Pilates vs. Balance Training in Health Community-Dwelling Seniors: a 3-arm, Randomized Controlled Trial

Abstract

The study examined effects of traditional balance vs. mat-based Pilates training on balance and trunk strength in healthy community dwellers. Forty-eight seniors were either stratified to a balance training group (BAL, n=16, 69.1 (SD 5.8) y), Pilates training group (PIL, n=17, 70.8 (6.5) y) or control group (CON, n=15, 69.2 (6.1) y). BAL performed traditional balance training, while PIL conducted mat-based Pilates-exercises (8 weeks, 2 sessions/week 66 min each). Balance performance (single limb stance and perturbed kneeling, Y-Balance test), dynamic and isometric trunk flexion and extension were assessed during pre- and post-testing. According to the magnitude-based inference approach, substantial positive effects in favor of BAL compared to CON were found for the Y-balance score (right leg, effect size (d)=0.68; left leg, d=0.56), trunk extension (d=0.68) and single leg stance (right leg, d=0.61; left leg, d=0.38). Dynamic (d=0.32) and isometric (d=0.15) trunk flexion revealed unclear effects. For the Y-balance score (right leg, d=0.48, left leg, d=0.75) and single leg stance (right leg, +d=0.61%; left leg, d=0.67), interestingly, BAL substantially exceeded PIL. PIL vs. CON revealed unclear effects for most parameters (0.05<d<0.36). Mat-based Pilates training did not cause relevant adaptations in trunk strength and balance performance, whereas balance training substantially improved balance and trunk strength.

Key words

neuromuscular performance - postural control - trunk strength - core stability - elderly - randomized controlled trial

• References

• 1 Barker AL, Bird ML, Talevski J. Effect of pilates exercise for improving balance in older adults: A systematic review with meta-analysis. Arch Phys Med Rehabil 2015; 96: 715-723
• 2 Batterham AM, Hopkins WG. Making meaningful inferences about magnitudes. Int J Sports Physiol Perform 2006; 1: 50-57
• 3 Bird ML, Hill KD, Fell JW. A randomized controlled study investigating static and dynamic balance in older adults after training with Pilates. Arch Phys Med Rehabil 2012; 93: 43-49
• 4 Borghuis J, Hof AL, Lemmink KA. The importance of sensory-motor control in providing core stability: implications for measurement and training. Sports Med 2008; 38: 893-916
• 5 Cohen J. Statistical power analysis for the behavior sciences. 2^nd ed Lawrence Erlbaum Associates; 1988
• 6 Cruz-Ferreira A, Fernandes J, Laranjo L, Bernardo LM, Silva A. A systematic review of the effects of pilates method of exercise in healthy people. Arch Phys Med Rehabil 2011; 92: 2071-2081
• 7 Donath L, Faude O, Bridenbaugh SA, Roth R, Soltermann M, Kressig RW, Zahner L. Transfer effects of fall training on balance performance and spatiotemporal gait parameters in healthy community-dwelling older adults: a pilot study. J Aging Phys Act 2014; 22: 324-333
• 8 Donath L, Faude O, Roth R, Zahner L. Effects of stair-climbing on balance, gait, strength, resting heart rate, and submaximal endurance in healthy seniors. Scand J Med Sci Sports 2014; 24: e93-e101
• 9 Donath L, Roth R, Zahner L, Faude O. Testing single and double limb standing balance performance: comparison of COP path length evaluation between two devices. Gait Posture 2012; 36: 439-443
• 10 Donath L, Roth R, Zahner L, Faude O. Slackline training and neuromuscular performance in seniors. Scand J Sport Sci Med 2015; in press
• 11 Frey I, Berg A, Keul J. Assessment and evaluation of leisure activity of participants in heart rehabilitation groups. Wien Klin Wochenschr 1995; 107: 774-777
• 12 Garcia-Soidan JL, Giraldez VA, Cachon Zagalaz J, Lara-Sanchez AJ. Does pilates exercise increase physical activity, quality of life, latency, and sleep quantity in middle-aged people?. Percept Mot Skills 2014; 119: 838-850
• 13 Gardner MM, Robertson MC, Campbell AJ. Exercise in preventing falls and fall related injuries in older people: a review of randomised controlled trials. Br J Sports Med 2000; 34: 7-17
• 14 Gildenhuys G, Fourie M, Shaw I, Shaw B, Toriola A, Witthuhn J. Evaluation of Pilates training on agility, functional mobility and cardiorespiratory fitness in elderly women: health and fitness. Afr J Phys Health Educ Recreat Dance 2013; 19: 505-512
• 15 Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012; 9: CD007146
• 16 Granacher U, Gollhofer A, Hortobagyi T, Kressig RW, Muehlbauer T. The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review. Sports Med 2013; 43: 627-641
• 17 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: 105-113
• 18 Granacher U, Muehlbauer T, Gollhofer A, Kressig RW, Zahner L. An intergenerational approach in the promotion of balance and strength for fall prevention – a mini-review. Gerontology 2011; 57: 304-315
• 19 Granacher U, Muehlbauer T, Gruber M. A qualitative review of balance and strength performance in healthy older adults: impact for testing and training. J Aging Res 2012; 2012: 708905
• 20 Granacher U, Muehlbauer T, Zahner L, Gollhofer A, Kressig RW. Comparison of traditional and recent approaches in the promotion of balance and strength in older adults. Sports Med 2011; 41: 377-400
• 21 Granacher U, Wick C, Rueck N, Esposito C, Roth R, Zahner L. Promoting balance and strength in the middle-aged workforce. Int J Sports Med 2011; 32: 35-44
• 22 Harriss DJ, Atkinson G. Ethical standards in sport and exercise science research: 2014 update. Int J Sports Med 2013; 34: 1025-1028
• 23 Hopkins WG. Analysis of a pre-post controlled trial (Excel spreadsheet). newstats.org/xParallelGroupTrial.xls. In 2006
• 24 Hopkins WG, Marshall SW, Batterham AM, Hanin J. Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc 2009; 41: 3-13
• 25 Hytonen M, Pyykko I, Aalto H, Starck J. Postural control and age. Acta Otolaryngol 1993; 113: 119-122
• 26 Hyun J, Hwangbo K, Lee CW. The effects of pilates mat exercise on the balance ability of elderly females. J Phys Ther Sci 2014; 26: 291-293
• 27 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. J Sports Sci Med 2011; 10: 105-111
• 28 Johnson EG, Larsen A, Ozawa H, Wilson CA, Kennedy KL. The effects of Pilates-based exercise on dynamic balance in healthy adults. J Bodyw Mov Ther 2007; 11: 238-242
• 29 Jones TS, Ghosh TS, Horn K, Smith J, Vogt RL. Primary care physicians perceptions and practices regarding fall prevention in adult’s 65 years and over. Accid Anal Prev 2011; 43: 1605-1609
• 30 Kim HJ, Kim J, Kim CS. The effects of pilates exercise on lipid metabolism and inflammatory cytokines mRNA expression in female undergraduates. J Exerc Nutr Biochem 2014; 18: 267-275
• 31 Kloubec JA. Pilates for improvement of muscle endurance, flexibility, balance, and posture. J Strength Cond Res 2010; 24: 661-667
• 32 Lutz W, Sanderson W, Scherbov S. The coming acceleration of global population ageing. Nature 2008; 451: 716-719
• 33 Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 2003; 83: 713-721
• 34 Moreau CE, Green BN, Johnson CD, Moreau SR. Isometric back extension exercise tests: A review of the literature. J Manip Physiol Ther 2001; 24: 110-122
• 35 Muehlbauer T, Besemer C, Wehrle A, Gollhofer A, Granacher U. Relationship between Strength, power and balance performance in seniors. Gerontology 2012;
• 36 Pata RW, Lord K, Lamb J. The effect of Pilates based exercise on mobility, postural stability, and balance in order to decrease fall risk in older adults. J Bodyw Mov Ther 2014; 18: 361-367
• 37 Plisky PJ, Gorman PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B. The reliability of an instrumented device for measuring components of the star excursion balance test. North Am J Sports Phys Ther 2009; 4: 92-99
• 38 Pocock SJ, Simon R. Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. Biometrics 1975; 31: 103-115
• 39 Rutjes AW, Di Nisio M. 24 weeks of Pilates-aerobic and educative training to improve body fat mass in elderly Serbian women. Clin Intervent Aging 2014; 9: 741
• 40 Salavati M, Hadian MR, Mazaheri M, Negahban H, Ebrahimi I, Talebian S, Jafari AH, Sanjari MA, Sohani SM, Parnianpour M. Test-retest reliability [corrected] of center of pressure measures of postural stability during quiet standing in a group with musculoskeletal disorders consisting of low back pain, anterior cruciate ligament injury and functional ankle instability. Gait Posture 2009; 29: 460-464
• 41 Shea S, Moriello G. Feasibility and outcomes of a classical Pilates program on lower extremity strength, posture, balance, gait, and quality of life in someone with impairments due to a stroke. J Bodyw Mov Ther 2014; 18: 332-360
• 42 Sherrington C, Tiedemann A, Fairhall N, Close JC, Lord SR. Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. N S W Public Health Bull 2011; 22: 78-83
• 43 Siebert T, Sust M, Thaller S, Tilp M, Wagner H. An improved method to determine neuromuscular properties using force laws-From single muscle to applications in human movements. Hum Mov Sci 2007; 26: 320-341
• 44 Skelton DA, Kennedy J, Rutherford OM. Explosive power and asymmetry in leg muscle function in frequent fallers and non-fallers aged over 65. Age Ageing 2002; 31: 119-125
• 45 Smith K, Smith E. Integrating pilates-based core strengthening into older adult fitness programs. Top Geriatr Rehabil 2005; 21: 57-67
• 46 Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and non-fatal falls among older adults. Inj Prev 2006; 12: 290-295
• 47 Suri P, Kiely DK, Leveille SG, Frontera WR, Bean JF. Increased trunk extension endurance is associated with meaningful improvement in balance among older adults with mobility problems. Arch Phys Med Rehabil 2011; 92: 1038-1043
• 48 Thompson WR, Gordon NF, Pescatelle LS. ACSM’s Guidelines for Exercise Testing and Prescription. 8 ed. Philadelphia: Lippincott, Williams & Wilkins; 2010
• 49 Vécseyné Kovách M, Kopkáné Plachy J, Bognár J, Olvasztóné Balogh Z, Barthalos I. Effects of Pilates and aqua fitness training on older adults’ physical functioning and quality of life. Biomedical Human Kinetics 2013; 5: 22-27
• 50 Vickers AJ, Altman DG. Statistics notes: Analysing controlled trials with baseline and follow up measurements. BMJ 2001; 323: 1123-1124
• 51 Wells C, Kolt GS, Marshall P, Hill B, Bialocerkowski A. The effectiveness of Pilates exercise in people with chronic low back pain: a systematic review. PLoS One 2014; 9: e100402