Effects of Mat and Reformer Pilates in Multiple Sclerosis

NCT06931522 | Completed

• 1 other identifier: 2023 - 960
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

Our study aims to investigate the effects of core stability-based Mat Pilates and Equipment-Based Pilates training on anticipatory postural adjustments (APA), balance, and gait in individuals with Multiple Sclerosis (MS). Participants diagnosed with MS will be randomly assigned to Mat Pilates, Equipment-Based Pilates, or a control group. Both Pilates programs will be conducted twice a week for eight weeks. Assessments will be conducted before and after the training period. Anticipatory postural adjustments (APA) will be evaluated using electromyography (EMG) electrodes placed on the Erector Spinae and Tibialis Anterior muscles while participants take a step. Biomechanical responses related to APAs, specifically center of pressure displacement, will be measured using a force platform (Biodex® BioSway). Core endurance will be assessed using the lateral bridge test, Modified Biering-Sorensen test, trunk flexion test, and prone bridge test, while core strength will be evaluated through sit-ups and push-ups. Balance will be measured using posturography. The Activities-Specific Balance Confidence (ABC) Scale will assess confidence in performing daily activities requiring balance. Functional mobility will be evaluated using the Timed Up and Go (TUG) test. Spatiotemporal gait parameters and variability will be analyzed with the BTS® G-WALK system. The Multiple Sclerosis Quality of Life Questionnaire (MSQOL-54) will assess quality of life. This study is unique in that, unlike previous Pilates studies, it will be the first to examine the effects of different Pilates methods on APAs, which are crucial for both locomotor activities and postural stability in individuals with MS. Additionally, it will be the first study to evaluate two commonly used Pilates techniques in terms of their impact on balance and gait.

Conditions

Multiple Sclerosis

Keywords

Multiple Sclerosis; balance; Pilates; gait

Outcome Measures

Primary Outcomes (3)

• Anticipatory postural adjustments (APA)

  Data will be collected using an EMG-IMU system (Trigno Avanti, Delsys), with an accelerometer detecting perturbation onset and EMG recording tibialis anterior activity (1000 Hz, 16-bit; SENIAM placement). Participants will stand barefoot on a force platform (feet shoulder-width apart) while perturbations are applied via a 4-kg pendulum. They will receive impacts with both hands at shoulder level and maintain balance. Three trials will be performed. EMG signals will be rectified, low-pass filtered (100 Hz), and analyzed from -600 to +500 ms around perturbation onset (T0). APAs (-100 to +50 ms) will be baseline-corrected and normalized, with mean values used for analysis. CoP data will be recorded during 30-s trials with perturbation at 15 s. CoP ellipse area will be calculated, and the mean of three trials will be analyzed.

  8 weeks

• Postural stability

  Postural stability will be assessed using a force plate (K-Force, K-Invent), a validated and reliable tool for CoP analysis. Measurements will be taken under eyes-open and eyes-closed conditions, each lasting 30 seconds and repeated three times, with 10-second rests between trials and a 1-minute break between conditions. The primary outcome will be CoP ellipse area (mm²), representing postural sway. Mean values from the three trials for each condition will be used for analysis.

  8 weeks

• Gait Parameters

  Spatiotemporal gait parameters will be assessed using a wearable inertial sensor system (G-Walk, BTS Bioengineering, Italy). Participants will walk a 10-m distance at a self-selected comfortable speed in three trials. Acceleration data will be sampled at 100 Hz and transmitted via Bluetooth to G-Studio software for analysis. Measured parameters will include gait velocity, cadence, stride length, gait cycle duration, and double support time (% of gait cycle). The mean of the three trials will be used for statistical analysis.

  8 weeks

Secondary Outcomes (1)

• Mobility

  8 weeks

Study Arms (3)

Mat Pilates

EXPERIMENTAL

In Mat Pilates training, exercise balls and elastic bands will be used. The exercises will be done with 10 repetitions for the first 4 weeks, and with 20 repetitions for the last 4 weeks. The difficulty level of the exercises will be increased in the following weeks according to the patient's condition.

Other: Mat Pilates

Reformer Pilates

EXPERIMENTAL

In the Reformer Pilates group, the difficulty level of the exercises will be provided by different positions, and the springs' resistance will be increased.

Other: Reformer Pilates

Control group

NO INTERVENTION

The control group will perform the relaxing exercise at home.

Interventions

Mat Pilates OTHER

In Mat Pilates training, exercise balls and elastic bands will be used. The exercises will be done with 10 repetitions for the first 4 weeks, and with 20 repetitions for the last 4 weeks. The difficulty level of the exercises will be increased in the following weeks according to the patient's condition.

Mat Pilates

Reformer Pilates OTHER

In the Reformer Pilates group, the difficulty level of the exercises will be provided by different positions, and the springs' resistance will be increased.

Reformer Pilates

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Diagnosis of Multiple Sclerosis by a specialist physician
• Having a disability level between 0-4.5 according to the Expanded Disability Status Scale (EDSS)
• Being between the ages of 18-65
• Not having had an attack in the last 3 months
• Mini-Mental Test score \> 25

You may not qualify if:

• Having another neurological disorder
• Having orthopedic, cardiovascular, and pulmonary problems that may affect the research results
• Having vision, hearing, and perception problems
• Having a disease that may affect the immune system, such as infection, cancer

Sponsors & Collaborators

• Gazi University: lead

Study Sites (1)

Gazi University

Ankara, Turkey (Türkiye)

Location

Related Publications (4)

• Rodriguez-Fuentes G, Silveira-Pereira L, Ferradans-Rodriguez P, Campo-Prieto P. Therapeutic Effects of the Pilates Method in Patients with Multiple Sclerosis: A Systematic Review. J Clin Med. 2022 Jan 28;11(3):683. doi: 10.3390/jcm11030683.

  PMID: 35160134 RESULT

• Massot C, Simoneau-Buessinger E, Agnani O, Donze C, Leteneur S. Anticipatory postural adjustment during gait initiation in multiple sclerosis patients: A systematic review. Gait Posture. 2019 Sep;73:180-188. doi: 10.1016/j.gaitpost.2019.07.253. Epub 2019 Jul 19.

  PMID: 31344607 RESULT

• Sever J, Babic J, Kozinc Z, Sarabon N. Postural Responses to Sudden Horizontal Perturbations in Tai Chi Practitioners. Int J Environ Res Public Health. 2021 Mar 7;18(5):2692. doi: 10.3390/ijerph18052692.

  PMID: 33800052 RESULT

• Bulguroglu I, Guclu-Gunduz A, Yazici G, Ozkul C, Irkec C, Nazliel B, Batur-Caglayan HZ. The effects of Mat Pilates and Reformer Pilates in patients with Multiple Sclerosis: A randomized controlled study. NeuroRehabilitation. 2017;41(2):413-422. doi: 10.3233/NRE-162121.

  PMID: 28946576 RESULT

MeSH Terms

Conditions

Multiple Sclerosis

Condition Hierarchy (Ancestors)

Demyelinating Autoimmune Diseases, CNS; Autoimmune Diseases of the Nervous System; Nervous System Diseases; Demyelinating Diseases; Autoimmune Diseases; Immune System Diseases

Study Officials

• Cagla Ozkul, PhD

  Gazi University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD

Study Record Dates

• First Submitted: March 21, 2025
• First Posted: April 17, 2025
• Study Start: June 10, 2025
• Primary Completion: January 23, 2026
• Study Completion: February 10, 2026
• Last Updated: March 30, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)