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Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease with multisystem involvement, primarily affecting the joints and musculoskeletal system. Joint pain, muscle weakness, and functional limitations negatively impact physical performance and psychosocial well-being in individuals with RA. Although clinical Pilates training (CPT) has shown potential benefits in individuals with RA, evidence regarding its effectiveness remains limited.
Objectives: The aim of this study was to investigate the effects of CPT on physical, functional and psychosocial outcomes in individuals with RA.
Methods: Thirty-eight individuals with RA were randomly allocated to a CPT group or a control group. The CPT group performed supervised, progressive mat-based CPT three times per week for eight weeks, while the control group followed a home-based relaxation exercise program with the same frequency and duration. Pain, trunk muscle endurance, balance, anxiety, depression, and functional status were assessed at baseline and post-intervention. Routine pharmacological treatment was continued throughout the study.
Results: Thirty-four participants completed the study (CPT group=17, control group=17). Groups were similar at the baseline regarding physical and disease-related characteristics (p>0.05, Table 1). Significant within-group improvements were observed in all assessed parameters in the CPT group (p<0.05), whereas no significant changes were found in the control group. Between-group comparisons demonstrated that the CPT group showed significantly greater improvements in trunk muscle endurance, and anxiety compared with the control group (p<0.05, Table 2).
Conclusions: The findings of this study suggest that an eight-week CPT performed three times per week, in addition to routine pharmacological treatment, may have beneficial effects on physical, functional and psychosocial outcomes in individuals with RA.
Baseline physical and disease-related characteristics of the groups.
| Clinical Pilates group (n=17)
| Control group (n=17)
| p | |
|---|---|---|---|
| Age, years | 53.71±9.08 | 54.35±8.93 | 0.835 a |
| BMI, kg/m 2 | 20.90±3.99 | 20.93±3.63 | 0.986 a |
| Gender/women, n (% ) | 15 (88.2%) | 16 (94.1%) | 1.000 b |
| Disease duration, months | 10 (1-30) | 9 (0.25-38) | 0.666 c |
| Drug use, n (% ) | |||
| Glucocorticoids (yes ) | 5 (29.4%) | 5 (29.4%) | 1.000 b |
| Conventional DMARDs (yes ) | 10 (88.2%) | 11 (64.7%) | 0.724 b |
| Biological DMARDs (yes ) | 12 (70.6%) | 12 (70.6%) | 1.000 b |
Abbreviations: BMI: Body mass index, DMARDs: disease-modifying anti-rheumatic disease, IQR: interquartile range, SD: standard deviation, kg/m 2 : kilograms per square meter, n: frequency, %: percentage, a : The Student’s T test, b : Fisher’s exact test, c : Mann-Whitney U test, p<0.05 .
Comparison of changes between groups.
| Clinical Pilates group (n=17)
| Control group (n=17)
| p | ES | |
|---|---|---|---|---|
| Physical Outcomes | ||||
| Pain (VAS, 0-100 mm) | 0 (-3,25-0) | -0,8 (-2.9-0.1) | 0.820 a | 0.04 |
| Trunk muscle endurance | ||||
| Lateral bridge test (Left, s) | 16 (7.46-26.92) | -1.40 (-3.96-3.71) | <0.001 a | 0.81 |
| Lateral bridge test (Right, s) | 18.07 (9.50-41.82) | 0.40 (-2.59-3.90) | <0.001 a | 0.86 |
| Modified Biering–Sorensen test (s) | 40.82 (10.25-54.41) | -0.90 (-7.74-3.40) | <0.001 a | 0.65 |
| Trunk flexor test (s) | 11.26 (2.45-24.74) | -3.10 (-4.32-1.05) | <0.001 a | 0.69 |
| Prone bridge test (s) | 15.88 (6.05-30.90) | 1.02 (-1.13-2.88) | <0.001 a | 0.68 |
| Balance parameters | ||||
| Static postural stability | ||||
| OSI (score ) | -0.1 (-0.15-0) | 0 (0.1-0.0) | 0.245 a | 0.21 |
| APSI (score ) | 0 (-0.1-0) | 0 (0-1) | 0.105 a | 0.30 |
| MLSI (score ) | 0 (0.1-0) | 0 (-0.1-0) | 0.758 a | 0.06 |
| LOS (%) | 2.29±8.68 | 0.35±10.99 | 0.572 b | 0.21 |
| Psychosocial Outcomes | ||||
| HADS (0-42) | -3.18±2.74 | 1.82±5.16 | 0.001 b | 1.25 |
| Functional Status | ||||
| HAQ (0-3) | -0.15 (-0.48/-0.09) | -0.06 (-0.26-0.10) | 0.158 a | 0.26 |
Abbreviations: VAS: Visual Analog Scale, OSI: overall stability index, APSI: anterior-posterior stability index, MLSI: mediolateral stability index, LOS: limit of stability, HADS: Hospital Anxiety and Depression Scale, HAQ: Health Assessment Questionnaire, s: second, mm: milimetre, a: Mann-Whitney U test, b.: The Student’s T test, p<0.05.
REFERENCES: [1] Yentür, S.B., Ataş, N., Öztürk, M.A., Oskay, D. (2021). Comparison of the effectiveness of pilates exercises, aerobic exercises, and pilates with aerobic exercises in patients with rheumatoid arthritis. Irish Journal of Medical Science, 190, 1027-1034.
[2] Khalili, M., Golpayegani, M. and Shahrjerdi, S. (2014). The effect of eight weeks Pilates training on pain and quality of life in men with Rheumatoid arthritis. Journal of Research Sport Rehabilitation, 2(4), 41-52.
Acknowledgments: NIL.
Disclosure of Interests: None declared.