Mat Pilates Improves Pain, Functionality Among Older Women With Knee Osteoarthritis

older woman, home exercise, yoga, stretching
Deutschland, NRW, Köln, Frau entspannt in Altbauwohnung, Silver Surfer
Researchers evaluated the effects of mat Pilates on health status, pain, stiffness, and functionality among older adult women with knee osteoarthritis.

Mat Pilates improves functional capacity and general health and decreases pain among older adult women with knee osteoarthritis (OA), according to study findings published in Journal of Bodywork Movement and Therapies.

Women with knee OA aged between 60 and 70 years were randomly assigned into 2 groups: a mat-Pilates treatment group and a control group. The control group received no physical intervention or guidance. After 15 mat Pilates sessions, the researchers compared factors related to quality of life between the groups. These factors included pain, stiffness, functional capacity, and general health status. One patient in the treatment group failed to complete all 15 Pilates sessions.

An experienced physical therapist developed a 60-minute mat-Pilates protocol, which the treatment group performed twice weekly; each session occurred in the same period of the circadian cycle between 1pm and 3pm. The protocol focused on dynamic strengthening and endurance exercises for the gluteal muscles, quadriceps, and core “powerhouse” muscles. Each participant performed 5 to 20 repetitions as tolerated for 7 exercises, including straight leg raises, lateral leg raises, side kicks forward and backward, shoulder bridges, spinal twists, and prone “swimming.”

The researchers used patient questionnaires, including the 24-item Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the 36-item Short-Form Health Survey (SF-36), to evaluate pain, stiffness, functional capacity, and general health status.

Compared with the control group, the mat-Pilates group significantly improved their functional capacity and decreased their pain as evidenced by their SF-36 scores (P <.05) and WOMAC scores (P <.05). The mat-Pilates group achieved the minimal clinically important differences (MCIDs) of 15.5 points for the WOMAC total score, 7.15 points for general health status on the SF-36, and 8.19 points for bodily pain on the SF-36. Scores reflecting joint stiffness did not significantly change between the groups.

Limitations of the study included the fact that individuals in the control group had higher body mass indexes, which may have worsened their knee OA and limited their daily physical activity more, influencing the group results. Participants did not record medication usage, potentially leading to memory bias regarding pain levels. In addition, the results could not be generalized to men.

The study authors concluded, “The preliminary results…suggest that…mat Pilates…improves the health status, pain, and functionality of older adult women with [knee] OA, guiding the clinical practice and future studies with this population.”


Rêgo TAM, Ferreira AP de L, Villela DW, et al. Effects of mat Pilates on older adult women with knee osteoarthritis: A randomized controlled trial. J Bodyw Mov Ther. Published online April 15, 2022. doi:10.1016/j.jbmt.2022.02.007