Table 3.

Pilates exercise intervention, outcomes measures, participants analyzed and recommendations.

References	Pilates intervention	Outcome measures of interested	Participants (n) analyzed intention to treat (IT)	Recommendations
Aibar-Almazán et al. (10) Spain	12 weeks / 2 sessions per week / 60 min The last sessions involved equipment such as resistance bands, rings, and balls.	International Falls Efficacy Scale- FES-16 Force platform Number of participants falls in the past year, n (%) Pilates, 25 (45.45%) Control, 17 (32.69%)	IT- yes PG = 55 CG = 52	Future studies should consider the mid- and long-term effects, on both men and women, of the intervention here described.
Barker et al. (33) Australia	24 weeks / 2 sessions per week / 60-min Pilates class practice guidelines for exercise to prevent falls (educational letter). Home exercises (20 min) >50 h over total study period Standing exercises. Equipment: reformer, trapeze, Wunda chair, chi ball, elastic band and foam roller.	Functional reach test- FRT Timed Up and Go- TUG Dynamic gait index -DGI Number of participants falls in the past year, n (%) Pilates, 6 (30%) Control, 9 (38%) Number of Falls Pilates, n = 13 Control, n = 11	IT- yes PG = 20 CG = 29, and CG = 24 (fall)	Pilates exercise is an enjoyable and acceptable form of exercise in community-dwelling older people at risk of falling. An appropriately designed Pilates exercise program appears to improve standing balance and reduce the risk of falls. Based on the fall injury rates estimated here, we can estimate (with 80% power) that a future definitive study would require 402 participants per arm to detect a 30% difference in fall injury rates. These estimations are based on a negative binomial distribution and a 6-month follow-up period. A large RCT that includes around 804 people is warranted to confirm effects.
Bird et al. (31) Australia	5 weeks / 2 sessions per week / 60 min After a 6-week washout period, participants perform the alternate intervention. Classes consisted of standing exercises / Pilates reformer and mat-based exercises. Home-based with a diary	Force platform The Timed Up and Go –TUG	IT- yes PG = 27 CG = 27	Although there were no between-condition differences between the Pilates and control conditions, significant improvements were observed in the pooled static and dynamic balance data from the 2 Pilates conditions. The reported improvements in mediolateral sway range and dynamic balance may have positive functional implications for physical fall risk factors in an older population.
Oliveira et al. (8) Brazil	12 weeks / 2 sessions per week /60 min Equipment: combo chair, Cadillac trapeze table, universal Reformer and ladder barrel. All exercises were performed with one set of 10 repetitions. The Borg CR10 scale 21 was used to determine the level of effort and load progression.	The Timed Up and Go-TUG -	IT – yes PG = 16 CG = 16	Further studies are needed to determine the effects of Pilates for older adults. Based on the present findings, Pilates performed with equipment elicits improvements in lower limb muscle strength, static and dynamic postural balance, functional mobility and quality of life of older adults when performed in two weekly sessions for 12 weeks.
Donath et al. (30) Switzerland	8 weeks/ 2 sessions per week/ 60 min Mat Pilates 6–12 repetitions were performed during each exercise.	Force Platform	No- IT PG = 17 BAL = 16 CG = 15	Pilates training did not cause relevant adaptations. Future studies may also observe specific adaptations in neuromuscular, cognitive function and psychosocial health parameters could be assessed upon Pilates training, e.g., in frailer and residential seniors. In these cases, randomized controlled three armed study designs are recommended. Accordingly, any control condition should then consider appropriate group allocation and social gatherings, in order to avoid socially confounding situations.
Gabizon et al. (34) Israel	12 weeks / 3 times a week / 60 min Classical Pilates method with Thera-Band elastic resistance bands and Swiss balls	Force Platform Number of participants falls in the past year, n (%) Intervention 3 (6.8) Control 0 (0.0)	No-IT PG = 44 CG = 44	Further research should be conducted to assess the potential effect of Pilates training on a population of weaker older adults who have a history of falls.
Josephs et al. (35) USA	12 weeks/ 2 times week / 60 min Pilates with Reformer, Cadillac and Chair apparatus. Each exercise 10 repetitions. The traditional group: elastic resistance bands, ankle weights, foam balance pads, boxes of varying heights and half foam rollers were props performed 20 repetitions. Home exercises 15–20 min. Monthly calendar to record their home exercise participation.	The Timed Up and Go-TUG Number of participants falls in the past year: Pilates, n = 10 Traditional, n = 8 Number of falls Mean (SD) Pilates= 1.5 (1.3) ranged 0–4 Traditional = 1.8 (2.2) ranged 0–7	No- IT PG = 13 CG = 11	Future research ideas include having three groups, Pilates, traditional and a control group and following the results longer term. This study indicates that balance and balance confidence can be improved in <50 h in patients with fall risk. A future research study should investigate this further in adults with fall risk.
Mesquita et al. (38) Brazil	4 weeks / 3 times a week/ 50 min Mat Pilates, with Swiss ball, TheraBand, and magic circle.	Force platform The Timed Up and Go-TUG Functional reach test -FRT	No-IT PG = 20 CG = 18 PNFG = 20	Recommend that further studies include larger samples of elderly women and greater numbers of sessions. This will help to elucidate the optimal alternatives that can be applied to increase balance, allowing PNF and Pilates exercises to be used not only for rehabilitation, but also as a preventive method.
Roller et al. (37) California	10 weeks / Once a week / 45-min Pilates with Reformer 10 repetitions each, using progressive resistance of 2–4 springs Falls diary	The Timed Up and Go- TUG 10 Min walk test-10 MWT Number of participants falls in the past year Mean (SD) Pilates = 2.00 (2.30) Control = 3.21 (5.57)	IT- yes PG = 27 CG = 28	Future studies examining the effect of Pilates Reformer exercises on balance, gait, and fall risk in older adults may also want to consider performing exercises that work specifically on balance in upright postures such as standing on a moving carriage
Surbala et al. (32) India	6 weeks / 2 times per week/ 45 min Mat Pilates, ball exercise and in standing position. All exercises were done for 10 repetitions with a rest period of 2 min before commencing the next exercise.	Functional reach test -FRT The Timed Up and Go-TUG Dynamic Gait Index-DGI	IT- yes PG = 17 CBT = 17 CG = 17	Future research with cross over designs may also be conducted to determine the participants' preference of exercise program between PI and CBT. Further controlled comparative studies with larger sample size are recommended in community dwelling old elderly (over 75 years) individuals and those with pathological conditions (e.g., Stroke, Parkinsonism, etc.) who are at higher risk of falls and falls related injuries
Vieira et al. (36) Brazil	12 weeks / 2 times per week / 60 min Mat Pilates using accessories such as exercise rubber, bands, swiss and exercise balls.	Timed Up and Go-TUG 6-min walk test-6 MWT	No – IT PG = 21 CG = 19	Pilates-inspired exercises improved dynamic balance, lower-extremity strength, and cardiovascular fitness in community-dwelling older women. Therefore, it might be a potentially effective exercise regimen to maintain physical fitness and, possibly, to prevent disability and falls in old age. Yet, further investigation is needed to evaluate the effectiveness of the Pilates method on functional and physical fitness of older adults with characteristics that differ from those of our sample.
Badiei et al. (11) Iran	8 weeks / 3 times per week / 60 min Mat Pilates by Pérez et al. (40)	Falls Efficacy Scale- FES-16 ITEM Number of participants falls in the past year Mean (SD) Pilates = 1.54 (1.79) Control = 2 (2.4), p = 0.4 Pilates, n (%) YES 15 (68.2) NO 5 (22.7) Control, n (%) YES 17 (77.3) NO 7 (31.8), p = 0.5	IT- yes PG = 22 CG = 22	The findings of the present study can help in creating a new attitude toward the possible roles of exercising in decreasing the risk of falling and other related factors in the elderly population, especially elderly women. In addition, health care providers can use this study to formulate similar interventional strategies that can improve the quality of life of the elderly.

n, Number; %, percentage; IT, Intention to treat; SD, Standard Deviation; TUG, Timed Up and Go; 6 MWT, 6-minute walk test; FRT, Functional Reach Test; DGI, Dynamic Gait Index; 10 MWT, 10 Minute walk test; FES-I, International Falls Efficacy Scale; RCT, Randomized controlled trial; PG, Pilates group; CG, control group; CBT, Conventional Balance Training; PI, principal investigator; TUG, Time Up and Go; PNF, Proprioceptive neuromuscular facilitation.