THE EFFECTS OF PILATES BASED CORE STABILITY TRAINING IN PEOPLE WITH MS

Abstract

Background: People with Multiple Sclerosis experience difficulties with balance and mobility. Pilates exercises are often used to address these difficulties. Design: This was a multi-centre, double blind, block randomised, controlled trial. Eligible participants were recruited from seven UK centres. Participants were randomly allocated to either: Pilates based core stability training (Pilates), Standardised Exercise (SE) or Relaxation (placebo). All received face-to-face training sessions over a 12 week period; together with a home exercise programme. Blinded assessments were taken before training, at the end of the 12 week programme and at 16 weeks (follow-up). The primary outcome measure was the 10metre timed walk (10mtw). Secondary outcome measures were the MS walking Scale (MSWS-12), Functional Reach Test (FRT ) (forwards and lateral), a 10 point Visual Analogue Scale (VAS) to determine “Difficulty in carrying a drink when walking”, and the Activities-specific Balance Confidence (ABC) Scale. Effects on deep abdominal muscles were measured with ultrasound imaging (USI) in a subgroup of patients. Independent t-tests were performed to compare groups. Sensitivity analyses were undertaken to confirm the results. A mixed factorial ANOVA analysed the effect of intervention over time upon TrAb and IO upon USI. Results: Of the 100 participants recruited, 13 relapsed leaving 94 for intention to treat analysis. At 12 weeks there were significant differences between: (1) Pilates and Relaxation for walking velocity (p=0.04), forward (p=0.04) and lateral (p=0.04) FRT. (2) SE and Relaxation for all measures (p<0.05) apart from the VAS. These remained at 16 weeks for 10mtw (p=0.04), LFR (p<0.01) MSWS-12 (p=0.03) and ABC (p= 0.03). There were no significant interactions (p>0.05) between groups or over time for TrAb and IO. Conclusions: Participants improved with both Pilates and SE in the short term; with broader and longer-lasting effects in the SE group. USI did not detect any effect of group over time.

Date of Award	2015
Original language	English
Awarding Institution	University of Plymouth
Supervisor	Jennifer Freeman (Other Supervisor)