Effectiveness of Pilates training in people with Multiple Sclerosis

 Effectiveness of Pilates training in people with Multiple Sclerosis

Introduction:

Multiple Sclerosis (MS) is a brain, and spinal cord disease, which is a result of the body’s immune system attacking the wall of the nervous system¹. The disorder interferes with the communication between the brain and the rest of the body. This disease leads to many disabilities, especially walking and balancing. There is no single test that can be said to detect the MS. The differential diagnosis is usually used to determine the possibility of the disease being Multiple sclerosis. In this case, the doctors typically rule out other diseases that might have similar signs to know if it is the only one remaining. Statistics from the Statista indicates that in 2015, approximately 291 people had Multiple sclerosis per 100,000 people in Canada being the highest in the word ².  Multiple sclerosis has no cure, and the only thing doctors do is to control the symptoms and manage the rate at which the nerves are being destroyed. This is usually done by suppressing the nervous system. Physiotherapy is one of the procedures used to manage the symptoms. Pilate training in specific has been used as a treatment.

Purpose:

The purpose of the study is to determine if the use of Pilate Treatment (PT) is effective for treating people with multiple sclerosis. The study will determine in which cases the PT seems not to work or the areas where the results are significant for proper recommendations.

Methods:

The research studies selected are those who gave information on the effectiveness of Pilates training on the flexibility, balance, gait, muscle strength, core stability, and overall quality of life of persons with MS. The electronic databases used for the search are Medline/PubMed, SPORTDiscus, Solar, Libguides, Pedro, Scopus, Ovid, Science Direct, JSOPT from Jan 2010 up to July 2020. the study used the keywords and Boolean Search Multiple Sclerosis AND Pilates training and Muscle Strength, Flexibility, Core Stability, Balance, Quality of life.

Selection Procedure and Eligibility Criteria:

Those studies that proposed a Pilates program for persons with MS included variables relating to flexibility, balance amongst their outcomes, confirmed MS diagnosis, independent ambulant of a minimum of 100 ft. who are willing to participate between the age of 18 or above were considered eligible. Investigations were excluded if: (a) the sample included participants with MS and other conditions including cardiovascular, orthopedic, neurological and other medical conditions and data for each population were not reported separately; (b) Pilates performed in combination with other exercise training modalities and its effects could not be isolated; (c) exercise training and current (within the prior six months)participation in a core stability-based exercise program, ongoing involvement in another interventional research study, (d) Pregnancy, (e) blurred vision (f) the intervention was based on the performance of a single exercise training session; (g) diagnosed psychiatric problems or cognitive decline that render the patient incapable of performing tests (h)the research was not published in a peer-reviewed journal with the full-text of the study was unavailable and (i)the research was not written in the English language. The studies were examined independently by reviewing the information which appeared in the titles and abstracts and classifying them as “selected” or “eliminated.” The studies which did not provide sufficient information were registered as “doubtful,” pending a subsequent reading of the full text. The studies that were then rejected included: (a) combined exercise interventions that did not include a measure of flexibility, balance, and gait. (b) the study was based on a single exercise training session. Finally, eight articles were chosen, which fulfilled the requirements and which were related to the objective of the study of this review.

Results:

All of the resources used except fox E. et al. (2016) agreed that pirate treatment could be effective in the treatment of MS. fox E. et al. (2016) in their experiment did not see any significant improvement in both waling or in balancing both in the short term and long term. However, Fox E (2015) had found that participants showed improvement in pirate for the short term. Each resource used tested different functionality like stability, respiratory, lower limbs, etc. For example, Kalron et al. (2017) tested walking and balancing improvements in their experiments. When all these experiments are combined, they are giving a general conclusion that there is effectiveness in using PT as a treatment for MS.

Guclu-Gunduz et al. (2014) experiment was made up of balance and strengthening exercises. The research found out that PM developed balance, mobility, and strength. They also found out that if the appropriate exercises appropriate for a particular level of disability, PM can significantly improve the patients’ health^3.  Abasıyanıka et al. (2020) suggested that a home exercise program can improve mobility, core stability, and inspiratory muscle strength in pwMS who cannot travel to treatment centers⁴. According to Kalron et al. (2017), PM can be a possible treatment of MS that can be used to improve balance and walk.

Discussion:

From the literature review done, there is effectiveness in using PT as a means of treating MS. This means PT can be used on patients, and to some extent, patients can be encouraged to do exercises at home to improve the balance and mobility⁴ further. Using PT can be used just before surgery is recommended, as there is a possibility that PT can significantly reduce the number of surgery done on MS patients.

For the result of experiments to apply to the general population, the sample population used in the experiment should be large enough to guarantee error-free findings. A small population usually is prone to biasness, which may be the source of errors. The primary possible cause of discrepancies in these experiments is the sample size. Examples of experiments that used small samples are Abasıyanık et al. (2020) and Karlon et al. (2017). Most of the experiments conducted have confirmed PT to be effective in treating MS. This is true based on the fact that of all the resources used, only fox E et al. (2016) did not detect any significant improvement in the participants’ functionality. Although each study tested its abilities, when all the results are combined, they all agree that PT is an effective treatment. The limitation of the research is that it did could not thoroughly verify the accuracy of the research reports used in the review. There is a possibility of the researcher ignoring other factors like the consistency of the exercises, which can significantly affect their research results.

Conclusion/Clinical Implications:

The research was trying to find out if the Pilates Training is efficient for the treatment of MS. The data gathered has proved that PM is efficient to be used per the hypothesis of the research. Every research paper used, except Fox et al. (2016), agrees there is an improvement in the patients’ physical capabilities doing PT exercises. There is also a need to consider the type of experiment being recommended to a patient. The results of PT much depend on the nature of the exercises being done based on the level of disability of the patient. Some exercises won’t work in certain situations.

References:

1. Caroline, N. L. (2014). Nancy Caroline’s emergency care in the streets, Canadian (7th ed.). Jones & Bartlett Publishers.
2. (2015). Multiple Sclerosis Prevalence Rate by Select Countries 2015. Retrieved August 8, 2020, from https://www.statista.com/statistics/372361/prevalence-rate-of-ms-in-select-countries/
3. Bulguroglu, I., Guclu-Gunduz, A., Yazici, G., Ozkul, C., Irkec, C., Nazliel, B., & Batur-Caglayan, H. Z. (2017). The effects of Mat Pilates and Reformer Pilates in patients with Multiple Sclerosis: A randomized controlled study. NeuroRehabilitation, 41(2), 413–422. https://doi.org/10.3233/NRE-162121
4. Abasıyanık, Z., Ertekin, Ö., Kahraman, T., Yigit, P., & Özakbaş, S. (2020). The effects of Clinical Pilates training on walking, balance, fall risk, respiratory, and cognitive functions in persons with multiple sclerosis: A randomized controlled trial. Explore, 1,
5. Fox, E. E., Hough, A. D., Creanor, S., Gear, M., & Freeman, J. A. (2016). Effects of Pilates-Based Core Stability Training in Ambulant People with Multiple Sclerosis: Multicenter, Assessor-Blinded, Randomized Controlled Trial. Physical therapy, 96(8), 1170–1178. https://doi.org/10.2522/ptj.20150166
6. Kalron, A., Rosenblum, U., Frid, L., & Achiron, A. (2017). Pilates exercise training vs. physical therapy for improving walking and balance in people with multiple sclerosis: a randomized controlled trial. Clinical Rehabilitation, 31(3), 319–328. https://doi-org.akin.css.edu/10.1177/0269215516637202
7. Duff, W., Andrushko, J. W., Renshaw, D. W., Chilibeck, P. D., Farthing, J. P., Danielson, J., & Evans, C. D. (2018). Impact of Pilates Exercise in Multiple Sclerosis: A Randomized Controlled Trial. International journal of MS care, 20(2), 92–100. https://doi.org/10.7224/1537-2073.2017-066
8. Guclu-Gunduz, A., Citaker, S., Irkec, C., Nazliel, B., & Batur-Caglayan, H. Z. (2014). The effects of Pilates on balance, mobility, and strength in patients with multiple sclerosis. NeuroRehabilitation, 34(2), 337-342.
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