The effects of supervised versus home Pilates-based core stability training on lower extremity muscle strength and postural sway in people with multiple sclerosis

Abstract

Background: Pilates-based core stability training (PBCST) is a controlled form of exercise that may improve the transmission of torque from the upper extremities and trunk to the lower extremities by enabling the core muscles to activate effectively. Objectives: The aim of this study was to investigate the effects of PBCST given as supervised or home-based on lower extremity strength and postural control in multiple sclerosis. Methods: Fifty individuals were enrolled and randomly allocated into two groups. Primary outcome measures were knee muscle strength and postural sway in different conditions. The supervised group received PBCST 2 days per week for 8 weeks at the clinic, and the other group performed PBCST at home. Exercises were progressed every 2 weeks in both groups. Results: Between groups, the supervised group was mostly superior to the home group ( p < 0.05). A significant improvement was noted in all parameters in both groups, except some sub-parameters of postural sway in home PBCST ( p < 0.05). Conclusions: Supervised PBCST was determined to be more effective than home PBCST in improving strength, postural control, core stability, physical capacity, and fatigue. Although supervised training is the primary choice, home training can be recommended to patients who have limitations attending supervised sessions.

Therapeutic Effects of the Pilates Method in Patients with Multiple Sclerosis: A Systematic Review

“…Another 93 potential articles were removed after the title and abstract review. Forty-five full texts were reviewed, and twenty articles [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] were used in the analysis based on inclusion and exclusion criteria. Figure 1 shows the PRISMA selection process flow chart [24].…”

“…Balance was studied in 14 papers [28,30,34,[36][37][38][40][41][42][43][44][45][46][47]. In each of these, one of the following scales or assessment methods was used: Timed Up and Go Test [28,30,34,38,[40][41][42][44][45][46], Berg Balance Scale [29,36,40,42,[44][45][46], Activities-Specific Balance Confidence Scale [34,41,43,46], Functional Reach Test [30,40], Balance Platform [28,37], Falls Efficacy Scale International [34], Fullerton Advanced Balance Scale [38], Four Square Step Test [40], Single-leg Stance [41], Trunk Impairment Scale [44], and Six-and-Spot Step Test [47]. In all 14, Pilates yielded significant improvements post-intervention.…”

“…This variable was assessed in 11 studies [28,31,32,34,[36][37][38]40,[42][43][44] using: 6 Minute Walk Test [32,34,[36][37][38]40], 12-Item Multiple Sclerosis Walking Scale [31,34,40,43], 10 Meter Walk Test [31,36,43], Timed 25-Foot Walk [34,42,44], 2 Minute Walk Test (2MWT) [28,31,40], the walking section of the Patients' Global Impression of Change Scale [31], and Rivermead Visual Gait Assessment [31]. Ten studies found significant improvements in gait postintervention [28,31,32,34,[36][37][38]40,43,44].…”

“…This variable was assessed in 11 studies [28,31,32,34,[36][37][38]40,[42][43][44] using: 6 Minute Walk Test [32,34,[36][37][38]40], 12-Item Multiple Sclerosis Walking Scale [31,34,40,43], 10 Meter Walk Test [31,36,43], Timed 25-Foot Walk [34,42,44], 2 Minute Walk Test (2MWT) [28,31,40], the walking section of the Patients' Global Impression of Change Scale [31], and Rivermead Visual Gait Assessment [31]. Ten studies found significant improvements in gait postintervention [28,31,32,34,[36][37][38]40,43,44]. Of note are the studies by Arntzen et al [31] (8 on PEDro scale), where there were significant differences in favour of Pilates with respect to standard physiotherapy care; and by Ozkul et al [32] (8 on PEDro scale), where Pilates presented significant improvements in gait quality when compared with relaxation exercises carried out at home.…”

“…Significant improvement compared with physician care [30] or with 1-h massage [38] • No significant differences between Pilates and rebound therapy [45] or aquatic therapy [47] Gait • Significant improvement [28,31,32,34,[36][37][38]40,43,44] • Significant improvement compared with standard physiotherapy care [31] or with home relaxation exercises [32] • No significant improvement [42] • Significant improvement in standardized exercises group compared to Pilates group [43] Physical-functional conditions • No significant improvement in post-intervention Pilates group, but there was in aerobic exercise group [42] (no difference between groups)…”