Defining Pilates exercise


Have you ever taken part in or even taught a Pilates class? Do you really know what it is and could you define it for others? We were interested to read a recently published paper by authors from Australia that aimed to describe Pilates exercise according to peer-reviewed literature, and compare definitions used in papers with healthy participants and those with low back pain.

Here’s what they did

They searched electronic databases for papers of any methodological approach or quality published in English that described Pilates exercise. They included 119 papers and used content analysis to record qualitative definitions of Pilates. Frequencies were calculated for mention of content categories, equipment, and traditional Pilates principles. Frequencies were then compared statistically in papers with healthy participants and those with low back pain.

Here’s what they found


Exercises can be mat-based or involve use of specialised equipment

Findings suggest that Pilates is:

  • a mind—body exercise that focuses on strength, core stability, flexibility, muscle control, posture and breathing.
  • Exercises can be mat-based or involve use of specialised equipment.
  • Posture was discussed statistically significantly more often in papers with participants with low back pain compared to papers with healthy participants.
  • Traditional Pilates principles of centering, concentration, control, precision, flow, and breathing were discussed on average in 23% of papers.
  • Apart from breathing, these principles were not mentioned in papers with low back pain participants.

The authors concluded

There is a general consensus in the literature of the definition of Pilates exercise. A greater emphasis may be placed on posture in people with low back pain, whilst traditional
principles, apart from breathing, may be less relevant.


The Musculoskeletal Elf’s view

The Musculoskeletal ElfIt is interesting to note that the traditional principles of Pilates were not mentioned in paper with low back pain patients. However, the authors noted that there was only a small number of papers that focused on Pilates in relation to participants with low back pain (n = 17) compared to papers with healthy participants (n = 49).

The authors used content analysis, this is a widely used qualitative research technique. It is used to interpret meaning from the content of text data. There are different approaches in coding schemes, origins of codes, and threats to trustworthiness. According to Hsieh and Shannon 2005 in conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context.

Well I’m just off to the woodland to meet the other Elves to do a bit of centering, concentration, control, precision, flow, and breathing!

  • Do you recommend Pilates for patients with low back pain?
  • What evidence is there for the effectiveness of Pilates in injury prevention or treatment for low back pain?

Send us your views on this blog and become part of the ever expanding Musculoskeletal Elf community.


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Tracey Howe

Hi I am Tracey Howe. I am a Professor of Rehabilitation Sciences at Glasgow Caledonian University, UK and Deputy Chair of Glasgow City of Science. I am also an editor for the Cochrane Musculoskeletal Review Group and a convenor for the Cochrane Health Care of Older People Field. I am a Trustee of the Picker Institute Europe. I started my career as a physiotherapist in the National Health Service in England. I have extensive experience of assessing the quality of research in Universities in the UK and internationally. I enjoy strategic visioning, creative problem-solving, and creating vibrant, multi-disciplinary environments, through collaboration, partnerships, and relationships, that empower others to succeed.

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