Perceived benefits, rationale and preferences of exercises utilized within Pilates group exercise programmes for people with chronic musculoskeletal conditions: A questionnaire of Pilates-trained physiotherapists

Introduction: An estimated 29% of the population, around 17.8 million people, live with a musculoskeletal condition in the UK. Pilates exercise has positive benefits, including reducing pain and disability for people with musculoskeletal conditions. The aim of the present study was to explore the views of Pilates-trained physiotherapists in relation to the perceived benefits of, and clinical reasoning for, exercise prescription in Pilates classes.

Methods: A qualitative approach was taken to both data collection and analysis, using a thematic framework. Data were collected via electronic questionnaires using open-ended questions. Participants included 15 Pilates-trained physiotherapists who regularly ran Pilates exercise classes within seven private physiotherapy clinics for people with a range of chronic musculoskeletal conditions.

Results: The results were organized into six main themes: Perceived benefits 1: Improved function and increased levels of activity. Perceived benefits 2: Improved ability to manage their musculoskeletal condition autonomously; Efficacy of group Pilates exercise; Optimum combination of exercises used within a class; Physiotherapist rationale for the most effective exercises; Precautions with specific exercises.

Conclusions: The study was the first to investigate perceived benefits, rationale and preference for choice of exercise among Pilates-trained physiotherapists. Physiotherapists felt that the Pilates classes facilitated an active lifestyle and self-management approach. They used a combination of exercises in each class to address all the main muscle groups, but some had specific exercise preferences related to the patients' needs. Exercises were linked to evidence around neuromuscular control, direction preference and biomechanical principles.