily living activities, mood (by reducing depressive symptoms), or quality of life. It is important to highlight that 6 of the included studies where considered low quality, while 4 were considered high quality. Due to the small number of studies and participants included in the review, more research is needed to further support these findings.  


Pilates may help older adults to improve their muscle strength and balance. Although these findings are encouraging, more research is needed on this topic, especially to understand whether these improvements in strength and balance help to prevent falls and maintain levels of physical function.




Control group
A group that receives either no treatment or a standard treatment.
Dynamic balance
Staying balanced while moving around or changing positions.
Advanced statistical methods contrasting and combining results from different studies.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Static balance
Staying balanced when in an upright position but without moving feet.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

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