The Effect of Reformer Pilates on Functional Capacity, Balance, and Quality of Life in Sedentary Women

In the modern world, technological advances and evolving lifestyles have led to a significant global public health concern: the sedentary lifestyle. Sedentary behavior is defined by low energy expenditure ($\\le 1.5$ METs) during activities like sitting or lying down. This trend contributes to the rise of chronic diseases, including cardiovascular conditions, Type 2 diabetes, and musculoskeletal disorders, placing a substantial burden on health systems.Women are particularly vulnerable to decreased physical activity due to physiological factors (e.g., pregnancy, menopause) and sociocultural aspects. This physical inactivity is linked to reduced muscle mass, bone density, poor functional capacity, and increased risk of falls. Furthermore, sedentary behaviors adversely affect psychosocial well-being, contributing to increased depression, anxiety, and a reduced overall quality of life.The Reformer Pilates method, based on principles such as core stabilization, control, and breathing, is a comprehensive exercise approach aimed at improving strength, flexibility, posture, and balance. The Reformer apparatus, with its springs and movable carriage, provides adjustable resistance and support, making it an efficient and safe exercise option, particularly for sedentary individuals. While existing literature supports the benefits of Pilates, there is a distinct gap regarding the combined effects of Reformer Pilates (not Mat Pilates) on the crucial parameters of functional capacity, balance, muscular endurance, and quality of life within the sedentary female population, using a high-evidence-level randomized controlled trial (RCT) design. This study aims to address this critical scientific gap.STUDY OBJECTIVE AND DESIGNThe primary objective of this study is to evaluate the effect of an 8-week Reformer Pilates exercise program on the levels of functional capacity, balance, muscular endurance, and quality of life in sedentary women, compared to a control group.This investigation is designed as a Randomized Controlled Trial (RCT). A total of 57 sedentary women were randomly assigned to either the Intervention Group (N=30) or the Control Group (N=27).INTERVENTION PROTOCOLIntervention Group: Participants in this group underwent an 8-week Reformer Pilates exercise program. The program involved 2 sessions per week, with each session lasting 50 minutes. All sessions were administered by the same physical therapist at a dedicated center (FLC Konsept Sağlıklı Yaşam Merkezi). The exercise protocol was standardized but personalized: the spring resistance on the Reformer apparatus was adjusted based on the individual participant's physical condition and tolerance to maximize efficiency and safety.Control Group: Participants in this group maintained their usual lifestyle and daily routine throughout the 8-week study period, without receiving any structured exercise intervention.OUTCOME MEASURESAll participants underwent comprehensive assessments at baseline and at the end of the 8-week intervention period. Measurements were taken by the same blinded physical therapist to ensure reliability and minimize bias.The primary outcome and secondary outcomes are defined as follows:Functional Capacity: Measured using the 1-Minute Sit-to-Stand Test.Balance: Measured using the Functional Reach Test.Muscular Endurance: Measured using the 30-Second Push-Up Test and the 30-Second Sit-Up Test.Quality of Life: Measured using the Short Form-36 Health Survey (SF-36) scale.

Inclusion criteria

• Female gender.
• Meeting the definition of sedentary (no participation in any regular exercise program within the last 6 months).
• Having sufficient ability to understand and comply with the study procedures.
• No physical or mental condition that would hinder safe participation in the study.
• Voluntarily agreeing to participate in the study and signing the informed consent form.

Exclusion criteria

• Presence of any neurological disorder that prevents safe exercise participation.
• Having an active sports life or currently participating in regular sports activities.
• Presence of cardiovascular, pulmonary, or serious orthopedic problems that contraindicate exercise (e.g., medical restriction by a physician).
• Being pregnant or breastfeeding.
• Presence of any acute pain or inflammatory condition.
• Having a known contraindication for Pilates exercises.