ABSTRACT Pilates therapy improves core muscle function and axial stability but its effects on balance in idiopathic Parkinson’s disease (IPD) have not been evaluated. The objective of this study was to evaluate the effects of a Pilates exercise program on postural stability and balance confidence in people with IPD. Ten IPD patients (Hoehn & Yahr Stage 1-3) with a history of falls or nearfalls had the following assessments before and after completion of a 6-week supervised Pilates exercise program: Activities-Specific Balance Confidence Scale (ABC); Berg Balance Scale (BBS); Schwab and England Scale (SES); Unified Parkinson’s Disease Rating Scale (UPDRS); pull-test; timed-up-and-go (TUG); 5-metre walk; static and dynamic posturography. There were significant improvements in BBS score, 5-metre walk time and TUG after the training program, as well as improvement trends in some posturographic measures. Participants also reported improved balance confidence with Activities of Daily Living (ADLs). Our findings suggest that Pilates therapy can be beneficial in IPD and warrants further evaluation in a larger study.
Cite this paper
Johnson, L. , Putrino, D. , James, I. , Rodrigues, J. , Stell, R. , Thickbroom, G. and Mastaglia, F. (2013) The effects of a supervised Pilates training program on balance in Parkinson’s disease. Advances in Parkinson's Disease, 2, 58-61. doi: 10.4236/apd.2013.22011.
  Boonstra, T.A., van der Kooij, H., Munneke, M. and Bloem B.R. (2008) Gait disorders and balance disturbances in Parkinson’s disease: Clinical update and pathophysiology. Current Opinion in Neurology, 21, 461-471.
 Pickering, R.M., Grimbergen, Y.A., Rigney, U., et al. (2007) A meta-analysis of six prospective studies of falling in Parkinson’s disease. Movement Disorders, 22, 1892-1900. doi:10.1002/mds.21598
 Shulman, L.M., Gruber-Baldini, A.L., Anderson, K.E., et al. (2008) The evolution of disability in Parkinson’s disease. Movement Disorders, 23, 790-796.
 Bloem, B.R. (1992) Postural instability in Parkinson’s disease. Clinical Neurology and Neurosurgery, 94, S41-45.
 Bronte-Stewart, H.M., Minn, A.Y., Rodrigues, K., Buckley, E.L. and Nashner, L.M. (2002) Postural instability in idiopathic Parkinson’s disease: The role of medication and unilateral pallidotomy. Brain, 125, 2100-2114.
 Gray, P. and Hildebrand, K. (2000) Fall risk factors in Parkinson’s disease. Journal of Neuroscience Nursing, 32, 222-228. doi:10.1097/01376517-200008000-00006
 Nallegowda, M., Singh, U., Handa, G., et al. (2004) Role of sensory input and muscle strength in maintenance of balance, gait, and posture in Parkinson’s disease: A pilot study. American Journal of Physical Medicine and Rehabilitation, 83, 898-908.
 Horak, F.B., Dimitrova, D. and Nutt, J.G. (2005) Direction-specific postural instability in subjects with Parkinson’s disease. Experimental Neurology, 193, 504-521.
 Visser, J.E., Allum, J.H., Carpenter, M.G., et al. (2008) Effect of subthalamic nucleus deep brain stimulation on axial motor control and protective arm responses in Parkinson’s disease. Neuroscience, 157, 798-812.
 Kloubec, J.A. (2010) Pilates for improvement of muscle endurance, flexibility, balance, and posture. Journal of Strength and Conditioning Research, 24, 661-667.
 Emery, K., De Serres, S.J., McMillan, A. and Coté, J.N. (2010) The effects of a pilates training program on armtrunk posture and movement. Clinical Biomechanics, 25, 124-130. doi:10.1016/j.clinbiomech.2009.10.003
 Kaesler, D.S., Mellifont, R.B., Swete Kelly, P. and Taafe, D.R. (2007) A novel balance exercise program for postural stability in older adults: A pilot study. Journal of Bodywork and Movement Therapies, 11, 37-43.
 Siqueira Rodrigues, B.G., Ali Cader, S., Bento Torres, N.V., Oliveira, E.M. and Martin Dantas, E.H. (2010) Pilates method in personal autonomy, static balance and quality of life of elderly females. Journal of Bodywork and Movement Therapies, 14, 195-202.
 Newell, D., Shead, V. and Sloane, L. (2012) Changes in gait and balance parameters in elderly subjects attending an 8-week supervised pilates programme. Journal of Bodywork and Movement Therapies, 16, 549-554.
 Bird, M.-L., Hill, K.D. and Fell, J.W. (2012) A randomized controlled study investigating static and dynamic balance in older adults after training with pilates. Archives of Physical Medicine and Rehabilitation, 93, 43-49.
 Hall, D.W., Nichols, J., Aguilar, L. and Larkam, E. (1999) Effects of pilates-based-training on static and dynamic balance in an elderly population. Medicine and Science in Sport and Exercise, 31, S388.
 Hughes, A.J., Daniel, S.E., Kilford, L. and Lees, A.J. (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: A clinic-pathological study of 100 cases. Journal of Neurology, Neurosurgery and Psychiatry, 55, 181-184. doi:10.1136/jnnp.55.3.181
 Hoehn, M.M. and Yahr, M.D. (1967) Parkinsonism: Onset, Progression and mortality. Neurology, 17, 427-442.
 Martínez-Martín, P., Gil-Nagel, A., Gracia, L.M., Gómez, J.B., Martínez-Sarriés, J., Bermejo, F. and The Cooperative Multicentric Group (1994) Unified Parkinson’s disease rating scale characteristics and structure. Movement Disorders, 9, 76-83. doi:10.1002/mds.870090112
 Adkin, A.L., Frank, J.S. and Jog, M.S. (2003) Fear of falling and postural control in Parkinson’s disease. Movement Disorders, 18, 496-502. doi:10.1002/mds.10396
 Berg, K.O., Maki, B.E., Williams, J.L., Holliday, P.J. and Wood-Dauphinee, S.L. (1992) Clinical and laboratory measures of postural balance in an elderly population. Archives of Physical Medicine and Rehabilitation, 73, 1073-1080.
 Smithson, F., Morris, M.E. and Iansek, R. (1998) Performance on clinical tests of balance in Parkinson’s disease. Physical Therapy, 78, 577-592.
 Visser, M., Marinus, J., Bloem, B.R., Kisjes, H., van den Berg, B.M. and van Hilten, J.J. (2003) Clinical tests for the evaluation of postural instability in patients with Parkinson’s disease. Archives of Physical Medicine and Rehabilitation, 84, 1669-1674.
 Morris, S., Morris, M.E. and Iansek, R. (2001) Reliability of measurement obtained with the timed “up & go” test in people with Parkinson disease. Physical Therapy, 81, 810-818.
 Johnson, L., James, I., Rodrigues, J., Stell, R., Thickbroom, G. and Mastaglia, F.L. (2013) Clinical and posturographic correlates of falling in a Parkinson’s disease cohort. Movement Disorders, in Press.