Research Corner (June 2025)

Summary of Pilates Research to June 2025

Halfway through the year, and it seemed a good time to summarise the research that has been published so far in 2025. Much of the research has reinforced the benefits of Pilates for various health conditions, highlighting its role in enhancing physical and mental well-being.

 

  1. Effects Relating to Pregnancy 

    A systematic review and meta-analysis included 11 studies (538 participants), with three studies rated as low risk of bias. The meta-analysis found that Pilates during pregnancy led to significant improvements in APGAR scores at 1 minute (SMD = 0.41), a reduction in labour duration (SMD = –0.56), and decreased labour pain (VAS score, SMD = –0.76), with all results stable on sensitivity analysis. The quality of the review was high, using the Cochrane RoB Tool and robust statistical methods. The interventions were typically supervised by qualified professionals, though specific instructor credentials were not always detailed. The review concluded that Pilates is a safe and effective intervention for improving immediate birth outcomes and reducing pain in pregnant women but called for more research to further clarify instructor qualifications and optimize protocols.1 

  2. Comprehensive Benefits for Women’s Health 

    This umbrella review and meta-analysis summarised the effects of Pilates on women’s health, finding small to moderate improvements across several outcomes. Pilates was associated with a moderate reduction in pain (standardized mean difference [SMD] ≈ –0.76), a small to moderate improvement in quality of life (SMDs ranging from 0.41 to 0.85 for various domains) and included the moderate reduction in labour duration for pregnant women as described in the previous item.1The review also reported significant improvements in flexibility, strength, and psychological well-being, though effect sizes varied by outcome and population. The overall risk of bias was judged as low to moderate using established tools. Most included studies were randomized controlled trials, but many had small sample sizes or short intervention periods, limiting the certainty of the evidence.

    The review concluded that Pilates is a safe and effective intervention for improving women’s health outcomes, but emphasised the need for more large, high-quality trials to confirm these benefits and address methodological limitations.2

     

  3. Alleviation of Fatigue in Chronic Conditions 

    This systematic review and meta-analysis included randomised controlled trials and quasi-experimental studies, finding that Pilates led to a small to moderate reduction in fatigue, with pooled effect sizes typically ranging from –0.35 to –0.60 (standardized mean difference), depending on the specific chronic condition and study subgroup. The quality of evidence was rated as moderate, as most studies were RCTs but often had small sample sizes and short intervention periods. Overall, the risk of bias was judged as low to moderate, with most studies adequately addressing randomisation and outcome assessment. In their analysis, they did not seem to take account of the fact that blinding is virtually impossible in an exercise intervention.The review concluded that Pilates is a promising intervention for managing fatigue in people with chronic conditions, but emphasized the need for larger, high-quality trials to confirm these findings and further clarify the true effect size and long-term benefits.3

     

  4. Pain Reduction and Enhanced Quality of Life 

    This systematic review evaluated the effects of Pilates on pain, disability, and quality of life in people with musculoskeletal conditions affecting the extremities. The review found that Pilates led to moderate reductions in pain and disability, with standardized mean differences (SMDs) typically ranging from –0.40 to –0.70, and moderate improvements in quality of life, though effect sizes varied by condition and outcome. The quality of evidence was rated as moderate, as most included studies were randomized controlled trials, but many had small sample sizes, short intervention durations, and, as is common in exercise research, could not blind participants or instructors, introducing some risk of performance and detection bias. The risk of bias was generally low to moderate.The review concluded that Pilates is a safe and effective intervention for reducing pain and disability and improving quality of life in people with musculoskeletal conditions in the extremities, but emphasized the need for larger, high-quality trials to confirm these findings and further clarify the true effect sizes and long-term benefits. Overall, Pilates appears to be a promising adjunct to standard care for this population, but the evidence base would benefit from more rigorous research designs.4

  5. Fall Prevention in Older Adults 

    Pilates gets a major plug on a Wikipedia page entitled “Falls Prevention” being identified as an effective exercise modality for improving balance and mobility in older adults, thereby reducing the risk of falls. Its emphasised that its low-impact nature and emphasis on controlled movements make it suitable for the elderly. 5, 6 

  6. Hypertensive Patients 

    This meta-analysis examined the effects of Pilates on blood pressure in hypertensive patients. It found that Pilates significantly reduced both systolic and diastolic blood pressure, suggesting it could be a useful non-pharmacological adjunct for hypertension management. However, the study had a small sample size (227 participants across 7 studies), high heterogeneity (I2 > 90%), and short intervention durations, indicating that while the results are promising, the evidence is not yet robust and larger, longer-term trials are needed to confirm these findings and assess safety over time.This study is of moderate quality: it follows systematic review protocols but is limited by the available data and study designs included. 7

     

  7. Practical Applications in Clinical Settings 

    The newly released book two volume Pilates Applications for Health Conditions by Madeline Black and Elizabeth Larkam8 offers practical guidance for integrating Pilates into treatment plans for various health issues. Volume 1 covers multi-system conditions, while Volume 2 focuses on locomotor system conditions.The books compile case studies and expert insights, serving as a valuable resource for healthcare practitioners. It explores how Pilates can be adapted and applied as a therapeutic exercise for a variety of health conditions, particularly in rehabilitation and chronic disease management.

    Included are detailed case reports from expert Pilates practitioners, illustrating how specific movement sequences can be tailored to address various health conditions. They emphasize the importance of tailored movement practices for each health condition to ensure safety and efficacy. The books are designed to be a practical resource for Pilates teachers, continuing education providers, and teachers-in-training.

    The series also addresses the history of research in Pilates practice and discusses the challenges of conducting such research.

 

Conclusion

The latest research underscores the benefits of Pilates; however, the research also shows that it requires individualised approaches and raises concerns about instructor qualifications and the limitations of large group classes.

The PAA recognises quality education, smaller group classes and individualised approaches, ensuring that the versatility of Pilates as a therapeutic exercise, beneficial across different age groups and health conditions, is poised to play an increasingly significant role in holistic health and rehabilitation strategies.

 

Robyn Rix, PAA President

 

References

  1. Li, Y., Lu, H., Zhang, L., Ren, Y., Dai, X., & Lin, L. (2025). Pilates exercise in pregnancy: a systematic review and meta-analysis. BMC Sports Science, Medicine and Rehabilitation, 17. https://doi.org/10.1186/s13102-025-01067-9
  2. Hyun Seo Ko MS, Soyoung Choi PhD RN. Effects of Pilates Exercise on Women’s Health Outcomes: An Umbrella Review with Meta-Analysis. Journal of Physical Activity Research. Vol. 10, No. 1, 2025, pp 7-17. https://pubs.sciepub.com/jpar/10/1/2
  3. Abonie, U. S., Ackah, M., & Kelly, M. (2025). Effectiveness of Pilates on fatigue in persons with chronic conditions: a systematic review and meta-analysis. Disability and Rehabilitation, 1-10. Advance online publication. https://doi.org/10.1080/09638288.2025.2512406
  4. Talia Barnet-Hepples, Anita Barros Amorim, Clebeson de Azeyêdo Nogueira, Maria Clara Silva de Melo, Amabile Borges Dario, Penelope Latey, Sâmara Raquel Alves Gomes, Liane de Brito Macedo, Pilates lessens pain and disability and improves quality of life in people with musculoskeletal conditions in the extremities: A systematic review, Annals of Physical and Rehabilitation Medicine,

Volume 68, Issue 6, 2025, 101973, ISSN 1877-0657, https://doi.org/10.1016/j.rehab.2025.101973.

https://www.sciencedirect.com/science/article/pii/S1877065725000387

  1. Patti, Antonino; Zangla, Daniele; Sahin, Fatma Nese; Cataldi, Stefania; Lavanco, Gioacchino; Palma, Antonio; Fischietti, Francesco (2021-04-02). “Physical exercise and prevention of falls. Effects of a Pilates training method compared with a general physical activity program: A randomized controlled trial”. Medicine. 100 (13): e25289. doi:10.1097/MD.0000000000025289. hdl:10447/527083. PMC 8021317. PMID 33787615.
  2. Długosz-Boś, Małgorzata; Filar-Mierzwa, Katarzyna; Stawarz, Robert; Ścisłowska-Czarnecka, Anna; Jankowicz-Szymańska, Agnieszka; Bac, Aneta (January 2021). “Effect of Three Months Pilates Training on Balance and Fall Risk in Older Women”. International Journal of Environmental Research and Public Health. 18 (7): 3663. doi:3390/ijerph18073663ISSN 1660-4601PMC 8037700PMID 33915843.
  1. Milla, C., Tazkira, B., Firdaus, S., Welliam, Y., & Susilo, H. (2024). 25. Simple Steps, Substantial Results: A Meta-Analysis of Pilates at Reducing Blood Pressure in Hypertensive Patients. Journal of Hypertension. https://doi.org/10.1097/01.hjh.0001026880.50796.e1
  2. Black, M., & Larkam, E. (Eds.). (2024). Pilates Applications for Health Conditions: Case Reports and Perspectives. Handspring Publishing.

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