Método Pilates e a lacuna de mensuração sensorial em idosos: revisão de escopo

The Pilates Method has been associated with improved balance and reduced fall risk in older adults, but whether these effects involve multisensory integration, a core mechanism of postural control in aging, remains underexplored. This scoping review aimed to map the evidence on the effects of Pilates on balance in older adults and quantify the proportion of clinical trials incorporating sensory measurement outcomes, discussing the neurophysiological plausibility of this relationship. The Joanna Briggs Institute and PRISMA-ScR guidelines were followed, with searches in PubMed and PEDro (August 2026) organized into two axes: Clinical (randomized controlled trials) and Neurophysiological (experimental and mechanistic studies on sensory reweighting). Eight clinical trials and 23 neurophysiological studies were mapped. Only 4 of the 8 trials showed a significant between-group improvement in balance and mobility, confirmed in full text for only 2 of these 4; the rest showed null, partial, or comparator-favoring results. Seventy-five percent (6/8) used only macroscopic motor outcomes, only 25% (2/8) incorporated an approximate measure of sensory organization, and risk of bias (Cochrane RoB 2) was predominantly high. The neurophysiological axis supports robust and convergent plausibility for sensory reweighting in aging, but no study investigated Pilates specifically as an inducing stimulus. The fragility of the clinical evidence does not support a conclusion of inefficacy, but exposes a disconnect between the two bodies of evidence: geriatric physical therapy research stands to gain from importing the instrumented outcomes and experimental paradigms already established in the neurophysiological field.