Pilates for people with multiple sclerosis who use a wheelchair: feasibility, efficacy and participant experiences

Abstract

Purpose: This mixed methods study aimed to explore the feasibility, efficacy and the participants’ experiences of a Pilates programme for people with Multiple Sclerosis (pwMS) who use a wheelchair. Method: Fifteen pwMS took part in the 12-week Pilates programme. At baseline and after 6 and 12 weeks of the programme, sitting stability, measured as maximum progression of the Centre of Pressure when leaning sideways (COPmax), posture, pain on a Visual Analogue Scale, function, fatigue and the impact of MS (MSIS29) were assessed. Ten participants took part in two focus groups within six weeks of the completion of the programme. Results: Significant improvements at the 12-week assessment were found in COPmax (p = 0.046), sitting posture (p = 0.004), pain in the shoulders (p = 0.005) and back (p = 0.005) and MSIS29 (p = 0.006). The majority of participants described various physical, functional, psychological and social benefits from participation that reflected increased confidence in activities of daily living. Enjoyment of the classes was expressed by all, and most wished to continue participation. Conclusions: Pilates appears to be efficacious in improving sitting stability and posture and decreasing pain and was also well tolerated by wheelchair users with MS. Further mixed methods studies are warranted.

Implications for Rehabilitation

• Group-based core stability exercise or Pilates for people with MS who use wheelchair is a feasible and safe way of exercising for this patient group.

• Pilates exercises for people moderately to severely affected by MS resulted in a decrease in back and shoulder pain and improvement in sitting balance.

• Future appropriately powered randomised controlled studies into Pilates for people with MS reliant on wheelchair are warranted.

• Exercise
• multiple sclerosis
• pilot study
• postural stability
• wheelchair

Acknowledgements

We wish to thank Claudia Galante for her assistance in moderating the focus group and for verification of the thematic analysis and Jane Christie who was the Pilates Instructor for this trial, for her comments on the manuscript regarding the Pilates class content.