Restoration of Sensorimotor Function in Middle-Aged Women With Chronic Lumbar Disc Herniation: The Effect of Pilates on Proprioception, Tibialis Anterior Strength, and Dynamic Balance

Proprioceptive Sense/Joint Position Sense

Ankle joint position sense will be assessed to evaluate proprioceptive function. The assessment will be performed in a standing position. Reflective markers will be placed on anatomical landmarks used as pivot points for goniometric measurement of the ankle, and participants' feet will be labeled with their names to prevent any confusion. Participants will be asked to transfer their body weight onto one leg. During this, on the side to be measured, they will be instructed to maintain a position with the hip at 30° flexion and the knee at 60° flexion, lightly touching the ground with the toes. Two rigid devices providing 0° and 10° angles at the ankle joint will be used. The ankle will be positioned at the target angle using these devices, and the participant will be asked to hold this position for 5 seconds. Afterward, the foot will be returned to the initial position. Participants will then be asked to look straight ahead and actively reproduce the same ankle position, at which poi

Time frame: From enrollment to the end of treatment at 8 weeks

Tibialis Anterior Muscle Test

The strength of the tibialis anterior muscle will be measured using the Lafayette Muscle Testing device (Model 01165, FDA Medical, Canada). The test will be conducted in a seated position. Prior to the assessment, participants will be informed about the procedure, and similar to manual muscle testing, they will be asked to pull their ankle toward themselves with maximum effort.

Time frame: "From enrollment to the end of treatment at 8 weeks"

Functional Reach Test

This test is a practically applicable assessment and is preferred in many studies for evaluating dynamic balance. The only requirements for its administration are a measuring tape and sufficient space.

Time frame: From enrollment to the end of treatment at 8 weeks

Time Up Go Test

Before the test, participants will be informed about the procedure and the test will be demonstrated. Upon the "start" command, the participant will be asked to rise from a chair, walk around a target placed 3 meters away, and return to sit on the chair. Timing will be measured using a stopwatch. The test will be repeated three times, and the best time, in seconds, will be recorded.

Time frame: From enrollment to the end of treatment at 8 weeks