Pilates versus resistance training on trunk strength and balance adaptations in older women: a randomized controlled trial

María Carrasco-Poyatos, Domingo J Ramos-Campo, Jacobo A Rubio-Arias, María Carrasco-Poyatos, Domingo J Ramos-Campo, Jacobo A Rubio-Arias

Abstract

Background: The neuromuscular decline impact in the functional independence of older women is determining the necessity of implementing new strategies focused on core strength training and postural stability maintenance to promote healthy aging.

Objectives: To define whether Pilates or resistance training is better at improving (a) core isometric and isokinetic muscular strength, and (b) static and dynamic balance, in older women.

Methods: This was a cluster randomized controlled trial. Physically independent older women (60-80 years) from day centers were randomly allocated to Pilates, Muscular and Control Groups (PG, MG and CG) using a block randomization method. Only the research staff performing the assessment and statistical analysis were blinded. Exercise groups trained twice a week (1 h per session) for 18 weeks in a moderate-to-vigorous intensity. Core strength (primary outcome): trunk and hip isometric and hip isokinetic muscular strength (Biodex System III Pro Isokinetic Dynamometer), alongside one leg static balance (portable force platform Kistler 9286AA) and dynamic balance (timed up and go (TUG)) were assessed.

Results: A total of 60 participants were randomized (PG, n = 20; MG, n = 20; CG, n = 20) and 49 completed the trial (PG, n = 16; MG, n = 19; CG, n = 14). Regarding hip isometric extension strength, PG was statistically better than CG (P = 0.004). There were no differences between groups regarding isokinetic strength or balance. Intra-group comparisons showed significant improvements (P < 0.05) in the dynamic balance and trunk and hip isometric extension strength for PG and MG, whereas every hip isokinetic measurement was improved in MG. Exercise programs did not produce any adverse event.

Conclusions: The Pilates training program was more effective for improving isometric hip and trunk extension strength, while the Muscular training program generated greater benefits on trunk and hip isokinetic strength. Moreover, both training programs showed moderate effects for the TUG.

Clinical trial registration: The trial was registered at ClinicalTrials.gov (identifier: NCT02506491).

Keywords: Dynamometer; Hip strength; Postural equilibrium; Trunk strength; Women.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2019 Carrasco-Poyatos et al.

Figures

Figure 1. Flow diagram of the progress…
Figure 1. Flow diagram of the progress of the randomized trial.

References

    1. Bergamin M, Gobbo S, Bullo V, Zanotto T, Vendramin B, Duregon F, Cugusi L, Camozzi V, Zaccaria M, Neunhaeuserer D, Ermolao A. Effects of a pilates exercise program on muscle strength, postural control and body composition: results from a pilot study in a group of post-menopausal women. AGE. 2015;37(6):118. doi: 10.1007/s11357-015-9852-3.
    1. Bertoli J, Dal Pupo J, Vaz MA, Detanico D, Biduski GM, De la Rocha Freitas C. Effects of mat pilates on hip and knee isokinetic torque parameters in elderly women. Journal of Bodywork and Movement Therapies. 2018;22(3):798–804. doi: 10.1016/j.jbmt.2017.08.006.
    1. Bird ML, Hill K, Ball M, Williams AD. Effects of resistance- and flexibility-exercise interventions on balance and related measures in older adults. Journal of Aging and Physical Activity. 2009;17(4):444–454. doi: 10.1123/japa.17.4.444.
    1. Bird M-L, Hill KD, Fell JW. A randomized controlled study investigating static and dynamic balance in older adults after training with pilates. Archives of Physical Medicine and Rehabilitation. 2012;93(1):43–49. doi: 10.1016/j.apmr.2011.08.005.
    1. Bolognini N, Pascual-Leone A, Fregni F. Using non-invasive brain stimulation to augment motor training-induced plasticity. Journal of NeuroEngineering and Rehabilitation. 2009;6(1):8. doi: 10.1186/1743-0003-6-8.
    1. Cadore EL, Rodríguez-Mañas L, Sinclair A, Izquierdo M. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Research. 2013;16(2):105–114. doi: 10.1089/rej.2012.1397.
    1. Carroll TJ, Riek S, Carson RG. Neural adaptations to resistance training: implications for movement control. Sports Medicine. 2001;31(12):829–840. doi: 10.2165/00007256-200131120-00001.
    1. De Oliveira LC, Pires-Oliveira DAA, Abucarub AC, Oliveira LS, De Oliveira RG. Pilates increases isokinetic muscular strength of the elbow flexor and extensor muscles of older women: a randomized controlled clinical trial. Journal of Bodywork and Movement Therapies. 2017;21(1):2–10. doi: 10.1016/j.jbmt.2016.03.002.
    1. De Souza R, De Faria Marcon L, De Arruda A, Pontes Junior FL, De Melo RC. Effects of mat pilates on physical functional performance of older adults. American Journal of Physical Medicine & Rehabilitation. 2017;97(6):414–425.
    1. Donath L, Roth R, Hürlimann C, Zahner L, Faude O. Pilates vs. balance training in health community-dwelling seniors: a 3-arm, randomized controlled trial. International Journal of Sports Medicine. 2016;37(3):202–210.
    1. Ester I, Garcia G, Maria S, Cavalcanti DB, Aoki MS. Isokinetic evaluation of the musculature involved in trunk flexion and extension: Pilates © method effect. Revista Brasileira de Medicina do Esporte. 2004;10(6):491–493.
    1. Eyigor S, Karapolat H, Durmaz B. Effects of a group-based exercise program on the physical performance, muscle strength and quality of life in older women. Archives of Gerontology and Geriatrics. 2007;45(3):259–271. doi: 10.1016/j.archger.2006.12.001.
    1. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 1975;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6.
    1. Fukagawa NK, Brown M, Sinacore DR, Host HH. The relationship of strength to function in the older adult. Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 1995;50A:55–59. doi: 10.1093/gerona/50A.Special_Issue.55.
    1. Gadelha A, Neri S, Oliveira R, Bottaro M, David A, Vainshelboim B, Lima RM. Severity of sarcopenia is associated with postural balance and risk of falls in community-dwelling older women. Experimental Aging Research. 2018;20(1):1–12.
    1. Gafner SC, Bastiaenen CH, Ferrari S, Gold G, Terrier P, Hilfiker R, Allet L. Hip muscle and hand-grip strength to differentiate between older fallers and non-fallers: a cross-sectional validity study. Clinical Interventions in Aging. 2018;13:1–8. doi: 10.2147/CIA.S146834.
    1. Gioffrè-Florio M, Murabito LM, Visalli C, Pergolizzi FP, Famà F. Trauma in elderly patients: a study of prevalence, comorbidities and gender differences. Giornale di Chirurgia - Journal of Surgery. 2018;39(1):35–40. doi: 10.11138/gchir/2018.39.1.035.
    1. Granacher U, Gollhofer A, Hortobágyi T, Kressig RW, Muehlbauer T. The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review. Sports Medicine. 2013;43(7):627–641. doi: 10.1007/s40279-013-0041-1.
    1. Granacher U, Lacroix A, Muehlbauer T, Roettger K, Gollhofer A. Effects of core instability strength training on trunk muscle strength, spinal mobility, dynamic balance and functional mobility in older adults. Gerontology. 2013;59(2):105–113. doi: 10.1159/000343152.
    1. Guadalupe-Grau A, Carnicero JA, Losa-Reyna J, Tresguerres JA, Gómez-Cabrera MC, Castillo C, Alfaro-Acha A, Rosado-Artalejo C, Rodriguez-Mañas L, García-García FJ. Endocrinology of ageing from a muscle function point of view: results from the Toledo study for healthy ageing. Journal of the American Medical Directors Association. 2017;18(3):234–239. doi: 10.1016/j.jamda.2016.09.005.
    1. Heyward VH. Advanced fitness assessment and exercise prescription. Champaign: Human Kinetics; 2002.
    1. Hopkins WG, Marshall SW, Batterham AM, Hanin J. Progressive statistics for studies in sports medicine and exercise science. Medicine & Science in Sports & Exercise. 2009;41(1):3–13. doi: 10.1249/MSS.0b013e31818cb278.
    1. Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age and Ageing. 2006;35(2):ii7–ii11. doi: 10.1093/ageing/afl077.
    1. Irez GB. The effects of different exercises on balance, fear and risk of falling among adults aged 65 and over. Anthropologist. 2014;18(1):129–134. doi: 10.1080/09720073.2014.11891528.
    1. Irez GB, Ozdemir RA, Evin R, Irez SG, Korkusuz F. Integrating pilates exercise into an exercise program for 65+ year-old women to reduce falls. Journal of Sports Science and Medicine. 2011;10(1):105–111.
    1. Ishizaki K, Mori N, Takeshima T, Fukuhara Y, Ijiri T, Kusumi M, Yasui K, Kowa H, Nakashima K. Static stabilometry in patients with migraine and tension-type headache during a headache-free period. Psychiatry and Clinical Neurosciences. 2002;56(1):85–90. doi: 10.1046/j.1440-1819.2002.00933.x.
    1. Johnson EG, Larsen A, Ozawa H, Wilson CA, Kennedy KL. The effects of pilates-based exercise on dynamic balance in healthy adults. Journal of Bodywork and Movement Therapies. 2007;11(3):238–242. doi: 10.1016/j.jbmt.2006.08.008.
    1. Kaesler DS, Mellifont RB, Swete Kelly P, Taaffe DR. A novel balance exercise program for postural stability in older adults: a pilot study. Journal of Bodywork and Movement Therapies. 2007;11(1):37–43. doi: 10.1016/j.jbmt.2006.05.003.
    1. Kang S, Hwang S, Klein AB, Kim SH. Multicomponent exercise for physical fitness of community-dwelling elderly women. Journal of Physical Therapy Science. 2015;27(3):911–915. doi: 10.1589/jpts.27.911.
    1. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged: the index of ADL: a standardized measure of biological and psychosocial function. JAMA. 1963;185(12):914–919. doi: 10.1001/jama.1963.03060120024016.
    1. Kibar S, Yardimci FÖ, Evcik D, Ay S, Alhan A, Manço M, Ergin E. Can a pilates exercise program be effective on balance, flexibility and muscle endurance? A randomized controlled trial. Journal of Sports Medicine and Physical Fitness. 2016;56(10):1139–1146.
    1. Kim J, Shin W. How to do random allocation (randomization) Clinics in Orthopedic Surgery. 2014;6(1):103–109. doi: 10.4055/cios.2014.6.1.103.
    1. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–186. doi: 10.1093/geront/9.3_Part_1.179.
    1. Lee I-H, Park S-Y. Balance improvement by strength training for the elderly. Journal of Physical Therapy Science. 2013;25(12):1591–1593. doi: 10.1589/jpts.25.1591.
    1. Luedke LE, Heiderscheit BC, Williams DS, Rauh MJ. Association of isometric strength of hip and knee muscles with injury risk in high scholl cross crountry runners. International Journal of Sports Physical Therapy. 2015;10(6):868–876.
    1. Markovic G, Sarabon N, Greblo Z, Krizanic V. Effects of feedback-based balance and core resistance training vs. pilates training on balance and muscle function in older women: a randomized-controlled trial. Archives of Gerontology and Geriatrics. 2015;61(2):117–123. doi: 10.1016/j.archger.2015.05.009.
    1. Marques EA, Mota J, Machado L, Sousa F, Coelho M, Moreira P, Carvalho J. Multicomponent training program with weight-bearing exercises elicits favorable bone density, muscle strength, and balance adaptations in older women. Calcified Tissue International. 2011;88(2):117–129. doi: 10.1007/s00223-010-9437-1.
    1. Marín-Cascales E, Alcaraz PE, Ramos-Campo DJ, Rubio-Arias JA. Effects of multicomponent training on lean and bone mass in postmenopausal and older women: a systematic review. Menopause. 2018;25(3):346–356. doi: 10.1097/GME.0000000000000975.
    1. Meyer C, Corten K, Wesseling M, Peers K, Simon JP, Jonkers I, Desloovere K. Test-retest reliability of innovated strength tests for hip muscles. PLOS ONE. 2013;8(11):e81149. doi: 10.1371/journal.pone.0081149.
    1. Miyakoshi N, Hongo M, Maekawa S, Ishikawa Y, Shimada Y, Itoi E. Back extensor strength and lumbar spinal mobility are predictors of quality of life in patients with postmenopausal osteoporosis. Osteoporosis International. 2007;18(10):1397–1403. doi: 10.1007/s00198-007-0383-3.
    1. Mokhtari M, Nezakatalhossaini M, Esfarjani F. The effect of 12-week pilates exercises on depression and balance associated with falling in the elderly. Procedia - Social and Behavioral Sciences. 2013;70(12):1717–1723. doi: 10.1016/j.sbspro.2013.01.246.
    1. Moreno-Segura N, Igual-Camacho C, Ballester-Gil Y, Blasco-Igual MC, Blasco JM. The effects of the pilates training method on balance and falls of older adults: a systematic review and meta-analysis of randomized controlled trials. Journal of Aging and Physical Activity. 2018;26(2):327–344. doi: 10.1123/japa.2017-0078.
    1. Newman AB, Kupelian V, Visser M, Simonsick E, Goodpaster B, Nevitt M, Kritchevsky SB, Tylavsky FA, Rubin SM, Harris TB, Health ABC Study Investigators Sarcopenia: alternative definitions and associations with lower extremity function. Journal of the American Geriatrics Society. 2003;51(11):1602–1609. doi: 10.1046/j.1532-5415.2003.51534.x.
    1. Oliveira LC, Oliveira RG, De Pires-Oliveira AA. Pilates increases the isokinetic muscular strength of the knee extensors and flexors in elderly women. Journal of Bodywork and Movement Therapies. 2017;21(4):815–822. doi: 10.1016/j.jbmt.2017.01.006.
    1. Orr R, Raymond J, Fiatarone Singh M. Efficacy of progressive resistance training on balance performance in older adults. Sports Medicine. 2008;38(4):317–343. doi: 10.2165/00007256-200838040-00004.
    1. Rikli R, Jones C. Senior fitness test manual. Champaign: Human Kinetics; 2001.
    1. Robertson RJ, Goss FL, Rutkowski J, Lenz B, Dixon C, Timmer J, Frazee K, Dube J, Andreacci J. Concurrent validation of the OMNI perceived exertion scale for resistance exercise. Medicine & Science in Sports & Exercise. 2003;35(2):333–341. doi: 10.1249/01.MSS.0000048831.15016.2A.
    1. Robinson B, Gordon J, Wallentine S, Visio M. Relationship between lower-extremity joint torque and the risk for falls in a group of community dwelling older adults. Physiotherapy Theory and Practice. 2004;20(3):155–173. doi: 10.1080/09593980490487500.
    1. Rodriguez-Laso A, McLaughlin SJ, Urdaneta E, Yanguas J. Defining and estimating healthy ageing in Spain: a cross-sectional study. Gerontologist. 2018;58(2):388–398. doi: 10.1093/geront/gnw266.
    1. Sai AJ, Gallagher JC, Smith LM, Logsdon S. Fall predictors in the community dwelling elderly: a cross sectional and prospective cohort study. Journal of Musculoskeletal and Neuronal Interactions. 2010;10(2):142–150.
    1. Sekendiz B, Altun O, Korkusuz F, Akin S. Effects of pilates exercise on trunk strength, endurance and flexibility in sedentary adult females. Journal of Bodywork and Movement Therapies. 2007;11(4):318–326. doi: 10.1016/j.jbmt.2006.12.002.
    1. Seo B-D, Yun Y-D, Kim H-R, Lee S-H. Effect of 12-week swiss ball exercise program on physical fitness and balance ability of elderly women. Journal of Physical Therapy Science. 2012;24(1):11–15. doi: 10.1589/jpts.24.11.
    1. Steinhilber B, Haupt G, Boeer J, Grau S, Krauss I. Erratum: reproducibility of concentric isokinetic and isometric strength measurements at the hip in patients with hip osteoarthritis: a preliminary study (Isokinetics and Exercise Science (2011) 19 (39-46)) Isokinetics and Exercise Science. 2011;20(1):147.
    1. Wells C, Kolt GS, Bialocerkowski A. Defining pilates exercise: a systematic review. Complementary Therapies in Medicine. 2012;20(4):253–262.
    1. Xue Q-L, Beamer BA, Chaves PHM, Guralnik JM, Fried LP. Heterogeneity in rate of decline in grip, hip, and knee strength and the risk of all-cause mortality: the women’s health and aging study II. Journal of the American Geriatrics Society. 2010;58(11):2076–2084. doi: 10.1111/j.1532-5415.2010.03154.x.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다