Clinical Pilates for Fibromyalgia: One-to-One vs Group
Sam’s world view
Each month we hear from Sam Wood - she summarises the most recent articles published in the Pilates industry.
In this randomized controlled trial, Franco and colleagues compared modified Pilates exercises to aerobic exercise in 98 women with fibromyalgia. Participants were randomly assigned to either Pilates or aerobic exercise, with both groups receiving twice-weekly, 60-minute supervised sessions for eight weeks. The Pilates group performed mat and equipment exercises progressed through basic, intermediate, and advanced levels; while the aerobic group exercised on treadmills or stationary bikes at 57-76% of maximum heart rate (mild-to-moderate intensity). Both groups also received educational booklets about fibromyalgia, self-care strategies, and the importance of exercise. A blinded assessor evaluated outcomes at baseline, eight weeks, six months, and 12 months.
The findings revealed that both interventions were similarly effective in reducing fibromyalgia impact with no significant difference between groups. However, Pilates demonstrated superior pain relief compared to aerobic exercise. Both groups showed improvements across secondary outcomes including kinesiophobia, disability, sleep quality, and functional capacity throughout the 12-month follow-up period.
The cost-effectiveness analysis provided important economic insights. Pilates was not cost-effective compared to aerobic exercise when examining fibromyalgia impact alone. However, when considering quality of life improvements measured through quality-adjusted life years (QALYs), Pilates appeared to be a cost-effective intervention, though this depends on the willingness-to-pay thresholds used by healthcare decision-makers and insurance systems.
The researchers concluded that modified Pilates represents a safe and effective alternative to aerobic exercise—a highly recommended intervention for fibromyalgia treatment. While both approaches produce similar improvements in overall fibromyalgia impact, Pilates offered superior pain relief and may provide better value when quality of life enhancement is prioritized. This study expands evidence-based treatment options for fibromyalgia patients and gives healthcare providers another evidence-based option for managing this challenging condition.
Reference List
Franco KFMF, Franco YRDS, Salvador EMES, Miyamoto GC, Cabral CMN. Effectiveness and cost-effectiveness of the modified Pilates method versus aerobic exercise in the treatment of patients with fibromyalgia: a randomized controlled trial. European Journal of Pain 2023;27(4):480-496.