Pilates as physiotherapy in patients with Parkinson disease: a pilot study

Abstract

Background. Pilates improves core muscle function and lumbopelvic stability. The basic principles of Pilates are concentration, control, centring, diaphragmatic breathing, lightness, precision, strength, and relaxation. This study aims to determine the effects of Pilates on clinical symptoms and static balance in patients with Parkinson disease (PD). Methods: Of 36 patients with PD, 15 (mean age, 73.5 years) who had a Hoehn and Yahr stage of 1 to 3 and a stable reaction to anti-Parkinson medication were randomly allocated to the Pilates group (n=8) or conventional exercise group (n=7). Participants were assessed 1 week before intervention (week 0) and 1 and 4 weeks after intervention completed (weeks 15 and 18). Motor and non-motor impairment and disability were assessed using the Spanish version of the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDSUPDRS). Static balance was assessed using the Stabilometric platform. Participants were instructed to stand centrally on the platform with feet hip-width apart and arms at their sides and with open eyes and closed eyes each for 30 s. Parameters recorded included centre of pressure of the body in the frontal plane (COP X), centre of pressure of the body in the sagittal plane (COP Y), speed of oscillation of the centre of pressure in the sagittal plane (forward-backward) [F-B speed], speed of oscillation of the centre of pressure in the frontal plane (mediumlateral) [M-L speed], and displacement area of the centre of pressure (ellipse area). Results: All 15 participants attended over 80% of the sessions. From pre-intervention to post-intervention, participants in the Pilates group had significant improvements in MDS-UPDRS, open eyes COP X, open eyes COP Y, open eyes ellipse area, and closed eyes COP Y. Whereas participants in the conventional exercise group had significant improvement in open eyes COP Y and closed eyes COP Y but had significant deterioration in open eyes F-B speed and closed eyes F-B speed. Compared with the conventional exercise group, the Pilates group had significantly greater improvement in all parameters except for body mass index, closed eyes ellipse area, and M-L speed. From post-intervention to follow-up, participants in both groups lost most of the improvement in MDS-UPDRS and in static balance parameters. Compared with the conventional exercise group, the Pilates group had significantly greater improvement in MDS-UPDRS, open eyes COP X, closed eyes COP X, and closed eyes COP Y. Conclusion: Pilates exercise is a useful rehabilitation strategy for people with mild to moderate PD, with a positive effect on motor impairment and static balance.