This randomized controlled trial evaluated the effects of an 8-week Clinical Pilates program on balance and physical function in individuals with multiple sclerosis (MS). Participants were randomly allocated to one of three groups: Clinical Pilates, conventional exercise-based physiotherapy, or a control group receiving postural guidance without a structured rehabilitation program. The two intervention groups completed 16 supervised exercise sessions over 8 weeks. Outcomes included static and dynamic balance, functional mobility, lower-limb motor function, fatigue, and exercise-related motivation. Assessments were conducted at baseline, after 4 and 8 weeks, and at a one-month follow-up.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
21
Participants received an 8-week Clinical Pilates-based rehabilitation program comprising 16 sessions, delivered twice weekly with a minimum interval of 48 hours between sessions. Each session lasted approximately 60 minutes and included mobility and breathing exercises, strengthening, balance and coordination exercises, trunk control, core activation, body awareness, and stretching. Exercises were performed in standing, sitting, supine, prone, and side-lying positions. Exercise intensity and complexity were progressively adjusted according to individual ability.
Participants received an 8-week conventional exercise-based physiotherapy program comprising 16 sessions, delivered twice weekly with a minimum interval of 48 hours between sessions. Each session lasted approximately 60 minutes and included progressive strengthening, postural control, sensory integration, balance, and functional training. Exercises progressed from stable to more demanding balance and functional activities, with difficulty individually adjusted according to each participant's abilities and performance.
Home-Based Study Site
Ioannina, Epirus, Greece
Change in Center of Pressure Sway Area
Center of pressure (CoP) sway area was assessed using a Bertec force platform during six standing conditions: feet together with eyes open, feet together with eyes closed, single-leg stance on the right and left leg, and tandem stance with the right and left foot leading. CoP sway area was used as a measure of static postural control, with lower values indicating less postural sway.
Time frame: Baseline, Week 4, Week 8, and 1-month follow-up
Change in Mini-BESTest Score
Dynamic balance was assessed using the Mini-Balance Evaluation Systems Test (Mini-BESTest), a 14-item clinical measure assessing anticipatory postural adjustments, reactive postural control, sensory orientation, and dynamic gait. The total score ranges from 0 to 28 points, with higher scores indicating better balance performance.
Time frame: Baseline, Week 4, Week 8, and 1-month follow-up
Change in Center of Pressure Displacement
Center of pressure (CoP) displacement in the mediolateral (ML) and anteroposterior (AP) directions was assessed using a Bertec force platform during six standing conditions: feet together with eyes open, feet together with eyes closed, single-leg stance on the right and left leg, and tandem stance with the right and left foot leading. Lower displacement values indicate less postural sway.
Time frame: Baseline, Week 4, Week 8, and 1-month follow-up
Change in Functional Gait Assessment (FGA) Score
Dynamic balance during walking was assessed using the Functional Gait Assessment (FGA). The FGA consists of 10 items assessing the ability to modify gait while performing different walking tasks. Each item is scored from 0 to 3, giving a total score ranging from 0 to 30. Higher scores indicate better functional gait and dynamic balance.
Time frame: Baseline, Week 4, Week 8, and 1-month follow-up
Change in Short Physical Performance Battery (SPPB) Score
Lower-limb physical performance was assessed using the Short Physical Performance Battery (SPPB), which includes standing balance, usual gait speed, and repeated chair-stand tests. Each component is scored from 0 to 4, giving a total score ranging from 0 to 12. Higher scores indicate better lower-limb physical performance.
Time frame: Baseline, Week 4, Week 8, and 1-month follow-up
Change in Fugl-Meyer Assessment-Lower Extremity (FMA-LE) Domain Scores
Lower-limb sensorimotor function was assessed using the Fugl-Meyer Assessment-Lower Extremity (FMA-LE). The following domains were analyzed separately: lower-extremity motor function (E-F; score range: 0-34), sensation (H; score range: 0-12), passive joint motion (I; score range: 0-20), and joint pain (J; score range: 0-20). Higher scores indicate better motor and sensory function, greater passive joint mobility, and less joint pain, respectively.
Time frame: Baseline, Week 4, Week 8, and 1-month follow-up
Change in Fatigue Severity Scale (FSS) Score
Fatigue was assessed using the Fatigue Severity Scale (FSS), a 9-item questionnaire evaluating the severity and impact of fatigue on daily functioning. Each item is rated from 1 to 7, with higher scores indicating greater fatigue severity.
Time frame: Baseline, Week 4, Week 8, and 1-month follow-up
Intrinsic Motivation Inventory (IMI) Scores
Exercise-related motivation was assessed using the 22-item version of the Intrinsic Motivation Inventory (IMI), comprising four subscales: interest/enjoyment, perceived competence, perceived choice, and pressure/tension. Items are rated on a 7-point scale from 1 (not at all true) to 7 (very true), with negatively worded items reverse-scored. Subscale scores are calculated by averaging the corresponding item scores and therefore range from 1 to 7. Higher scores indicate greater levels of the construct represented by each subscale (i.e., greater interest/enjoyment, perceived competence, perceived choice, or pressure/tension). The IMI was administered only to participants in the two intervention groups.
Time frame: 2nd, 5th and 8th week
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.