The effects of Clinical Pilates training on walking, balance, fall risk, respiratory, and cognitive functions in persons with multiple sclerosis: A randomized controlled trial

Abstract

Context: Multiple sclerosis (MS) is a chronic progressive and neurodegenerative disease. Exercise programs are needed to maintain and increase functional status in persons with MS (pwMS). Pilates exercises designed by a physiotherapist can enhance participation and functionality in pwMS.

Objective: The aim of this study was to investigate the effects of Clinical Pilates training on balance, walking, fall risk, respiratory, and cognitive functions in pwMS compared with an active comparator (home exercise training).

Design: This study was a randomized controlled study.

Settings: This study was designed by researchers at Dokuz Eylül University, Izmir, Turkey.

Participants: Forty-two pwMS were included in this randomized controlled trial.

Main outcome measures: Walking, core stability, balance confidence, respiratory muscle strength, and cognitive functions were assessed before and after the program.

Interventions: The participants were randomly divided into two groups. The Pilates exercises group (n = 21) received therapy weekly for 8 weeks along with a home exercise program. The home exercise group (n = 21) was given standardized exercises reflecting routine clinical practice. The program compliance was monitored by telephone calls once a week.

Results: There were no significant differences in walking speed (p = 0.096), perceived walking ability (p = 0.165), and fear of falling (p = 0.385) between the Pilates and home exercise groups. Clinical Pilates training was superior to the home exercise program in walking endurance (p = 0.001), postural stability (p = 0.028), core stability (p = 0.016), respiratory (maximum inspiratory pressure: p = 0.037, maximum expiratory pressure: p = 0.008), and cognitive functions (p = 0.001-0.007). Clinical Pilates training may be preferred as an alternative method to improve balance, walking, respiratory, and cognitive functions in pwMS.

Keywords: Balance; Clinical Pilates; Cognition; Exercise; Multiple sclerosis; Walking.