Feasibility of Pilates exercise to decrease falls risk: a pilot randomized controlled trial in community-dwelling older people

Objective: To evaluate the feasibility of Pilates exercise in older people to decrease falls risk and inform a larger trial. Design: Pilot Randomized controlled trial. Setting: Community physiotherapy clinic. Participants: A total of 53 community-dwelling people aged 60years (mean age, 69.3years; age range, 61-84). Interventions: A 60-minute Pilates class incorporating best practice guidelines for exercise to prevent falls, performed twice weekly for 12weeks. All participants received a letter to their general practitioner with falls risk information, fall and fracture prevention education and home exercises. Main outcome measure(s): Indicators of feasibility included: acceptability (recruitment, retention, intervention adherence and participant experience survey); safety (adverse events); and potential effectiveness (fall, fall injury and injurious fall rates; standing balance; lower limb strength; and flexibility) measured at 12 and 24weeks. Results: Recruitment was achievable but control group drop-outs were high (23%). Of the 20 participants who completed the intervention, 19 (95%) attended 75% of the classes and reported classes were enjoyable and would recommend them to others. The rate of fall injuries at 24weeks was 42% lower and injurious fall rates 64% lower in the Pilates group, however, was not statistically significant (P=0.347 and P=0.136). Standing balance, lower-limb strength and flexibility improved in the Pilates group relative to the control group (P<0.05). Estimates suggest a future definitive study would require 804 participants to detect a difference in fall injury rates. Conclusion: A definitive randomized controlled trial analysing the effect of Pilates in older people would be feasible and is warranted given the acceptability and potential positive effects of Pilates on fall injuries and fall risk factors. Trial Registration: The protocol for this study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN1262000224820).