Research: Pilates Exercises Improves Anticipatory Muscular Activation in Elderly Women: A RCT Study

Excerpts from the study

Najmeh Noghani, Rahman Sheikhhoseini  & Farideh Babakhani

Published online: 07 Sep 2022 :

Summary of abstract:

Aims: to investigate the effects of Pilates exercise on the anticipatory activation of selected lower limb muscles and balance in elderly women who had previous history of falling.

Methods: A randomized clinical trial study with 22 elderly women with 10 in the control and 12 in the experimental group. The experimental group performed the Pilates exercises for eight weeks (three sessions of one hour per week).

Results: Pilates exercises had a significant effect on the Berg balance scale, the timed up and go test, the onset time of the tibialis anterior, vastus lateralis, vastus medialis, and biceps femoris.

Conclusion: Pilates exercises can improve anticipatory activation of lower extremity muscles, balance and performance in elderly women with falling history. In older women, participating in Pilates exercises can shorten the onset time and lower the co-activation ratio. Pilates exercises are recommended for the training and rehabilitation of elderly people who have a history of falling.

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Selected quotes from the study

Existing evidence suggests that using Pilates …… improves flexibility and dynamic balance,1 and in general, Pilates has been suggested to improve independence, static balance, and quality of life in the elderly.2 Recently, another study found that Pilates may have a greater effect than a general physical activity on physical performance in elderly population.3

It has been demonstrated that anticipatory muscular adjustments for postural control differ significantly between the elderly and the young and between the elderly with and the elderly without a history of falls.4  Antagonist muscles are activated nearly simultaneously with agonist muscles in the elderly (co-contraction). This muscle co-activation can lead to a loss of balance.5,6 On the other hand, Pilates exercises have been shown to prevent involuntary body movements by using resources such as gravity and the resistance of springs, either to resist or assist movement execution.7

Classes in the first week

All of the traditional Pilates method recommendations were followed: centralization, concentration, control, precision, breathing, and flow.


Classes in the next ten weeks of intervention


This exercise program ….improved activity onset time (predictive anticipatory function of the tibialis anterior, vastus lateralis, vastus medialis, and biceps femoris).

According to the current study, exercise affects anticipatory postural adjustments, which may reflect changes in the central nervous system and improve muscle function by improving proprioception and neuromuscular coordination.8 Improved anticipatory movement in the central nervous system may have altered muscle activation patterns, motor control, and postural muscle latency.9,10

However, while co-contraction may be a compensatory strategy, high co-contraction levels in the elderly may increase energy expenditure, decrease efficiency during movement, increase mechanical work, increase metabolism, and increase motor units to control postural causes slow movement.11  Furthermore, chronic co-contraction may result in increased joint compression forces and the progression of osteoarthritis.12 Although co-contraction improves joint stability while standing, it impairs dynamic postural control.13 Previous research has found that ….the elderly have more co-contraction in the knee joint, ankle, and ankle stabilizer.

In healthy older persons, the six-week intervention was sufficient to improve gait patterns.


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