AUTHOR OF THE YEAR
EVIDENCE-BASED PRACTICE :
PILATES AND YOGA
The continued growth in popularity of both Pilates and yoga prompts the question , how effective are these mind body disciplines ?
WORDS : DR MARK MCKEAN PhD
N either yoga nor Pilates are new
practices , but their presence within the fitness industry has never been greater . While club timetables vie with ever proliferating dedicated studios for their share of the mind body market , the question arises of just who should be practicing these disciplines – and for what outcomes ?
First under the microscope is Pilates .
Pilates
A systematic review by Wells et al . ( 2012 ) suggests the literature defined Pilates as a ‘ mind body exercise that focuses on strength , core stability , flexibility , muscle control , posture and breathing .’ Pilates emphasises control of both body position and movement and was originally called ‘ Controlology ’. The authors of this review identified several repeated principles that are commonly found in Pilates , namely ‘ centring ’, concentration , control , precision , flow , and breathing .
Due to the broad range of peer reviewed publications on Pilates , I am fortunate to be able to draw on both systematic and literature reviews to discuss the use of this discipline .
Effects on healthy people
In 2011 , Cruz-Ferreira et al published a systematic review in this area , but when determining value of the studies confirmed there was a low scientific rigour on all papers . These studies ranged in length of intervention and frequency of sessions per week , and involved both mat and reformer methods . However , none of the studies assessed for their review involved any follow up after the period of intervention , so the long term effectiveness of any of these changes is , as yet , unknown . In this review , Pilates was shown to improve flexibility ( strong evidence for its effectiveness ), dynamic balance ( strong evidence ) and muscular endurance ( moderate evidence ) in healthy people . There was limited or no evidence to support its effectiveness in changing or improving tranversus abdominis thickness , blood pressure , abdominal strength , postural alignment , body composition or vertical jump . In most cases the quality of the research was the limiting factor , and until better research methods are applied , it will be difficult to conclude the true value of Pilates in these areas . Finally , a systematic review by Aladro-Gonzalvo ( 2012 ) reported there was poor evidence indicating a positive effect of Pilates on body composition .
Effects on back pain
A systematic review and meta-analysis conducted in 2011 by Choon Wyn Lim and colleagues resulted in only seven quality research papers in this area . Their analysis reported that Pilates-based exercise was better for pain relief than minimal interventions , but did not support the superiority of Pilates over any other form of exercise in reducing non-specific low back pain . However , the authors again acknowledge the low quality of studies available . Another 2011 systematic review ( Pereira et al . 2011 ) provided similar outcomes and concluded that there is poor evidence to show that Pilates improves pain or functionality of people with low back pain . In fact , movement-based interventions have been shown to be infrequently effective for changing observable movement patterns . Further , a relationship between changes in movement patterns and improvement in pain or activity limitation was also infrequently observed ( Laird et al . 2012 ).
A 2013 meta-analysis by Aladro-Gonzalvo et al . confirmed similar outcomes , with no evidence to show Pilates was more effective than any other therapeutic treatment , and moderately superior to no treatment at all in improving disability and providing pain relief . The authors caution readers on the use of Pilates in this area and suggest the optimal implementation of Pilates in cases with nonspecific low back pain is unclear .
Effects on older adults
A more recent review into the effectiveness of Pilates in older adults by Bergamin et al . ( 2015 ) provides several clear and positive outcomes . There was good evidence to show the effectiveness of Pilates on improving strength and maintaining this over long periods , improving dynamic balance , improving flexibility and range of motion as well as improving walking and gait . The authors conclude that Pilates may
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