Background: Pilates can be an interesting rehabilitation strategy for people with multiple sclerosis (MS), since is a low-cost and attractive physical exercise modality that has shown to have beneficial effects in other neurological pathologies. For prescribing Pilates to this population, health professionals should be aware of its potential benefits, a goal that can be achieved by making available updated scientific evidence in this regard. Therefore, the purpose of this study was to conduct a systematic review and a meta-analysis aimed at identifying the characteristics and methodological quality of the investigations that have studied the effects of Pilates in people affected with MS.
Methods: Four electronic databases (MEDLINE/PubMed, PEDro, SPORTDiscuss and Scopus) were systematically searched up to April 2018 for intervention studies focused on the effects of Pilates on people with MS. A meta-analysis was conducted according to previous consensus regarding core outcome measures for this type of research. The methodological quality of the studies finally included was performed by means of the Physiotherapy Evidence Database and the Quality Assessment Tool for Before-After Studies with No Control Group.
Results: Fourteen studies, 10 randomized controlled trials and 4 quasi-experimental, were finally selected. The methodological quality of the randomized controlled trials was considered poor in five studies and good in three investigations. The four quasi-experimental studies showed a methodological quality ranging from "poor" to "fair. Ten of the eleven investigations that analyzed the effects of Pilates on the patients' physical function reported significant effects on different variables related to this outcome. Four out of the six studies that informed about the effects of Pilates on fatigue reported significant benefits. Two of the three studies that analyzed the impact of performing Pilates on the patients' quality of life reported significant benefits for this outcome. Pilates also resulted on significant changes on balance confidence and walking ability. Depression was not influenced by this therapy. The meta-analysis performed showed that Pilates was not more effective than other therapies for improving functional mobility, cardiorespiratory fitness, fatigue and quality of life.
Conclusions: Pilates is a feasible therapy for people with MS that can lead to improvements on their physical function, and it might be helpful for reducing self-perceived fatigue. The potential beneficial effects of Pilates are not significantly greater than those derived from the performance of other physical therapies. Further high-quality RCTs are needed to consolidate the existing scientific evidence regarding the impact of Pilates on this population.
Keywords: Fatigue; Multiple sclerosis; Physical function; Pilates; Quality of life; Rehabilitation.
Copyright © 2019. Published by Elsevier B.V.