Abstract
The Pilates Method is a rehabilitation tool with verified benefits in pain management, physical function, and quality of life in many different physiotherapy areas. It could be beneficial for patients with multiple sclerosis (pwMS). The aim of the study was to summarize current evidence for the effectiveness of Pilates in pwMS. A comprehensive search of Cinahl, Scopus, Web of Science, PEDro, and PubMed (including PubMed Central and Medline) was conducted to examine randomized controlled trials (RCT) that included Pilates intervention in multiple sclerosis. The PEDro scale and the Cochrane risk-of-bias tool, RoB-2, were used to evaluate risk of bias for RCT. Twenty RCT (999 patients) were included. Ten were of good quality (PEDro), and seven had low risk of bias (RoB-2). Pilates improves balance, gait, physical-functional conditions (muscular strength, core stability, aerobic capacity, and body composition), and cognitive functions. Fatigue, quality of life, and psychological function did not show clear improvement. There was good adherence to Pilates intervention (average adherence ≥ 80%). Cumulative data suggest that Pilates can be a rehabilitation tool for pwMS. High adherence and few adverse effects were reported. Future research is needed to develop clinical protocols that could maximize therapeutic effects of Pilates for pwMS.
Highlights
Multiple sclerosis (MS) is a chronic autoimmune and inflammatory neurological disease that affects the myelinated axons in the central nervous system, characterized by neurological deterioration over time [1]
MS cases are twice as high in women as in men [1], and it is more prevalent in North America, Western Europe, and Australasia [4]
MS shows several patterns: 80% of all cases are “relapsing-remitting” MS (RRMS), characterized by exacerbations and remissions, which can turn into “secondary-progressive” MS (SPMS), with progressive disability between attacks; 15% are cases of “primaryprogressive” MS (PPMS), where there is a progressive disability from the beginning; and 5% are “progressive-relapsing” MS (PRMS), where the disease worsens gradually, and presents outbreaks [5]
Summary
Multiple sclerosis (MS) is a chronic autoimmune and inflammatory neurological disease that affects the myelinated axons in the central nervous system, characterized by neurological deterioration over time [1]. MS is the most common non-traumatic disabling disease in young adults [2]. It usually starts in early adult life, typically in the third decade [3], with most patients presenting with periodic neurological relapses [4], but the disease course is unpredictable [5]. MS is one of the most common diseases of the central nervous system (2.2 million people worldwide in 2016 data) [4]. Lublin et al [6] recommended reviewing these descriptions of the clinical course or phenotype of MS in 2014, suggested defining phenotypes based on disease activity (based on clinical relapse rate and imaging findings) and disease progression, and recommended removing the PRMS phenotype
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