Therapeutic Effects of the Pilates Method in Patients with Multiple Sclerosis: A Systematic Review

Gustavo Rodríguez-Fuentes, Lucía Silveira-Pereira, Pedro Ferradáns-Rodríguez, Pablo Campo-Prieto, Gustavo Rodríguez-Fuentes, Lucía Silveira-Pereira, Pedro Ferradáns-Rodríguez, Pablo Campo-Prieto

Abstract

The Pilates Method is a rehabilitation tool with verified benefits in pain management, physical function, and quality of life in many different physiotherapy areas. It could be beneficial for patients with multiple sclerosis (pwMS). The aim of the study was to summarize current evidence for the effectiveness of Pilates in pwMS. A comprehensive search of Cinahl, Scopus, Web of Science, PEDro, and PubMed (including PubMed Central and Medline) was conducted to examine randomized controlled trials (RCT) that included Pilates intervention in multiple sclerosis. The PEDro scale and the Cochrane risk-of-bias tool, RoB-2, were used to evaluate risk of bias for RCT. Twenty RCT (999 patients) were included. Ten were of good quality (PEDro), and seven had low risk of bias (RoB-2). Pilates improves balance, gait, physical-functional conditions (muscular strength, core stability, aerobic capacity, and body composition), and cognitive functions. Fatigue, quality of life, and psychological function did not show clear improvement. There was good adherence to Pilates intervention (average adherence ≥ 80%). Cumulative data suggest that Pilates can be a rehabilitation tool for pwMS. High adherence and few adverse effects were reported. Future research is needed to develop clinical protocols that could maximize therapeutic effects of Pilates for pwMS.

Keywords: exercise therapy; multiple sclerosis; neurorehabilitation; physical therapy modalities; pilates-based exercise.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart of the study selection.
Figure 2
Figure 2
Risk of bias of the reviewed studies: (up) for each domain, (down) overall judgement.

References

    1. Goldenberg M.M. Multiple sclerosis review. Pharm. Ther. 2012;37:175–184.
    1. Dobson R., Giovannoni G. Multiple sclerosis—A review. Eur. J. Neurol. 2018;26:27–40. doi: 10.1111/ene.13819.
    1. Reich D.S., Lucchinetti C.F., Calabresi P.A. Multiple Sclerosis. N. Engl. J. Med. 2018;378:169–180. doi: 10.1056/NEJMra1401483.
    1. Wallin M.T., Culpepper W.J., Nichols E., Bhutta Z.A., Gebrehiwot T.T., Hay S.I., Khalil I.A., Krohn K.J., Liang X., Naghavi M., et al. Global, regional, and national burden of multiple sclerosis 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18:269–285. doi: 10.1016/S1474-4422(18)30443-5.
    1. Amatya B., Khan F., Galea M. Rehabilitation for people with multiple sclerosis: An overview of Cochrane Reviews. Cochrane Database Syst. Rev. 2019;1:CD012732. doi: 10.1002/14651858.CD012732.pub2.
    1. Lublin F.D., Reingold S.C., Cohen J.A., Cutter G.R., Sørensen P.S., Thompson A.J., Wolinsky J.S., Balcer L.J., Banwell B., Barkhof F., et al. Defining the clinical course of multiple sclerosis: The 2013 revisions. Neurology. 2014;83:278–286. doi: 10.1212/WNL.0000000000000560.
    1. Heine M., Van De Port I., Rietberg M.B., van Wegen E.E.H., Kwakkel G. Exercise therapy for fatigue in multiple sclerosis. Cochrane Database Syst. Rev. 2015;9:CD009956. doi: 10.1002/14651858.CD009956.pub2.
    1. Nilsagård Y., Gunn H., Freeman J., Hoang P., Lord S., Mazumder R., Cameron M. Falls in people with MS—an individual data meta-analysis from studies from Australia, Sweden, United Kingdom and the United States. Mult. Scler. J. 2014;21:92–100. doi: 10.1177/1352458514538884.
    1. Rietberg M.B., Brooks D., Uitdehaag B.M., Kwakkel G. Exercise therapy for multiple sclerosis. Cochrane Database Syst. Rev. 2005;2005:CD003980. doi: 10.1002/14651858.CD003980.pub2.
    1. Dalgas U., Stenager E., Ingemann-Hansen T. Review: Multiple sclerosis and physical exercise: Recommendations for the application of resistance-, endurance- and combined training. Mult. Scler. J. 2008;14:35–53. doi: 10.1177/1352458507079445.
    1. Motl R.W., Sandroff B. Benefits of Exercise Training in Multiple Sclerosis. Curr. Neurol. Neurosci. Rep. 2015;15:62. doi: 10.1007/s11910-015-0585-6.
    1. Petajan J.H., White A.T. Recommendations for physical activity in patients with multiple sclerosis. Sports Med. 1999;27:179–191. doi: 10.2165/00007256-199927030-00004.
    1. Snook E.M., Motl R.W. Effect of Exercise Training on Walking Mobility in Multiple Sclerosis: A Meta-Analysis. Neurorehabilit. Neural Repair. 2008;23:108–116. doi: 10.1177/1545968308320641.
    1. Padgett P.K., Kasser S.L. Exercise for Managing the Symptoms of Multiple Sclerosis. Phys. Ther. 2013;93:723–728. doi: 10.2522/ptj.20120178.
    1. Pearson M., Dieberg G., Smart N. Exercise as a Therapy for Improvement of Walking Ability in Adults with Multiple Sclerosis: A Meta-Analysis. Arch. Phys. Med. Rehabil. 2015;96:1339–1348.e7. doi: 10.1016/j.apmr.2015.02.011.
    1. Motl R.W., Sandroff B., Kwakkel G., Dalgas U., Feinstein A., Heesen C., Feys P., Thompson A. Exercise in patients with multiple sclerosis. Lancet Neurol. 2017;16:848–856. doi: 10.1016/S1474-4422(17)30281-8.
    1. Khan F., Amatya B. Rehabilitation in Multiple Sclerosis: A Systematic Review of Systematic Reviews. Arch. Phys. Med. Rehabil. 2016;98:353–367. doi: 10.1016/j.apmr.2016.04.016.
    1. Demaneuf T., Aitken Z., Karahalios A., Leong T.I., De Livera A.M., Jelinek G.A., Weiland T., Marck C.H. Effectiveness of Exercise Interventions for Pain Reduction in People with Multiple Sclerosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch. Phys. Med. Rehabil. 2018;100:128–139. doi: 10.1016/j.apmr.2018.08.178.
    1. Tallner A., Waschbisch A., Wenny I., Schwab S., Hentschke C., Pfeifer K., Mäurer M. Multiple sclerosis relapses are not associated with exercise. Mult. Scler. J. 2011;18:232–235. doi: 10.1177/1352458511415143.
    1. Pilutti L.A., Platta M.E., Motl R.W., Latimer A. The safety of exercise training in multiple sclerosis: A systematic review. J. Neurol. Sci. 2014;343:3–7. doi: 10.1016/j.jns.2014.05.016.
    1. Wells C., Kolt G., Bialocerkowski A. Defining Pilates exercise: A systematic review. Complement. Ther. Med. 2012;20:253–262. doi: 10.1016/j.ctim.2012.02.005.
    1. Cruz-Ferreira A., Fernandes J., Laranjo L., Bernardo L.M., Silva A. A Systematic Review of the Effects of Pilates Method of Exercise in Healthy People. Arch. Phys. Med. Rehabil. 2011;92:2071–2081. doi: 10.1016/j.apmr.2011.06.018.
    1. Byrnes K., Wu P.-J., Whillier S. Is Pilates an effective rehabilitation tool? A systematic review. J. Bodyw. Mov. Ther. 2017;22:192–202. doi: 10.1016/j.jbmt.2017.04.008.
    1. Page M.J., McKenzie J.E., Bossuyt P.M., Boutron I., Hoffmann T.C., Mulrow C.D., Shamseer L., Tetzlaff J.M., Akl E.A., Brennan S.E., et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71.
    1. Maher C.G., Sherrington C., Herbert R.D., Moseley A.M., Elkins M. Reliability of the PEDro Scale for Rating Quality of Randomized Controlled Trials. Phys. Ther. 2003;83:713–721. doi: 10.1093/ptj/83.8.713.
    1. Foley N.C., Teasell R.W., Bhogal S.K., Speechley M.R. Stroke Rehabilitation Evidence-Based Review: Methodology. Top. Stroke Rehabil. 2003;10:1–7. doi: 10.1310/Y6TG-1KQ9-LEDQ-64L8.
    1. Sterne J.A.C., Savović J., Page M.J., Elbers R.G., Blencowe N.S., Boutron I., Cates C.J., Cheng H.Y., Corbett M.S., Eldridge S.M., et al. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. doi: 10.1136/bmj.l4898.
    1. Güngör F., Tarakci E., Özdemir-Acar Z., Soysal A. The effects of supervised versus home Pilates-based core stability training on lower extremity muscle strength and postural sway in people with multiple sclerosis. Mult. Scler. J. 2021;28 doi: 10.1177/13524585211012202.
    1. Fleming K.M., Coote S.B., Herring M.P. Home-based Pilates for symptoms of anxiety, depression and fatigue among persons with multiple sclerosis: An 8-week randomized controlled trial. Mult. Scler. J. 2021;27:2267–2279. doi: 10.1177/13524585211009216.
    1. Gheitasi M., Bayattork M., Andersen L.L., Imani S., Daneshfar A. Effect of twelve weeks pilates training on functional balance of male patients with multiple sclerosis: Randomized controlled trial. J. Bodyw. Mov. Ther. 2020;25:41–45. doi: 10.1016/j.jbmt.2020.11.003.
    1. Arntzen E.C., Straume B., Odeh F., Feys P., Normann B. Group-based, individualized, comprehensive core stability and balance intervention provides immediate and long-term improvements in walking in individuals with multiple sclerosis: A randomized controlled trial. Physiother. Res. Int. 2019;25:e1798. doi: 10.1002/pri.1798.
    1. Ozkul C., Guclu-Gunduz A., Eldemir K., Apaydin Y., Yazici G., Irkec C. Combined exercise training improves cognitive functions in multiple sclerosis patients with cognitive impairment: A single-blinded randomized controlled trial. Mult. Scler. Relat. Disord. 2020;45:102419. doi: 10.1016/j.msard.2020.102419.
    1. Banitalebi E., Ghahfarrokhi M.M., Negaresh R., Kazemi A., Faramarzi M., Motl R.W., Zimmer P. Exercise improves neurotrophins in multiple sclerosis independent of disability status. Mult. Scler. Relat. Disord. 2020;43:102143. doi: 10.1016/j.msard.2020.102143.
    1. Abasıyanık Z., Ertekin Ö., Kahraman T., Yigit P., Özakbaş S. The effects of Clinical Pilates training on walking, balance, fall risk, respiratory, and cognitive functions in persons with multiple sclerosis: A randomized controlled trial. Explore. 2020;16:12–20. doi: 10.1016/j.explore.2019.07.010.
    1. Fleming K., Coote S., Herring M. The feasibility of Pilates to improve symptoms of anxiety, depression, and fatigue among people with Multiple Sclerosis: An eight-week randomized controlled pilot trial. Psychol. Sport Exerc. 2019;45:101573. doi: 10.1016/j.psychsport.2019.101573.
    1. Eftekhari E., Etemadifar M. Impact of Clinical Mat Pilates on Body Composition and Functional Indices in Female Patients with Multiple Sclerosis. Crescent J. Med. Biol. Sci. 2018;5:297–305.
    1. Ozkul C., Guclu-Gunduz A., Irkec C., Fidan I., Aydin Y., Ozkan T., Yazici G. Effect of combined exercise training on serum brain-derived neurotrophic factor, suppressors of cytokine signaling 1 and 3 in patients with multiple sclerosis. J. Neuroimmunol. 2018;316:121–129. doi: 10.1016/j.jneuroim.2018.01.002.
    1. Duff W.R., Andrushko J., Renshaw D.W., Chilibeck P.D., Farthing J.P., Danielson J., Evans C.D. Impact of Pilates Exercise in Multiple Sclerosis. Int. J. MS Care. 2018;20:92–100. doi: 10.7224/1537-2073.2017-066.
    1. Eftekhari E., Etemadifar M. Interleukin-10 and brain-derived neurotrophic factor responses to the Mat Pilates training in women with multiple sclerosis. Sci. Med. 2018;28:31668. doi: 10.15448/1980-6108.2018.4.31668.
    1. Kalron A., Rosenblum U., Frid L., Achiron A. Pilates exercise training vs. physical therapy for improving walking and balance in people with multiple sclerosis: A randomized controlled trial. Clin. Rehabilitation. 2016;31:319–328. doi: 10.1177/0269215516637202.
    1. Bulguroglu I., Guclu-Gunduz A., Yazici G., Ozkul C., Irkec C., Nazliel B., Batur-Caglayan H. The effects of Mat Pilates and Reformer Pilates in patients with Multiple Sclerosis: A randomized controlled study. NeuroRehabilitation. 2017;41:413–422. doi: 10.3233/NRE-162121.
    1. Kara B., Küçük F., Poyraz E.C., Tomruk M.S., Idıman E. Different types of exercise in Multiple Sclerosis: Aerobic exercise or Pilates, a single-blind clinical study. J. Back Musculoskelet. Rehabilitation. 2017;30:565–573. doi: 10.3233/BMR-150515.
    1. Fox E.E., Hough A.D., Creanor S., Gear M., Freeman J.A. Effects of Pilates-Based Core Stability Training in Ambulant People with Multiple Sclerosis: Multicenter, Assessor-Blinded, Randomized Controlled Trial. Phys. Ther. 2016;96:1170–1178. doi: 10.2522/ptj.20150166.
    1. Kucuk F., Kara B., Poyraz E.C., Idiman E. Improvements in cognition, quality of life, and physical performance with clinical Pilates in multiple sclerosis: A randomized controlled trial. J. Phys. Ther. Sci. 2016;28:761–768. doi: 10.1589/jpts.28.761.
    1. Hosseini Sisi S.Z., Sadeghi H., Massood Nabavi S. The effects of 8 weeks of rebound therapy and Pilates practices on static and dynamic balances in males with multiple sclerosis. Adv. Environ. Biol. 2014;7:4290–4293.
    1. Guclu-Gunduz A., Citaker S., Irkec C., Nazliel B., Batur-Caglayan H.Z. The effects of pilates on balance, mobility and strength in patients with multiple sclerosis. NeuroRehabilitation. 2014;34:337–342. doi: 10.3233/NRE-130957.
    1. Marandi S.M., Nejad V.S., Shanazari Z., Zolaktaf V. A Comparison of 12 Weeks of Pilates and Aquatic Training on the Dynamic Balance of Women with Mulitple Sclerosis. Int. J. Prev. Med. 2013;4:S110–S117.
    1. Sánchez-Lastra M.A., Martínez-Aldao D., Molina A.J., Ayán C. Pilates for people with multiple sclerosis: A systematic review and meta-analysis. Mult. Scler. Relat. Disord. 2019;28:199–212. doi: 10.1016/j.msard.2019.01.006.
    1. Middleton L.E., Barnes D.E., Lui L.-Y., Yaffe K. Physical Activity over the Life Course and Its Association with Cognitive Performance and Impairment in Old Age. J. Am. Geriatr. Soc. 2010;58:1322–1326. doi: 10.1111/j.1532-5415.2010.02903.x.
    1. Giesser B.S. Exercise in the management of persons with multiple sclerosis. Ther. Adv. Neurol. Disord. 2015;8:123–130. doi: 10.1177/1756285615576663.
    1. Willey J.Z., Gardener H., Caunca M.R., Moon Y.P., Dong C., Cheung Y.K., Sacco R.L., Elkind M.S., Wright C.B. Leisure-time physical activity associates with cognitive decline. Neurology. 2016;86:1897–1903. doi: 10.1212/WNL.0000000000002582.
    1. Vanderbeken I., Kerckhofs E. A systematic review of the effect of physical exercise on cognition in stroke and traumatic brain injury patients: The Northern Manhattan Study. NeuroRehabilitation. 2017;40:33–48. doi: 10.3233/NRE-161388.
    1. Marques K.A.P., Trindade C.B.B., Almeida M.C.V., Bento-Torres N.V.O. Pilates for rehabilitation in patients with multiple sclerosis: A systematic review of effects on cognition, health-related physical fitness, general symptoms and quality of life. J. Bodyw. Mov. Ther. 2020;24:26–36. doi: 10.1016/j.jbmt.2020.01.008.
    1. Washington F., Langdon D. Factors affecting adherence to disease-modifying therapies in multiple sclerosis: Systematic review. J. Neurol. 2021:1–12. doi: 10.1007/s00415-021-10850-w.

Source: PubMed

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