Effect of Pilates exercises on core muscle thickness, physical performance, and fatigue in patients with Parkinson’s disease: A randomized controlled trial

Year 2024, Volume: 11 Issue: 2, 71 - 80, 09.08.2024

Derya Çağlar , Arzu Güçlü Gündüz , Ahmet Tüfekçi , Mehmet Beyazal , Mustafa-umut Caglar , Sefa Eldemir

Abstract

Purpose: It was aimed to examine the effects of Pilates exercises on core muscle thickness, physical performance, fatigue, activities of daily living (ADL), and quality of life (QoL) in patients with Parkinson’s disease (PwPD).
Methods: This study was conducted with 34 patients randomly assigned to the Pilates or Control group (n=17 each). The Pilates group received Pilates training 3 days a week for 8 weeks, while the control group received breathing exercises, active range of motion exercises, and relaxation exercises as a home program. Core muscle thickness was evaluated by ultrasonography and core stability was evaluated by core strength and endurance tests. Lower extremity functional strength was evaluated with the 5 Times Sit-Up Test, balance with the Berg Balance Scale, functional mobility with the Timed Up and Go Test, and functional exercise capacity with the 6-Minute Walk Test. Fatigue was evaluated with the Parkinson's Fatigue Scale-16,.
Results: Transversus abdominus and multifidus muscle thicknesses (except for right side multifidus muscle), physical performance parameters, fatigue, ADL, and QoL improved in the Pilates group (p<0.05). In the control group, improvement was observed only in ADL (p<0.05).
Conclusion: Results show core muscle thickness as well as improved physical performance, fatigue, ADL, and QoL after Pilates in PwPD. As a result, core-based training, Pilates, may be used to train core muscles and improve functional results, fatigue, and daily activities.

Keywords

Parkinson, Pilates exercises, Abdominal muscles, Physical performance, Core stability

Ethical Statement

Ethical Statement: The study was approved by the Republic of Gazi University Faculty of Medicine Clinical Research Ethics Committee (No. 23, with the decision number 2019/10), and written informed consent was obtained from all patients participating in the study.

Supporting Institution

No

Thanks

No

Parkinson hastalarında Pilates egzersizlerinin core kas kalınlığı, fiziksel performans ve yorgunluk üzerine etkisi: Randomize kontrollü bir çalışma

Abstract

Amaç: Parkinson hastalığı (PH) olan hastalarda Pilates egzersizlerinin core kas kalınlığı, fiziksel performans, yorgunluk, günlük yaşam aktivitesi (GYA) ve yaşam kalitesi (YK) üzerindeki etkilerinin incelenmesi amaçlandı.
Yöntem: Bu çalışma, Pilates veya kontrol grubuna rastgele atanan 34 hasta (her biri n=17) ile gerçekleştirildi. Pilates grubuna 8 hafta boyunca haftada 3 gün Pilates eğitimi verilirken, kontrol grubuna ev programı olarak solunum egzersizleri, aktif eklem hareket açıklığı egzersizleri ve gevşeme egzersizleri verildi. Core kas kalınlığı ultrasonografi ile, core stabilitesi, core kuvvet ve dayanıklılık testleri ile değerlendirildi. Alt ekstremite fonksiyonel kuvveti 5 Kez Otur-Kalk Testi ile, denge Berg Denge Skalası ile, fonksiyonel mobilite Zamanlı Kalk ve Yürü Testi ile, fonksiyonel egzersiz kapasitesi ise 6 Dakika Yürüme Testi ile değerlendirildi. Yorgunluk, Parkinson Yorgunluk Ölçeği-16 ile değerlendirildi.
Bulgular: Pilates grubunda transversus abdominus ve multifidus kas kalınlıkları (sağ taraf multifidus kası hariç), fiziksel performans parametreleri, yorgunluk, GYA ve YK’de gelişme görüldü (p<0,05). Kontrol grubunda ise sadece GYA'da iyileşme görüldü (p<0,05).
Sonuç: Sonuçlar, PH’li bireylerde Pilates sonrası core kas kalınlığının yanı sıra fiziksel performans, yorgunluk, GYA ve YK'de iyileşme olduğunu göstermektedir. Sonuç olarak, core bölge antrenmanı olan Pilates, core bölge kaslarını eğitmek ve fonksiyonel sonuçları, yorgunluğu ve günlük aktiviteleri iyileştirmek için kullanılabilir.

Keywords

Parkinson hastalığı, Pilates egzersizleri, Abdominal kaslar, Fiziksel performans, Core stabilite

Ethical Statement

Etik Bildirim: Çalışma Gazi Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu tarafından (Karar numarası : 23, 2019/10) onaylandı ve çalışmaya katılan tüm hastalardan yazılı onam alındı.

Supporting Institution

Yok

Thanks

Yok

References

• Atroshi Alexander GE. Biology of Parkinson's disease: pathogenesis and pathophysiology of a multisystem neurodegenerative disorder. Dialogues Clin Neurosci. 2022;6:259-280.
• Tomlinson CL, Herd CP, Clarke CE, et al. Physiotherapy for Parkinson's disease: a comparison of techniques. Cochrane Database Syst Rev. 2014;6:CD002815-CD002815.
• Monticone M, Ambrosini E, Laurini A, et al. In‐patient multidisciplinary rehabilitation for Parkinson's disease: a randomized controlled trial. Mov Disord. 2015;30:1050-1058.
• Francardo V, Schmitz Y, Sulzer D, et al. Neuroprotection and neurorestoration as experimental therapeutics for Parkinson's disease. J Exp Neurol. 2017;298:137-147.
• Fisher BE, Li Q, Nacca A, et al. Treadmill exercise elevates striatal dopamine D2 receptor binding potential in patients with early Parkinson’s disease. Neuroreport. 2013;24:509-514.
• Feng Y-S, Yang S-D, Tan Z-X, et al. The benefits and mechanisms of exercise training for Parkinson's disease. Life Sci. 2020;245:117345.
• Combs SA, Diehl MD, Chrzastowski C, et al. Community-based group exercise for persons with Parkinson disease: a randomized controlled trial. NeuroRehabilitation. 2013;32:117-124.
• Pohl M, Mrass GJ, Oertel WH. Rehabilitation in Parkinson’s disease. Parkinson’s disease: the treatment options LeWitt P, Oertel W, eds. 1st ed. Martin Dunitz Ltd, London; 1999:215-228.
• Strojek K, Karpińska A, Piekorz Z, et al. Different forms movement therapy used in rehabilitation of Parkinson's disease. Health and Sport. 2018;8:290-298.
• Bulguroglu I, Guclu-Gunduz A, Yazici G, et al. The effects of Mat Pilates and Reformer Pilates in patients with Multiple Sclerosis: A randomized controlled study. NeuroRehabilitation. 2017;41:413-422.
• Deuel LM, Seeberger LC. Complementary therapies in Parkinson disease: a review of acupuncture, Tai Chi, Qi Gong, yoga, and cannabis. Neurotherapeutics. 2020;17:1434-1455.
• Josephs S, Pratt ML, Meadows EC, et al. The effectiveness of Pilates on balance and falls in community dwelling older adults. J Bodyw Mov Ther. 2016;20:815-823.
• Mollinedo-Cardalda I, Cancela-Carral JM, Vila-Suárez MH. Effect of a Mat Pilates Program with theraband on dynamic balance in patients with Parkinson's disease: feasibility study and randomized controlled trial. Rejuvenation Res. 2018;21:423-430.
• Pandya S, Nagendran T, Shah A, et al. Effect of Pilates training program on balance in participants with idiopathic Parkinson’s disease-An interventional study. Int J Heal Sci Res. 2017;7:186-196.
• Johnson L, Putrino D, James I, et al. The effects of a supervised Pilates training program on balance in Parkinson’s disease. Advances in Parkinson's disease. 2013;2:58-61.
• Daneshmandi H, Sayyar S, Bakhshayesh B. The effect of a selective Pilates program on functional balance and falling risk in patients with Parkinson’s disease. Zahedan J. Res. Med. Sci. 2017;19:7886.
• Cancela JM, Mollinedo Cardalda I, Ayán C, et al. Feasibility and efficacy of mat pilates on people with mild-to-moderate Parkinson's disease: A preliminary study. Rejuvenation Res. 2018;21:109-116.
• Suresh K. An overview of randomization techniques: an unbiased assessment of outcome in clinical research. J Hum Reprod Sci. 2011;4:8-11.
• Joyce AA, Kotler DH. Core training in low back disorders: role of the pilates method. Curr Sports Med Rep. 2017;16:156-161.
• Whittaker JL, Stokes M. Ultrasound imaging and muscle function. J Orthop Sports Phys Ther. 2011;41:572-580.
• Kim M-H, Oh J-S. Effects of performing an abdominal hollowing exercise on trunk muscle activity during curl-up exercise on an unstable surface. J Phys Ther Sci. 2015;27:501-503.
• Rayes ABR, de Lira CAB, Viana RB, et al. The effects of Pilates vs. aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional tasks outcomes for individuals who are overweight/obese: a clinical trial. PeerJ. 2019;7:6022.
• Özyürek S, Bayraktar D, Genç A. Are the alterations in body posture related to decreased trunk muscle endurance in healthy young adults? J Back Musculoskelet Rehabil. 2018;31:431-436.
• Zalleg D, Dhahbi AB, Dhahbi W, et al. Explosive push-ups: from popular simple exercises to valid tests for upper-body power. J Strength Cond Res. 2020;34:2877-2885.
• De Blaiser C, De Ridder R, Willems T, et al. Evaluating abdominal core muscle fatigue: Assessment of the validity and reliability of the prone bridging test. Scand J Med Sci Sports. 2018;28:391-399.
• Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's disease. Arch Phys Med Rehabil. 2011;92:1431-1436.
• Goodwin VA, Richards SH, Taylor RS, et al. The effectiveness of exercise interventions for people with Parkinson's disease: a systematic review and meta-analysis. Mov Disord. 2008;23:631-640.
• Podsiadlo D, Richardson S. The timed “Up and Go” test. Arch Phys Med Rehabil. 1989;67:387-389.
• Gibbons WJ, Fruchter N, Sloan S, et al. Reference values for a multiple repetition 6-minute walk test in healthy adults older than 20 years. J Cardiopulm Rehabil Prev. 2001;21:87-93.
• Fu R, Cui SS, Du JJ, et al. Validation of the Parkinson Fatigue Scale in Chinese Parkinson's disease patients. Brain Behav. 2017;7:00712.
• Çilga G, Genç A, Çolakoğlu BD, et al. Turkish adaptation of Parkinson fatigue scale and investigating its psychometric properties. Int J Rehabil Res. 2019;42:20-25.
• Opara J, Małecki A, Małecka E, et al. Motor assessment in Parkinsons disease. Ann Agric Environ Med. 2017;24:411-415.
• Akbostancı M, Balaban H, Atbaşoğlu C. Birleşik Parkinson Hastalığı Değerleme Ölçeği Motor Muayene Bölümü ve Anormal İstemsiz Hareketler Ölçeği’nin değerlendiriciler arası güvenilirlik çalışması. Parkinson Hastalığı ve Hareket Bozuklukları Dergisi. 2000;3:7-13.
• Jesus-Ribeiro J, Vieira E, Ferreira P, et al. Reliability and Validity of 39-Item Parkinson's Disease Questionnaire and Parkinson's Disease Quality of Life Questionnaire. Acta Med Port. 2017;30:395-401.
• Kayapınar T. Parkinson Hastalığı Yaşam Kalitesi Anketi (PDQ-39) Güvenirlik ve Geçerlilik Çalışması [Yüksek Lisans Tezi]. İstanbul: Haliç Üniversitesi; 2018.
• Batıbay S, Külcü DG, Kaleoğlu Ö, et al. Effect of Pilates mat exercise and home exercise programs on pain, functional level, and core muscle thickness in women with chronic low back pain. J Orthop Sci. 2021;26:979-985.
• Cruz-Díaz D, Bergamin M, Gobbo S, et al. Comparative effects of 12 weeks of equipment based and mat Pilates in patients with Chronic Low Back Pain on pain, function and transversus abdominis activation. A randomized controlled trial. Complement Ther Med. 2017;33:72-77.
• Rodríguez-Fuentes G, Silveira-Pereira L, Ferradáns-Rodríguez P, et al. Therapeutic Effects of the Pilates Method in Patients with Multiple Sclerosis: A Systematic Review. J Clin Med Res. 2022;11:683.
• Göz E, Özyürek S, Aktar B, et al. The effects of Pilates training on abdominal muscle thickness and core endurance in patients with Parkinson’s disease: a single-blind controlled clinical study. Turk J Med Sci. 2023;53:990-1000.
• Bliss LS, Teeple P. Core stability: the centerpiece of any training program. Curr Sports Med Rep. 2005;4:179-183.
• Herlofson K, Kluger BM. Fatigue in Parkinson's disease. J Neurol Sci. 2017;374:38-41.
• Ortiz-Rubio A, Cabrera-Martos I, Torres-Sánchez I, et al. Effects of a resistance training program on balance and fatigue perception in patients with Parkinson's disease: A randomized controlled trial. Med Clin. 2018;150:460-464.
• Lamotte G, Rafferty MR, Prodoehl J, et al. Effects of endurance exercise training on the motor and non-motor features of Parkinson's disease: a review. J Parkinsons Dis. 2015;5:21-41.