Core Stability, Postural Balance, and Flexibility in Healthy Women: A Comparative Study Between Pilates Practitioners and Sedentary Individuals

Overview

This study aims to compare core muscle stability, postural balance, and flexibility between healthy women who regularly practice Pilates and those with a sedentary lifestyle. The researcher will evaluate if long-term Pilates practice (5 months or more) leads to significant improvements in physical performance compared to a lack of regular exercise. Assessment tools include the Pressure Biofeedback Unit (PBU) for core activation, the McGill battery for endurance, the Y-Balance test for dynamic stability, and the Sit-and-Reach test for flexibility.

Detailed description

This cross-sectional comparative study involves 55 healthy female participants divided into two groups: a Pilates group (minimum 5 months of practice, twice weekly) and a sedentary control group (less than 150 minutes of physical activity per week). To ensure objectivity and high-quality data, an "Assessor Blinding" protocol will be implemented, where the investigator performing physical measurements remains unaware of the participants' group allocation.

Primary outcomes include:

1. Deep muscle stabilization measured via a Pressure Biofeedback Unit (PBU) in a prone position. 2. Core endurance assessed using the McGill Core Endurance Battery (Flexor, Extensor, and Side Bridge tests). 3. Dynamic postural balance evaluated through the Y-Balance Test (YBT) in anterior, posteromedial, and posterolateral directions. 4. Static balance measured by the Single Leg Stance Test (SLST) with eyes open and closed. 5. Hamstring and lower back flexibility assessed by the Sit and Reach Test. Statistical analysis will be performed using IBM SPSS version 26.0 to compare the outcomes between the two groups.

Primary outcome measures

• Deep Muscle Stabilization Pressure Biofeedback Device - PBU [Time frame: At the single assessment session (Day 1)]
• Core Muscle Endurance [Time frame: At the single assessment session (Day 1)]
• Dynamic Postural Balance Y-Balance Test (YBT) [Time frame: At the single assessment session (Day 1)]

Secondary outcome measures (2)

• Static Postural Balance Test or Single Leg Standing Test (SLST) [Time frame: At the single assessment session (Day 1)]
• Lower Back and Hamstring Flexibility [Time frame: At the single assessment session (Day 1)]

Eligibility criteria

Inclusion criteria

• Healthy female volunteers aged 20-45.
• For the Pilates group: having practiced mat Pilates, reformer Pilates, or any equipment-based Pilates discipline for at least 6 months; attending regular 60-minute sessions at least twice a week with a certified instructor.
• For the control group: having a sedentary lifestyle (weekly moderate physical activity time less than 150 minutes).
• Objectively demonstrating sedentary status using the International Physical Activity Questionnaire (IPAQ); only participants in the "low physical activity" category will be included in the control group.
• Having full cognitive ability to understand, follow, and execute all physical assessment instructions.
• Willingness to voluntarily sign the informed consent form prior to the study.

Exclusion criteria

• History of any surgery involving the spine, pelvis, or lower extremities within the last 12 months prior to the study.
• Currently pregnant or less than 6 months postpartum.
• Diagnosed vestibular disorders or chronic clinical balance disorders.
• History of neurological disease (MS, Parkinson's, etc.) or systemic metabolic disorder (diabetes, etc.).
• Having a pain intensity greater than 2/10 on the visual analog scale (VAS) in the lower back or lower extremities.
• Professional sports history or participation in other exercise programs exceeding 3 hours per week (excluding Pilates for the Pilates group).
• Acute musculoskeletal injuries or acute illnesses that may affect energy levels on the day of evaluation.
• Concurrent participation in other intensive core strengthening programs such as "advanced yoga" that may affect results.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Observational model

Case-control

Study locations

Turkey (Türkiye) · 1 center

• Istinye University, Topkapi Campus — Istanbul

Publications

• Alshehre Y, Alkhathami K, Brizzolara K, Weber M, Wang-Price S. Reliability and Validity of the Y-balance Test in Young Adults with Chronic Low Back Pain. Int J Sports Phys Ther. 2021 Jun 1;16(3):628-635. doi: 10.26603/001c.23430. PMID 34123515
• Fallahasady E, Rahmanloo N, Seidi F, Rajabi R, Bayattork M. The relationship between core muscle endurance and functional movement screen scores in females with lumbar hyperlordosis: a cross-sectional study. BMC Sports Sci Med Rehabil. 2022 Oct 13;14(1):182. doi: 10.1186/s13102-022-00567-2. PMID 36229857
• De Blaiser C, Roosen P, Willems T, De Bleecker C, Vermeulen S, Danneels L, De Ridder R. The role of core stability in the development of non-contact acute lower extremity injuries in an athletic population: A prospective study. Phys Ther Sport. 2021 Jan;47:165-172. doi: 10.1016/j.ptsp.2020.11.035. Epub 2020 Nov 30. PMID 33302113
• Wells C, Kolt GS, Bialocerkowski A. Defining Pilates exercise: a systematic review. Complement Ther Med. 2012 Aug;20(4):253-62. doi: 10.1016/j.ctim.2012.02.005. Epub 2012 Mar 13. PMID 22579438

Identifiers

NCT: NCT07578714 · 2026/53

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗