Effect of Pilates on Glucose and Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Objective: The benefits of Pilates for blood glucose and lipids remain unclear. The purpose of this study was to examine the effect of Pilates on their levels.Methods: Searches were conducted in five databases to identify relevant articles published until October 29, 2020. Paired reviewers independently screened the articles and extracted data from each included study. Meta-analysis was performed to assess the effects of Pilates on blood glucose and lipids. Subgroup analyses and sensitivity analyses were conducted to explore heterogeneity.Results: According to the inclusion and exclusion criteria, 15 randomized controlled trials (RCTs) comprising 587 participants were included in the study. Overall, the Pilates group (PG) had a significantly greater reduction in post-prandial blood glucose than the control group (CG) (MD = −22.25 mg/dL, 95% CI: [−28.34, 16.17] mg/dL, P < 0.00001, I2 = 0%); glycated hemoglobin (HbA1c) (MD = −0.78%, 95% CI: [−1.13, −0.42]%, P < 0.0001, I2 = 88%); total cholesterol (TC) (MD = −20.90 mg/dL, 95% CI: [−37.21, −4.60] mg/dL, P = 0.01, I2 = 84%); triglycerides (TG) (MD = −12.59 mg/dL, 95% CI: [−19.88, −5.29] mg/dL, P = 0.0007, I2 = 86%); and low density lipoprotein cholesterol (LDL-C) (MD = −12.39 mg/dL, 95% CI: [−16.82, −7.95] mg/dL, P < 0.00001, I2 = 45%) compared to CG, whereas no significant difference was detected between the two groups in fasting blood glucose (MD = −7.04 mg/dL, 95% CI: [−17.26, 3.17] mg/dL, P = 0.18, I2 = 93%), insulin (MD = −1.44 μU/mL, 95% CI: [−4.30, 1.41] μU/mL, P = 0.32, I2 = 0%); and high density lipoprotein cholesterol (HDL-C) (MD = −2.68 mg/dL, 95% CI: [−9.03, 3.67] mg/dL, P = 0.41, I2 = 89%). However, by subgroup analysis, we found that compared to the CG, PG showed no significant improvement in blood glucose and lipids levels for non-diabetics, while it presented a significantly greater decrease in post-prandial blood glucose, TC, TG, and LDL-C for diabetic patients. Notably, for diabetic patients, Pilates and medication treatments showed no significant reduction in fasting blood glucose (MD = −7.00 mg/dL, 95% CI: [−26.06, 12.06] mg/dL, P = 0.40) and HbA1c (MD = −0.23%, 95% CI: [−0.58, 0.13]%, P = 0.21, I2 = 0%) than medications treatment used alone, and Pilates combined with medications and dietary treatments presented no significant improvement in fasting blood glucose than a combination of medications and dietary treatments (MD = −10.90 mg/dL, 95% CI: [−32.35, 10.54] mg/dL, P = 0.32, I2 = 94%).Conclusions: Overall, Pilates could improve post-prandial blood glucose, fasting blood glucose, HbA1c, TG, TC, and LDL-C for diabetic patients, which could be influenced by its duration and intensity. Moreover, it had no significant effect on blood glucose and lipids for non-diabetic individuals. However, Pilates, as an adjunctive treatment to medications was not superior to medications used alone in lowering fasting blood glucose and HbA1c. Furthermore, Pilates combined with medications and dietary treatments showed no significant improvement in fasting blood glucose, whereas it had a greater reduction in post-prandial blood glucose and HbA1c for diabetic patients.Systematic Review Registration:https://osf.io/xgv6w.

Electroacupuncture for Gastrointestinal Function Recovery after Gynecological Surgery: A Systematic Review and Meta-Analysis

“…All the corresponding meta-analysis results were illustrated by the forest map intuitively. Cochran's Q -test and I 2 index were employed to estimate heterogeneity [ 19 ], and I 2 statistic greater than 50% was considered as substantially heterogeneous. When a substantially heterogeneous was observed, subgroups analysis or sensitivity analyses were used to determine the risk factor resulted in the high heterogeneity.…”

“…Grading of recommendations, assessment, development, and evaluation (GRADE) approach was utilized to evaluate the quality of evidence [ 20 ]. In addition, publication bias was assessed by Begg's and Egger's tests [ 19 ], and the visual inspection of funnel plots would be applied if the index was reported in more than 10 included studies. The significant difference level was set at P < 0.05.…”

Psychophysiological Adaptations to Pilates Training in Overweight and Obese Individuals: A Topical Review

“…MHR: maximum heart rate; RPE: rating of perceived exertion. [ 32 , 33 , 34 , 35 , 36 , 38 , 39 , 52 ].…”

“…Therefore, Pilates training has been defined as a therapeutic or preventive exercise intervention [ 29 ]. On the other hand, only few studies investigated the role of Pilates training in cardiorespiratory fitness [ 34 ], body composition [ 35 , 36 ], and cardiometabolic [ 37 , 38 ] and mental health [ 39 ] in various populations. It is worth noticing that Pilates training mainly attracts physically inactive, middle-aged women who are primarily interested in improving physical fitness (e.g., body posture and flexibility) and secondarily in rehabilitation (e.g., pain and disability reduction) while demonstrating some pain or musculoskeletal discomfort [ 40 ].…”

“…Interestingly, recent studies indicate inconsistent results without a clear consensus [ 48 , 49 , 50 ], and comparative studies are scarce [ 51 , 52 ]. Figure 1 summarizes the effects of Pilates training on cardiometabolic health, physical performance, and well-being in several populations [ 32 , 33 , 34 , 35 , 36 , 38 , 39 , 52 ].…”