What are the effects of pilates in the post stroke population? A systematic literature review & meta-analysis of randomised controlled trials

Objective: Stroke is a leading cause of death and disability worldwide. Pilates, a programme of mind-body exercises is theorised to have beneficial effects on strength, postural control, balance, proprioception, coordination and gait in people with deficits due to a neurological condition. However, the evidence of pilates in stroke patients has never been systemised. The objectives of this systematic literature review are to investigate the effects of pilates in post stroke individuals and compare this intervention to other forms of exercise, standard care and/or physiotherapy. Data Sources: A comprehensive search was conducted in the following databases: Pubmed (including MEDline), Web of Science, the Cochrane library, Science Direct, Embase and PEDro. Study Selection: Studies were selected, screened, filtered and reviewed in detail to identify those that met the inclusion criteria. Data Extraction: Data was extracted to a table with specific headings for analysis and studies were rated using the Physiotherapy Evidence Database (PEDro) scale. Data Synthesis: Data from a total of 5 included studies with 122 participants was pooled and analysed using the Revman 5 software. Significant findings were found in favour of the pilates intervention groups on balance (P<0.00001), quality of Life (P=0.0002), and gait parameters (P=0.001), when results from the studies were combined and analysed. Conclusions: This review found moderate evidence for pilates exercises improving balance in post stroke individuals and limited evidence for improvements in quality of life, cardiopulmonary function and gait. Future studies should examine long term follow up, home programmes and comparisons with other forms of exercise in post stroke patients.