Pilates practice and elderly women

Does it help reducing the fall risk factors?

Falls are one of the most common geriatric syndromes. They are often associated with comorbidities and can lead to various disabilities, increased morbidity and important economical and medical costs in terms of management.

Several studies identified modifiable and non-modifiable fall risk factors: balance confidence, fear of falling and postural control are particularly linked to balance troubles and falling. These factors can drastically limit physical and daily activities as well as function, further increasing the risk of falling through a vicious circle leading to higher dependence and mortality.

Evidence has shown that physical exercise interventions are beneficial for the prevention of falls as they can positively influence the modifiable risk factors. Several types of exercises have been studied, including the Pilates method which is a body-mind exercises technique based on six key principles: centreing, concentration, precision, control, breathing and flow.

This method has been proposed as a suitable and efficient way to prevent falls for older adults, but research in this area remains limited. Therefore, the present study assessed the effects of Pilates exercises on psychological fall risk factors (balance confidence and fear of falling) and postural control among women over 60.

The authors found that a Pilates training programme provides beneficial and positive effects on these three risk factors in elderly women.

The authors found that balance confidence, fear of falling and postural control significantly improved after the Pilates programme; no injuries nor adverse effects were found.

Pilates exercises could therefore be helpful in the prevention of fall but also in limiting the fall vicious circle

> From: Aibar-Almazán et al., Eur J Sport Sci 19 (2019) 1386-1394 . All rights reserved to European College of Sports Science. Click here for the online summary.

Expert opinion

The present study is particularly interesting in terms of clinical implications, as it provides evidence of the effects of Pilates exercises on three major fall risk factors among older women. These findings appear to be consistent with previous studies.

Therefore, this intervention should be considered and included in the exercise toolbox available to all clinicians as it could help limiting the risk of falls and reducing the physical, psychological and economical effects of falling.

The authors assessed two major psychological fall risk factors which are the balance confidence and the fear of falling. These are known to be key factors that must be taken into account when thinking about prevention of falls and the present study confirms this fact while adding strong evidence to the few and limited ones existing so far.

Another interesting point is that adherence to the Pilates programme was very good (none of the participants missed more than three consecutive sessions), which is of importance as adherence is essential in any exercise programme.

The quality of the study is very high (PEDro score: 8/10). The authors built a randomised, blinded and controlled trial with strict inclusion and exclusion criteria, including a representative sample with a high level of adherence. Moreover, many details about the programme and exercises performed in the study (fully detailed in a specific Appendix).

It could be interesting to assess in further studies whether the positive effects of Pilates exercises remain after twelve weeks and whether such results could be extended to older adults globally.

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