Effectiveness Of Pilates On Fatigue In Adults With Chronic Conditions: Systematic Review And Meta-analysis

Fatigue is a prevalent symptom in chronic conditions and leads to a decline in function and quality of life. Despite the benefits of exercise on fatigue in persons with chronic conditions, adherence to exercise remains low in this population. Thus, alternative forms of exercise may be important to meet their specific needs. In this context, Pilates, a low-to-moderate intensity, predominantly floor-based exercise, is a plausible rehabilitation strategy that could help persons with chronic conditions manage their fatigue and improve function. However, its effect across diverse chronic conditions has not been comprehensively synthesised. PURPOSE: To comprehensively synthesize the effect of Pilates on fatigue, quality of life and physical function in persons with chronic conditions and explore potential intervention moderators. METHODS:A systematic review and meta-analysis were conducted. PubMed, SPORTDiscus, AMED and the Cumulated Index of Nursing and Allied Health Literature (CINAHL) were searched up to September 2024. The Cochrane Risk of Bias (ROB-2) tool and the Physiotherapy Evidence Database (PEDro) scale were used to evaluate methodological quality. Data was synthesised and random-effects modelling was used to pool data across comparable studies. Results are presented as standardised mean difference (SMD) with 95% confidence intervals (CI). RESULTS: Pilates had a significant effect on fatigue, quality of life and physical function. The meta-analysis showed Pilates had significant effect on physical function [SMD = 45.80 (95% CI: 9.91; 81.69), p = 0.01] but the effects on fatigue [SMD = -2.59 (95% CI: -7.47; 2.30), p = 0.30] and quality of life [SMD = 9.46 (95% CI: -6.23; 25.15), p = 0.24] were not significantly greater than those in the control group. The type of chronic condition and control did not influence effect. However, subgroup analyses revealed that interventions with smaller duration (6-8 weeks) significantly influenced the effect of Pilates on fatigue. CONCLUSIONS: The study findings suggest that Pilates is a feasible rehabilitation strategy that has beneficial effects on physical function and may also be help reduce the fatigue and improve quality of life in persons with chronic conditions.