Effects of pilates exercises on strength, endurance and muscle power in older adults: Systematic review and meta-analysis

Introduction Pilates exercises have been used by the older adults and have shown potential to improve some components of physical fitness. Objective To verify the effects of Pilates on strength, endurance and muscle power in older adults. Methods The searches were performed in the databases: PubMed, EMBASE, CENTRAL, CINAHL, Web of Science, SPORTDiscus, LILACS and PEDro until September 2022, without filters that limited the date of publications or language. The studies included were: randomized clinical trials (RCTs); interventions that used Pilates; interventions with outcomes involving strength, endurance and/or muscle power; participants over 60 years old. Results 24 RCTs (1190 participants) were selected. There is low quality evidence that Pilates did not significantly improve muscle strength compared to the control group (Standardized Mean Difference (SMD) = 1.18 [95%CI -0.71, 3.08] I2 = 93%), and moderate quality compared to other exercises (SMD = 0.01 [CI95% −0.46, 0.48] I2 = 0%). Very low quality evidence shows that Pilates can improve muscular endurance of upper limbs compared to control group (Mean Difference (MD) = 4.87 [95%CI 2.38, 7.36] I2 = 88%) and lower limbs compared to other exercises (MD = 2.68 [CI95% 0.26, 5.10] I2 = 87%). It was not possible to perform muscle power analysis due to the reduced number of studies. Conclusion Currently, it is not feasible to recommend Pilates exercises as a means to improve strength, endurance and muscle power in the older adults. More RCTs covering this topic are needed given the low quality of evidence available at this time.