Review The effects of Pilates exercise training on physical fitness and wellbeing in the elderly: A systematic review for future exercise prescription V. Bullo a , M. Bergamin a, ⁎, S. Gobbo a , J.C. Sieverdes b , M. Zaccaria a , D. Neunhaeuserer a , A. Ermolao a a Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy b Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, United States of America abstract article info Available online 12 March 2015 Keywords: Elderly Pilates Physical fitness Fall prevention Review This systematic review aims to summarize the effects of Pilates exercise training (PET) in elderly population on physical fitness, balance and fall prevention, and its effects on mood states, quality of life and independence in the daily living activities. Methods. Keyword “Pilates” associated with “elderly”, “aging” and “old subjects” were identified as terms for the literature research in MEDLINE, Embase, PubMed, Scopus, PsycINFO and SPORTDiscus. Only studies published in peer-reviewed journals written in English language were considered. A meta-analysis was performed and effect sizes (ES) calculated. Results. 10 studies were identified (6 RCTs and 4 uncontrolled trials); age ranged from 60 to 80 years. Overall, PET showed large ES to improve muscle strength (ES = 1.23), walking and gait performances (ES = 1.39), activities of daily living, mood states and quality of life (ES = 0.94), moderate to high effect on dynamic balance (ES = 0.77), small effects on static balance (ES = 0.34) and flexibility (ES = 0.31), while a small effect on cardio- metabolic outcomes (ES = 0.07). Conclusions. PET should be taken into account as a way to improve quality of life in the elderly, due to the imparted benefits of fall prevention, physical fitness, and mood states. In this context, physicians might include PET as a tool for exercise prescriptions for the elderly. © 2015 Elsevier Inc. All rights reserved. Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Study design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Literature search . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Inclusion and exclusion criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Study quality assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Data extraction and synthesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Data analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Studies description and results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Muscle strength outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Static and dynamic balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Walking and gait measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Activities of daily living, mood states and quality of life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Cardio-metabolic effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Pilates and muscle strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Pilates and balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Pilates and mobility/walking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Preventive Medicine 75 (2015) 1–11 ⁎ Corresponding author. E-mail address: marco.bergamin@unipd.it (M. Bergamin). http://dx.doi.org/10.1016/j.ypmed.2015.03.002 0091-7435/© 2015 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Preventive Medicine journal homepage: www.elsevier.com/locate/ypmed