Pilates may be beneficial in knee OA rehabilitation

In patients with knee osteoarthritis who are undergoing rehabilitation, Pilates helps alleviate pain and yields improvements in range of motion, proprioception, dynamic balance, and quality of life, according to a systematic review and meta-analysis.

Researchers searched multiple online databases for randomized controlled trials (RCTs) in which the impact of Pilates exercises in adult patients with knee OA was evaluated. Studies involving participants with systemic arthritis, knee joint surgery within the past 12 months, lower extremity arthroplasty, intra-articular steroid injections within the past 6 months, or any neurological conditions were excluded.

The meta-analysis included 11 studies involving 476 participants, of which seven contributed to the quantitative synthesis. Pooled data showed that Pilates exercises reduced pain relative to no intervention (standardized mean difference [SMD], −1.09, 95 percent confidence interval [CI], −2.04 to −0.14; I²=66 percent; p=0.02; 3 studies, n=66; low-quality evidence). However, its effect on pain was not significant when compared with over conventional exercises (SMD, −0.28, 95 percent CI, −1.06 to 0.50; I²=86 percent; p=0.49; 5 studies, n=210; very low-quality evidence).

Looking at other outcomes, Pilates exerted no significant impact on knee health as assessed by the WOMAC total score (SMD, −0.14, 95 percent CI, −1.12 to 0.85; I²=91 percent; p=0.78; 4 studies, n=202; very low-quality evidence) but conferred a beneficial effect on knee range of motion (SMD, 1.07, 95 percent CI, 0.56–1.57; I²=0 percent; p=0.0001; 2 studies, n=70; low-quality evidence) when compared with conventional exercise.

Qualitative analysis showed evidence of improvements in balance, proprioception, and quality of life in some individual studies. However, the quality of the evidence was considered very low to low.