Effects of Cervical Sensorimotor Training With Pilates Reformer on Balance and Cervical Joint Position Sense

The Effect of Cervical Sensorimotor Control Training Combined With Reformer Exercise on Static and Dynamic Balance and Cervical Joint Position Sense

This study investigates the effects of Pilates reformer exercise combined with cervical sensorimotor training using laser-guided visual feedback on balance performance. Participants were randomly assigned to three groups: a combined training group, a Pilates-only group, and a control group. Static and dynamic balance were assessed before and after the intervention.

This study was registered retrospectively on ClinicalTrials.gov after participant enrollment had begun. Institutional Review Board (IRB) approval was obtained prior to participant enrollment.

Study Overview

• Status: Completed
• Conditions: Postural Balance; Focus of Study is Effects of Neuromuscular Training; Pilates
• Intervention / Treatment: Behavioral: Cervical Sensorimotor Training; Behavioral: Pilates Reformer Exercise

Detailed Description

Postural control is maintained through the integration of sensory information from the visual, vestibular, and somatosensory systems. Among these systems, cervical proprioception plays a critical role in providing information about head position and movement, which contributes to the regulation of balance and postural stability. Alterations or deficits in cervical proprioceptive input may negatively influence sensorimotor control and balance performance.

Laser-guided visual feedback training has been used to enhance cervical joint position sense and improve sensorimotor control by providing real-time visual information about head and neck movements. This method allows individuals to actively adjust head position based on visual feedback, thereby facilitating proprioceptive retraining.

The reformer exercise method is a form of resistance-based exercise that emphasizes controlled movements, core stabilization, and neuromuscular coordination. Integrating cervical proprioceptive training with reformer exercise may further enhance postural control by promoting coordinated activation of trunk and neck musculature.

The purpose of this study is to investigate the effects of a reformer exercise program incorporating cervical proprioceptive training using laser-guided visual feedback on balance ability. Pilates Reformer-based exercises combined with cervical proprioceptive training tasks were proceeded. Balance performance and proprioception were evaluated using static and dynamic balance measures and cervical joint position error before and after the intervention.

The findings of this study may provide evidence regarding the potential benefits of integrating laser-guided visual feedback-based cervical proprioceptive training into exercise programs aimed at improving balance and postural stability.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• South Korea
  • Seoul, South Korea, 03760
    • Ewha Womans University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Female adults aged 30-49 years
• Individuals who use a computer for ≥6 hours per day
• Individuals who have experienced musculoskeletal pain and discomfort (neck, shoulder, or lower back) within the past year
• Individuals who voluntarily agreed to participate in the study
• Individuals able to participate in exercise training

Exclusion Criteria:

• History of musculoskeletal or neurological surgery within the past 6 months
• Individuals diagnosed with severe fractures or neurological disorders requiring surgical treatment
• Any severe condition affecting balance or gait

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cervical Sensorimotor Training with Pilates Reformer Exercise; Participants performed Pilates reformer exercise combined with cervical sensorimotor training using laser-guided visual feedback.	Behavioral: Cervical Sensorimotor Training; Laser-guided cervical sensorimotor training designed to improve cervical joint position sense. Training included head repositioning tasks with visual feedback under progressively challenging postural conditions involving different base-of-support and surface stability levels.; Other Names: laser-guided visual-vestibular-cervical sensorimotor training; Behavioral: Pilates Reformer Exercise; Pilates Reformer-based exercise focusing on trunk stabilization, postural alignment, controlled balance using spring-based resistance and different base-of-support.
Active Comparator: Pilates-only Exercise Group; Participants performed a Pilates reformer exercise program without cervical sensorimotor training.	Behavioral: Pilates Reformer Exercise; Pilates Reformer-based exercise focusing on trunk stabilization, postural alignment, controlled balance using spring-based resistance and different base-of-support.
No Intervention: Control Group; Participants had no intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Title: Dynamic balance - COP medio-lateral excursion rate(COP ML Rate) during gait stance phase	Dynamic postural control assessed as the COP medio-lateral rate during gait (COP medio-lateral distance (mm)/foot width (mm)x100); higher percentages indicate greater COP curvature, reflecting a more normal foot rollover pattern. Unit of Measure: percent (%)	Baseline and 12 weeks
Dynamic balance - COP Sway Rate during gait stance phase	Dynamic postural control assessed as COP Sway Rate during gait (Net Sway Length/COP Path Length × 100); values closer to 0% indicate better dynamic balance. Unit of Measure: percent (%)	Baseline and 12 weeks
Dynamic balance - Y-Balance Test (YBT) composite score	Dynamic balance assessed using Y-Balance Test score (% of limb length); higher values indicate better dynamic balance. Unit of Measure: percent (%)	Baseline and 12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Title: Static balance - COP Sway Distance during quiet standing	Static postural stability assessed as the distance of center of pressure (COP) sway during quiet standing; values closer to 0 mm indicate better static balance. Unit of Measure: millimeters (mm)	Baseline and 12 weeks
Static balance - COP ellipse area during quiet standing	Static postural stability assessed as the area of the COP sway ellipse during quiet standing, with smaller areas indicating better static balance. Unit of Measure: square millimeters (mm²)	Baseline and 12 weeks
Cervical Joint Position Sense(CJPS) - Accuracy	Cervical Joint Position Sense-Accuracy assessed using the Cervical Joint Position Error Test (CJPET) as the mean absolute linear repositioning error over five repetitions to the left and five to the right; values closer to 0 cm indicate better cervical position sense. Unit of Measure: centimeters (cm)	Baseline and 12 weeks
Cervical Joint Position Sense(CJPS) - Precision	Cervical Joint Position Sense - Precision assessed using the CJPET as the standard deviation of linear repositioning error over five repetitions to the left and five to the right; values closer to 0 cm indicate better cervical position sense. Unit of Measure: centimeters (cm)	Baseline and 12 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Static posture balance - plantar pressure distribution across foot quadrants	Static posture balance assessed as plantar pressure distribution across four foot quadrants during quiet standing; values closer to 25% indicate better static posture balance. Unit of Measure: percent (%)	Baseline and 12 weeks
Rearfoot alignment - resting calcaneal stance position (RCSP)	Rearfoot alignment assessed using RCSP in degrees. An angle of 0° is ideal (normal range: -2° to +2°), with positive values indicating valgus and negative values indicating varus. Unit of Measure: degrees (°)	Baseline and 12 weeks

Collaborators and Investigators

• Sponsor: Ewha Womans University

Publications and helpful links

General Publications

• Zarei, H., Norasteh, A. A., Rahmanpournashrudkoli, A. and Hajihoseini, E. (2020). The effects of Pilates training on static and dynamic balance of female deaf students: A randomized controlled trial. Journal of Bodywork and Movement Therapies, 24, 63-69.
• Wannaprom, N., Treleaven, J., Jull, G. and Uthaikhup, S. (2018). Neck muscle vibration produces diverse responses in balance and gait speed between individuals with and without neck pain. Musculoskeletal Science and Practice, 35, 25-29. https://doi.org/10.1016/j.msksp.2018.02.001
• Treleaven, J. (2017). Dizziness, unsteadiness, visual disturbances, and sensorimotor control in traumatic neck pain. Journal of Orthopaedic & Sports Physical Therapy, 47, 492-502. https://doi.org/10.2519/jospt.2017.7052

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2021
• Primary Completion (Actual): November 30, 2021
• Study Completion (Actual): December 10, 2021

Study Registration Dates

• First Submitted: March 11, 2026
• First Submitted That Met QC Criteria: March 16, 2026
• First Posted (Actual): March 19, 2026

Study Record Updates

• Last Update Posted (Actual): March 19, 2026
• Last Update Submitted That Met QC Criteria: March 16, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: balance; visual feedback; Pilates exercise; sensorimotor training; cervical joint position sense
• Other Study ID Numbers: ewha-202108-CSP-balance; IRB: ewha-202108-0034-01 (Other Identifier: Institutional Review Board of Ewha Womans University)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: IPD will not be shared due to privacy and ethical restrictions.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No