Multiple sclerosis and adapted movement
What a systematic review of 20 trials reports on Pilates in multiple sclerosis: balance, gait, strength and cognition. A summary of reported benefits, limits and the role of adapted movement in neurorehabilitation.
Multiple sclerosis is a chronic neurological disease with varied symptoms: fatigue, muscle weakness, gait and balance problems, a high fall risk and sometimes cognitive change. Exercise was long viewed with caution; today, solid evidence suggests physical activity can support function, quality of life and independence without typically worsening disease activity, with medical clearance and individual adaptation.
The cited paper is a systematic review (PRISMA) of randomized controlled trials using Pilates in people with multiple sclerosis. Searches in international databases through 2021 yielded 20 included studies with about 999 participants; methodological quality varied, and some trials were rated as low risk of bias.
The synthesis points to gains in balance, gait, physical and functional capacity (strength, core stability, aerobic fitness, body composition) and, in some trials, cognitive function. By contrast, fatigue, quality of life and psychological outcomes such as anxiety and depression did not show a clear, consistent benefit across studies.
A strength highlighted in the review is adherence: where compliance was reported, attendance was often above 80 percent, and adverse effects were uncommon and mild in studies that documented them. Interventions mostly used mat Pilates, typically two or three sessions per week for eight to twelve weeks, led by a physiotherapist, ideally with Pilates certification.
The authors stress important limits: often younger samples, more women, differing disability levels, incompletely described protocols and non-uniform outcome measures. Pilates does not replace neurological care, but supports its use as a complementary rehabilitation tool, with careful progression and attention to how the body responds.
The review’s conclusion: Pilates appears safe and feasible for many people with MS and may help key functional outcomes, though larger trials and standardized protocols are still needed. For tables, methodology and full references, see the published study in PDF.