Effects of pilates on lower-limb strength and gait patterns in women with knee hypermobility: A preliminary study

Background Joint hypermobility affects 10–25% of adults and is characterized by excessive joint mobility caused by connective tissue laxity. Although exercise interventions are beneficial, the effectiveness of a Pilates program focusing on controlled muscle contractions and body awareness remains unexplored. Objective This study investigates the impact of an 8-week online Pilates program, conducted via Zoom, on lower-limb strength and gait in women with knee hypermobility compared to healthy controls. Methods Nine adults with knee hypermobility (age: 25.0 ± 7.1) and five healthy controls (age: 20.2 ± 1.3), all women, participated in bi-weekly Pilates classes over 8 weeks via Zoom. Assessments were conducted pre-, mid-, and post-intervention using an isokinetic dynamometer to measure hamstrings and quadriceps strength, as well as treadmill gait analysis to measure knee angles at heel-strike and push-off. A Shapiro-Wilk test established normality and a repeated measures analysis of variance was conducted to test for differences in outcome measures ( p < .05). Results Significant improvements were observed in the hypermobility group in quadriceps strength (F(2,16) = 7.304, p = .018), hamstrings strength (F(2,16) = 19.515, p < .001), hamstrings-to-quadriceps ratio (from 51.0 ± 10.15% to 59.1 ± 9.6%, p = .037) and knee angles at heel-strike (from 183.2 ± 7.2° to 178.5 ± 5.2°, p = .001) and push-off (179.1± 2.2° to 175.7 ± 2.9°, p < .001). In the control group, an increase in quadriceps strength was observed (F(2,8) = 29.861, p < .001). Conclusions Our findings suggest that an 8-week Pilates intervention improves lower-limb strength and decreases hyperextended knee angles during walking.