Effects of Pilates exercises on cardiorespiratory fitness: A systematic review and meta-analysis

Complement Ther Clin Pract. 2023 Aug:52:101772. doi: 10.1016/j.ctcp.2023.101772. Epub 2023 May 23.


Background and purpose: Randomized controlled trials (RCTs) suggest that Pilates improves cardiorespiratory fitness (CRF). However, there is a lack of systematic review studies on this topic. Our aim was to verify the effects of Pilates exercises on CRF in healthy adults.

Methods: A systematic literature search was performed in: PubMed, Embase, CENTRAL, CINAHL, Web of Science, SPORTDiscus, LILACS, and PEDro (search on January 12, 2023). Methodological quality was assessed using the PEDro scale. A meta-analysis was performed using the standardized mean difference (SMD). The quality of evidence was rated by the GRADE system.

Results: In total, 12 RCTs were eligible (569 participants). Only three studies presented high methodological quality. Very low to low quality evidence showed that: a) Pilates was superior to control groups (SMD = 0.96 [CI95% 0.39 to 1.54] n = 457, studies = 12), even when only high methodological quality studies were included (SMD = 1.14 [CI95% 0.25 to 2.04] n = 129, studies = 3); b) to be effective, Pilates needed to be performed for ≥1440 min; c) the effects were significant regardless of the form of Pilates application (mat or equipment); d) Pilates was not different from other exercises regarding the effects on CRF.

Conclusion: Pilates had a large effect on CRF, provided that it was administered for at least 1440 min (equivalent to 2x-week for three months or 3x-week for two months). However, due to the low quality of the evidence, these results should be interpreted with caution.

Keywords: Exercise; Human; Physical conditioning; Physical fitness; Physical functional performance; Resistance training.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Adult
  • Cardiorespiratory Fitness*
  • Exercise
  • Exercise Movement Techniques* / methods
  • Exercise Therapy / methods
  • Humans