The Effects of the Pilates Training Method on Balance and Falls of Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Exercising with the Pilates method may be a beneficial treatment to improve balance and decrease the number of falls. To ascertain this, our search in 7 databases included 15 randomized controlled trials in which Pilates was the primary intervention. Participants were over 60 years of age; the outcomes were related to balance and falls. The Cochrane tool and PEDro scale were used to assess risk of bias and quality of individual studies. Current evidence supported the view that exercising with the Pilates method improves the balance of older adults with a high practical effect in terms of the dynamic (SMD = 0.75 [0.17;1.32]), static (SMD = 1.33 [0.53;2.13]), and overall balance (SMD = 0.96[0.00;1.91]). Pilates also produced greater improvements with a moderate effect in terms of the dynamic (SMD = 0.37[-0.36;1.11]) and overall balance (SMD = 0.58[0.19;0.96]) compared to other training approaches oriented to the same end. Literature evaluating the effects on falls is scarce, and results were not conclusive.

Balance Training With a Dynamometric Platform Following Total Knee Replacement: A Randomized Controlled Trial.

BACKGROUND AND PURPOSE: Sensorimotor training has proven to be an efficient approach for recovering balance control following total knee replacement (TKR). The purpose of this trial was to evaluate the influence of specific balance-targeted training using a dynamometric platform on the overall state of balance in older adults undergoing TKR. METHODS: This was a randomized controlled clinical trial conducted at a university hospital rehabilitation unit. Patients meeting the inclusion criteria were randomly assigned to a control group or an experimental group. Both groups participated in the same 4-week postoperative rehabilitation training protocol. Participants in the experimental group performed additional balance training with a dynamometric platform consisting of tests related to stability challenges, weight-shifting, and moving to the limits of stability. The primary outcome measure was the overall state of balance rated according to the Berg Balance Scale. Secondary outcomes in terms of balance were the Timed Up and Go Test, Functional Reach Test, and Romberg open and closed-eyes tests. Data processing included between-group analysis of covariance, minimal detectable change assessment for the primary outcome measure, and effect size estimation. Confidence intervals (CIs) were set at 95%. RESULTS: Forty-three participants meeting the inclusion criteria and having signed the informed consent were randomly assigned to 2 groups. Thirty-seven completed the training (86.1%). Significant between-group differences in balance performance were found as measured with the Berg Balance Scale (P = .03) and Functional Reach Test (P = .04) with a CI = 95%. Significant differences were not recorded for the Timed Up and Go Test or Romberg open and closed-eyes tests (P > .05). Furthermore, Cohen's effect size resulted in a value of d = 0.97, suggesting a high practical significance of the trial. DISCUSSION AND CONCLUSIONS: According to the Berg Balance Scale and Functional Reach Test, participants with TKR who have followed a 4-week training program using a dynamometric platform improved balance performance to a higher extent than a control group training without such a device. The inclusion of this instrument in the functional training protocol may be beneficial for recovering balance following TKR.