Abstract
Background: Stroke remains a major cause of adult disability, often resulting in deficits in core stability, balance, and functional mobility, which hinder independence and daily functioning. Pilates-based rehabilitation, which focuses on controlled movement, breathing, and trunk stabilization, has gained interest as a neuromotor training method to enhance postural control and recovery after stroke.
Objective: To conduct a critical review and assessment of the existing evidence regarding the effectiveness of Pilates-based training in enhancing core stability, balance, and functional mobility in individuals who have experienced a stroke.
Methods: A literature search was conducted using PubMed, Scopus, ResearchGate, and Google Scholar for studies published between 2016 and 2025. Studies investigating Pilates interventions in post-stroke populations with measurable outcomes on balance, mobility, and core strength were included. Ten studies met the inclusion criteria: three systematic reviews, five randomized controlled trials (RCTs), one pilot study, and one case study. The methodological quality was assessed using the Center for Evidence-Based Medicine (CEBM) levels of evidence, ranging from 1a to 4.
Results: Most RCTs and systematic reviews demonstrated significant improvements in balance (Berg Balance Scale, Functional Reach Test), functional mobility (Timed Up and Go, 10-Meter Walk Test, Functional Independence Measure), and core stability (Trunk Impairment Scale, core endurance tests) after Pilates interventions. The duration of the interventions ranged from 4 to 12 weeks, with 2–3 sessions per week. Pilates was found to be equally or more effective than conventional balance or strength training in improving postural control and functional outcomes in older adults. However, variability in exercise protocols, small sample sizes, and lack of long-term follow-up limit the generalizability of the findings.
Conclusion: Evidence suggests that Pilates-based training is an effective and safe adjunct to conventional physiotherapy for improving core stability, balance, and functional mobility in stroke patients. While existing RCTs and reviews show promising results, future large-scale, high-quality randomized trials with standardized Pilates protocols and long-term follow-ups are recommended to establish clinical guidelines and confirm sustained benefits.