Background Falls are the leading cause of injury-related deaths in older adults. Physical exercise is a suitable strategy to reduce the risk of falls, but there is little research on the effectiveness of specific exercise modalities. Objectives To estimate the effectiveness of Pilates compared to habitual or non-exercise on physical performance and the risk of falls in older adults. Data sources Five databases were searched through April 15, 2021. Study selection Randomized controlled trial in people aged ≥60 years. Outcomes: balance, strength, flexibility, functionality, and risk of falls. Data synthesis Pooled standardized mean differences were calculated using a random-effects model. Subgroup analyses based on Pilates' modality, the existence of a detailed exercise protocol, supervision by a certified instructor, and overall risk of bias were performed. Results Thirty-nine studies were included in the systematic review and meta-analyses. The meta-analyses indicated a moderate effect of Pilates on balance (ES = 0.36; 95% CI = 0.21 to 0.50), strength (ES = 0.63; 95% CI = 0.44 to 0.81), flexibility (ES = 0.41; 95% CI = 0.16 to 0.67), and functionality (ES = 0.51; 95% CI = 0.32 to 0.72) as well as a large effect on the risk of falls (ES = 0.90; 95% CI = 0.41 to 1.38) in older adults when compared with control groups. The level of certainty of the findings was low for balance, flexibility, and functionality and moderate for strength and falls.
Conclusion and implications of key findingsPilates may promote the autonomy of older people in their daily living activities.
Contribution of the Paper• Pilates is an alternative exercise for reducing the risk of falls.• Pilates improves balance, strength, flexibility, and functionality in older people.• Pilates may increase the autonomy of older adults in their daily living activities.