Pilates-Based Exercise for Fall Risk Reduction in Older Adults: A Pilot Study

My colleagues, Dawn-Marie Ickes, Gabrielle Shrier and Allyson Cabot are presenting their study at the APTA CSM Scientific Meeting this year: Pilates-Based Exercise for Fall Risk Reduction in Older Adults: A Pilot Study M. Roller1; A. F. Kachingwe1; D. Ickes2; A. L. Cabot2; G. Shrier2; J. Beling1 1. Physical Therapy, California State University, Northridge, Northridge, CA, United States. 2. Core Conditioning, Studio City, CA, United States.

Falls are a common cause of morbidity and mortality in older adults. Impairments in balance, strength, range of motion, and functional mobility can lead to increased fall risk. Pilates is a form of exercise designed to improve core strength, flexibility, and functional mobility, making it an exceptional form of exercise for individuals at risk for falls. The purpose of this study was to investigate the effects of a Pilates-based exercise intervention in improving balance and reducing fall risk with a population of adults over 65 who are known fallers or at risk for falls.8 subjects (5 males, 3 females; mean age 78.6 years) participated in the study. Inclusion criteria included a self-reported history of two or more falls or one injurious fall in the past year or a Timed Up and Go (TUG) test of >13.5 seconds suggesting risk for falling. Six subjects completed the intervention and post-testing. Subjects attended 10 sessions of a 45-minute Pilates-based exercise program once a week at Core Conditioning in Studio City, CA. Pilates training utilized the Balanced Body® Pilates Studio Reformer® under the supervision of a physical therapist who is a Gold Certified PMA Pilates Instructor with 9 years of experience using this methodology. Participant to instructor ratio was 4:1 with all subjects working on Reformers concurrently in a group class format. Each subject performed 10 specific exercises, 10 repetitions each, using varying resistance of 2-4 springs progressed according to each participant’s ability. Outcome measures: Activities-specific Balance Confidence (ABC) scale; Timed Up-and-Go (TUG) test; Berg Balance Scale (BBS; Computerized Dynamic Posturography (CDP) on the NeuroCom Smart Equitest® including Sensory Organization Test (SOT), Adaptation Test (ADT) and Motor Control Test (MCT; Active Range of Motion (AROM) of ankle dorsiflexion, hip extension and straight-leg raise The following outcomes measures improved significantly at the p<0.05 level: TUG scores significantly decreased from 14.8 to 11.1 seconds suggesting reduced fall risk; SOT composite scores significantly increased from 55.7 to 64.2/100 suggesting increased postural stability; BBS scores significantly increased from 44.8 to 51.8/56 suggesting improved static and dynamic balance; Right ankle dorsiflexion AROM significantly increased from 5.2° to 10.3° Pilates-based exercise using the Reformer performed once per week resulted in significant improvements in static and dynamic balance, ankle range of motion, functional mobility, and reduced fall risk in eight adults over age 65 who were at risk for falling. This pilot study suggests that rehabilitation focusing on Pilates exercise using the Reformer only once a week is an excellent intervention to improve balance and decrease fall risk in older adults. Future randomized-controlled studies should be performed to further validate these findings.