The pilates method and static body balance vs muscle strengthening with elastic bands and dynamic body balance in multiple sclerosis patients: a longitudinal study

Aim: The aim of this research was to investigate in subjects with multiple sclerosis whether the Pilates method of training associated with balance exercises, compared with elastic band exercises, walking exercises and education in step, can modify the following parameters: torso flexibility, body balance in an upright position, spine posture, gait cycle and the muscular strength of the lower limbs. Methods: 15 subjects with relapsing-remitting multiple sclerosis were recruited and divided into two groups, both having completed a series of twice-weekly training sessions over a period of four months. The PES (Pilates and static balance) group, composed of 8 subjects, performed an exercise programme consisting of the Pilates method and static balance training (weight 58±13 kg, age 45±11years, height 161±10 cm, EDSS 4,5±2). The TED (toning up and dynamic balance) group, composed of 7 subjects, performed an exercise programme consisting of muscle strengthening with elastic bands and dynamic body balance ( weight 62±17 kg, age 56±15 years, height 161±11 cm, edss 4,5±2). All participants were required to undertake these functional tests: postural stability (BTS. P-Walk®, Milano, Italia), forearm flexor strength (Baseline digital dynamometer), sit and reach test, spinal column morphology (Spinalmouse®, Idiag, Volketswil, Switzerland), sit to stand, gait analysis (BTS G-Walk®, Milano, Italia). Assessments were carried out after an exercise period of one month, during which the subjects learnt the exercise technique (T0), after two months (T1) and after another two months (T2). Results: The data showed the following results in the PES group Gait cycle (Anova p<0.05): Rhythm of Gait cycle (steps/min) T0 vs T2, Post hoc, p<0,05, -10%; T1 vs T2, Post hoc, p<0,05, -7%). Duration of Gait cycle (sec), T0 vs T2, Post hoc, p<0,05, +14%; T1 vs T2, Post hoc, p<0,05, +11%). In the sit and reach test: T0 vs T1, Anova p<0.05; Post hoc, p<0.05, +12%). In the sit to stand test (number of repetitions): T0 vs T2, Anova p<0.05; Post hoc, p<0.05, +12%). Furthermore, the contact time between repetitions decreased (T0 vs T2, Anova p<0.05; Post hoc, p<0.05, -14%). Conclusions: Adapted physical activity which combines the Pilates method with static balance exercises significantly increases lower limb strength, gait cycle and extension of muscles and tendons in the torso and in the hamstrings.