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The effects of pilates exercise on depression and sleep quality in adults: A systematic review and meta-analysis of randomized controlled trials

Yiwei Huang, Yuanhang Sun, Xiangyang Sun, Seongno Lee

Article ID: 3174
Vol 9, Issue 12, 2024, Article identifier:

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Abstract

Background: In recent years, Pilates has become widely popular due to its distinctive training methods, drawing substantial public interest. Studies have shown that Pilates positively influences the alleviation of depressive symptoms and the enhancement of sleep quality among adults. Yet, there has been no systematic review of these findings. Thus, this research aims to assess the effects of Pilates on adult depression and sleep quality through a comprehensive review and meta-analysis, aiming to underpin exercise prescription with solid evidence. Methods: We conducted a thorough search across five databases (PubMed, Web of Science, Scopus, Embase, and Cochrane Library) for randomized controlled trials (RCTs) that examine the impacts of Pilates on adult depression and sleep quality, including studies up to September 2024. The primary endpoints were changes in depression symptoms and sleep quality. We used Review Manager 5.4 and Stata 18 for statistical analysis, calculating effect sizes with standardized mean differences (SMD) and standard deviations (SD), with confidence intervals set at 95%. The quality of included studies was assessed using the Cochrane risk assessment tool. Results: This review included 19 studies with a total of 876 participants. All studies were deemed low risk. The meta-analysis demonstrated that Pilates training significantly reduces depression symptoms (SMD = -0.77; 95% CI: [-1.00, -0.53]; P<0.01) and improves sleep quality (SMD = -0.46; 95% CI: [-0.78, -0.14]; P<0.01).


Keywords

Pilates; Adults; Depression; Sleep Quality; Meta-analysis

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References

1. World Health Organization. (2023). Depressive Disorder (Depression) World Health Organization. Geneva, Switzerland.URL: https://www.who.int/news-room/fact-sheets/detail/depression

2. American Psychiatric Association. (2015). The American Psychiatric Association practice guidelines for the psychiatric evaluation of adults. American Psychiatric Pub.

3. Ferrari, A. J., Somerville, A. J., Baxter, A. J., Norman, R., Patten, S. B., Vos, T., & Whiteford, H. (2013). Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature. Psychological medicine, 43(3), 471-481.

4. Mangione, C. M., Barry, M. J., Nicholson, W. K., Cabana, M., Chelmow, D., Coker, T. R., ... & US Preventive Services Task Force. (2022). Screening for depression and suicide risk in children and adolescents: US preventive services task force recommendation statement. Jama, 328(15), 1534-1542.

5. Li, W., Liu, Y., Deng, J., & Wang, T. (2024). Influence of aerobic exercise on depression in young people: a meta-analysis. BMC psychiatry, 24(1), 1-14.

6. Scott, A. J., Webb, T. L., Martyn-St James, M., Rowse, G., & Weich, S. (2021). Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep medicine reviews, 60, 101556.

7. Kulchycki, M., Halder, H. R., Askin, N., Rabbani, R., Schulte, F., Jeyaraman, M. M., ... & Oberoi, S. (2024). Aerobic Physical Activity and Depression Among Patients With Cancer: A Systematic Review and Meta-Analysis. JAMA Network Open, 7(10), e2437964-e2437964.

8. Fleming, K. M., Coote, S. B., & Herring, M. P. (2019). The feasibility of Pilates to improve symptoms of anxiety, depression, and fatigue among people with Multiple Sclerosis: An eight-week randomized controlled pilot trial. Psychology of Sport and Exercise, 45, 101573.

9. World Health Organization. (2022). World mental health report: Transforming mental health for all. World Health Organization.

10. Riemann, D., Nissen, C., Palagini, L., Otte, A., Perlis, M. L., & Spiegelhalder, K. (2015). The neurobiology, investigation, and treatment of chronic insomnia. The Lancet Neurology, 14(5), 547-558.

11. Taylor, D. J., Lichstein, K. L., Durrence, H. H., Reidel, B. W., & Bush, A. J. (2005). Epidemiology of insomnia, depression, and anxiety. Sleep, 28(11), 1457-1464.

12. Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., ... & Riemann, D. (2011). Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. Journal of affective disorders, 135(1-3), 10-19.

13. Malhi, G. S., Bell, E., Bassett, D., Boyce, P., Bryant, R., Hazell, P., ... & Murray, G. (2021). The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Australian & New Zealand Journal of Psychiatry, 55(1), 7-117.

14. Cuijpers, P., Oud, M., Karyotaki, E., Noma, H., Quero, S., Cipriani, A., ... & Furukawa, T. A. (2021). Psychologic treatment of depression compared with pharmacotherapy and combined treatment in primary care: a network meta-analysis. The Annals of Family Medicine, 19(3), 262-270.

15. Pigott, H. E. (2015). The STAR* D trial: it is time to reexamine the clinical beliefs that guide the treatment of major depression. The Canadian Journal of Psychiatry, 60(1), 9-13.

16. Braund, T. A., Tillman, G., Palmer, D. M., Gordon, E., Rush, A. J., & Harris, A. W. (2021). Antidepressant side effects and their impact on treatment outcome in people with major depressive disorder: an iSPOT-D report. Translational psychiatry, 11(1), 417.

17. Kishi, T., Ikuta, T., Sakuma, K., Okuya, M., Hatano, M., Matsuda, Y., & Iwata, N. (2023). Antidepressants for the treatment of adults with major depressive disorder in the maintenance phase: a systematic review and network meta-analysis. Molecular Psychiatry, 28(1), 402-409.

18. Ionescu, D. F., Rosenbaum, J. F., & Alpert, J. E. (2015). Pharmacological approaches to the challenge of treatment-resistant depression. Dialogues in clinical neuroscience, 17(2), 111-126.

19. Thornicroft, G., Chatterji, S., Evans-Lacko, S., Gruber, M., Sampson, N., Aguilar-Gaxiola, S., ... & Kessler, R. C. (2017). Undertreatment of people with major depressive disorder in 21 countries. The British Journal of Psychiatry, 210(2), 119-124.

20. Tian, S., Liang, Z., Qui, F., Yu, Y., Wang, C., Zhang, M., & Wang, X. (2024). Optimal exercise modality and dose to improve depressive symptoms in adults with major depressive disorder: A Systematic Review and Bayesian Model-Based Network Meta-Analysis of RCTs. Journal of Psychiatric Research.

21. Evans-Lacko, S. A. G. S., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Benjet, C., Bruffaerts, R., ... & Thornicroft, G. (2018). Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys. Psychological medicine, 48(9), 1560-1571.

22. De Crescenzo, F., D'Alò, G. L., Ostinelli, E. G., Ciabattini, M., Di Franco, V., Watanabe, N., ... & Cipriani, A. (2022). Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis. The Lancet, 400(10347), 170-184.

23. Riemann, D., Espie, C. A., Altena, E., Arnardottir, E. S., Baglioni, C., Bassetti, C. L., ... & Spiegelhalder, K. (2023). The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023. Journal of sleep research, 32(6), e14035.

24. Ma, Y., Hall, D. L., Ngo, L. H., Liu, Q., Bain, P. A., & Yeh, G. Y. (2021). Efficacy of cognitive behavioral therapy for insomnia in breast cancer: a meta-analysis. Sleep medicine reviews, 55, 101376.

25. Reynolds, A. C., Sweetman, A., Crowther, M. E., Paterson, J. L., Scott, H., Lechat, B., ... & Eastwood, P. R. (2023). Is cognitive behavioral therapy for insomnia (CBTi) efficacious for treating insomnia symptoms in shift workers? A systematic review and meta-analysis. Sleep medicine reviews, 67, 101716.

26. Krystal, A. D. (2004). The changing perspective on chronic insomnia management. Journal of Clinical Psychiatry, 65(8), 20-25.

27. Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of clinical sleep medicine, 13(2), 307-349.

28. Wilson, S. J., Nutt, D. J., Alford, C., Argyropoulos, S. V., Baldwin, D. S., Bateson, A. N., ... & Wade, A. G. (2010). British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders. Journal of psychopharmacology, 24(11), 1577-1601.

29. Zhao, N., Lund, H. N., & Jespersen, K. V. (2024). A systematic review and meta-analysis of music interventions to improve sleep in adults with mental health problems. European Psychiatry, 67(1), e62.

30. Han, B., Duan, Y., Zhang, P., Zeng, L., Pi, P., Chen, J., & Du, G. (2024). Effects of exercise on depression and anxiety in postmenopausal women: a pairwise and network meta-analysis of randomized controlled trials. BMC public health, 24(1), 1816.

31. Léger, D., Poursain, B., Neubauer, D., & Uchiyama, M. (2008). An international survey of sleeping problems in the general population. Current medical research and opinion, 24(1), 307-317.

32. World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. World Health Organization.

33. Driver, H. S., & Taylor, S. R. (2000). Exercise and sleep. Sleep medicine reviews, 4(4), 387-402.

34. Noetel, M., Sanders, T., Gallardo-Gómez, D., Taylor, P., del Pozo Cruz, B., Van Den Hoek, D., ... & Lonsdale, C. (2024). Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. bmj, 384.

35. Ashrafinia, F., Mirmohammadali, M., Rajabi, H., Kazemnejad, A., SadeghniiatHaghighi, K., Amelvalizadeh, M., & Chen, H. (2014). The effects of Pilates exercise on sleep quality in postpartum women. Journal of bodywork and movement therapies, 18(2), 190-199.

36. A'Naja, M. N., Reed, R., Sansone, J., Batrakoulis, A., McAvoy, C., & Parrott, M. W. (2024). 2024 ACSM worldwide fitness trends: future directions of the health and fitness industry. ACSM's Health & Fitness Journal, 28(1), 14-26.

37. A'Naja, M. N., Batrakoulis, A., Camhi, S. M., McAvoy, C., Sansone, J. S., Reed, R., ... & ALVURDU, S. (2024). 2025 ACSM Worldwide Fitness Trends: Future Directions of the Health and Fitness Industry. ACSM's Health & Fitness Journal, 28(6), 11-25.

38. Xu, H., Liu, J., Li, P., & Liang, Y. (2024). Effects of mind-body exercise on perimenopausal and postmenopausal women: a systematic review and meta-analysis. Menopause, 31(5), 457-467.

39. Xie, W., Lu, D., Liu, S., Li, J., & Li, R. (2024). The optimal exercise intervention for sleep quality in adults: A systematic review and network meta-analysis. Preventive Medicine, 107955.

40. Bullock, A., Kovacevic, A., Kuhn, T., & Heisz, J. J. (2020). Optimizing sleep in older adults: Where does high-intensity interval training fit?. Frontiers in psychology, 11, 576316.

41. Vancini, R. L., Rayes, A. B. R., Lira, C. A. B. D., Sarro, K. J., & Andrade, M. S. (2017). Pilates and aerobic training improve levels of depression, anxiety and quality of life in overweight and obese individuals. Arquivos de neuro-psiquiatria, 75, 850-857.

42. Ju, M., Zhang, Z., Tao, X., Lin, Y., Gao, L., & Yu, W. (2023). The impact of Pilates exercise for depression symptoms in female patients: A systematic review and meta-analysis. Medicine, 102(41), e35419.

43. Latey, P. (2001). The Pilates method: history and philosophy. Journal of bodywork and movement therapies, 5(4), 275-282.

44. Casonatto, J., & Yamacita, C. M. (2020). Pilates exercise and postural balance in older adults: A systematic review and meta-analysis of randomized controlled trials. Complementary therapies in medicine, 48, 102232.

45. Caetano, M. B. D., Fantinati, A. M. M., de Morais, E. R., de Oliveira, L. C., Durigan, J. L. Q., & Garcia, P. A. (2024). Is high-volume pilates training better to improve physical-functional performance in community-dwelling older adults? A randomized and controlled clinical trial. Journal of Bodywork and Movement Therapies, 39, 645-653.

46. Bergamin, M., Gobbo, S., Bullo, V., Zanotto, T., Vendramin, B., Duregon, F., ... & Ermolao, A. (2015). Effects of a Pilates exercise program on muscle strength, postural control and body composition: results from a pilot study in a group of post-menopausal women. Age, 37, 1-8.

47. Kioumourtzoglou, E., Derri, V., Mertzanidou, O., & Tzetzis, G. (1997). Experience with perceptual and motor skills in rhythmic gymnastics. Perceptual and motor skills, 84(3_suppl), 1363-1372.

48. Caldwell, K., Harrison, M., Adams, M., & Triplett, N. T. (2009). Effect of Pilates and taiji quan training on self-efficacy, sleep quality, mood, and physical performance of college students. Journal of bodywork and movement therapies, 13(2), 155-163.

49. Bernardo, L. M. (2007). The effectiveness of Pilates training in healthy adults: An appraisal of the research literature. Journal of bodywork and movement therapies, 11(2), 106-110.

50. Curi, V. S., Vilaça, J., Haas, A. N., & Fernandes, H. M. (2018). Effects of 16-weeks of Pilates on health perception and sleep quality among elderly women. Archives of Gerontology and Geriatrics, 74, 118-122.

51. Aibar-Almazán, A., Hita-Contreras, F., Cruz-Díaz, D., de la Torre-Cruz, M., Jiménez-García, J. D., & Martínez-Amat, A. (2019). Effects of Pilates training on sleep quality, anxiety, depression and fatigue in postmenopausal women: A randomized controlled trial. Maturitas, 124, 62-67.

52. Fleming, K. M., Coote, S. B., & Herring, M. P. (2021). Home-based Pilates for symptoms of anxiety, depression and fatigue among persons with multiple sclerosis: An 8-week randomized controlled trial. Multiple Sclerosis Journal, 27(14), 2267-2279.

53. Ashrafinia, F., Mirmohammadali, M., Rajabi, H., Kazemnejad, A., SadeghniiatHaghighi, K., Amelvalizadeh, M., & Chen, H. (2014). The effects of Pilates exercise on sleep quality in postpartum women. Journal of bodywork and movement therapies, 18(2), 190-199.

54. Yucel, H., & Uysal, O. (2016). Pilates-based mat exercises and parameters of quality of life in women with Type 2 diabetes. Iran Red Crescent Med J, 18(3), e21919.

55. Chen, Z., Ye, X., Shen, Z., Chen, G., Chen, W., He, T., & Xu, X. (2020). Effect of pilates on sleep quality: a systematic review and meta-analysis of randomized controlled trials. Frontiers in neurology, 11, 158.

56. Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Prisma Group. (2010). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. International journal of surgery, 8(5), 336-341.

57. Bennett, M. M., Crowe, B. J., Price, K. L., Stamey, J. D., & Seaman Jr, J. W. (2013). Comparison of Bayesian and frequentist meta-analytical approaches for analyzing time to event data. Journal of Biopharmaceutical Statistics, 23(1), 129-145.

58. Wan, X., Wang, W., Liu, J., & Tong, T. (2014). Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC medical research methodology, 14, 1-13.

59. Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. Bmj, 327(7414), 557-560.

60. Tao, Y., Lu, J., Lv, J., & Zhang, L. (2024). Effects of high-intensity interval training on depressive symptoms: A systematic review and meta-analysis. Journal of Psychosomatic Research, 111652.

61. Fleming, K. M., & Herring, M. P. (2018). The effects of pilates on mental health outcomes: A meta-analysis of controlled trials. Complementary therapies in medicine, 37, 80-95.

62. Saltan, A., & Ankaralı, H. (2021). Does Pilates effect on depression status, pain, functionality, and quality of life in university students? A randomized controlled study. Perspectives in psychiatric care, 57(1), 198-205.

63. Akbaş, E., Erdem, E. U., Guneş, E., Özkan, T. D., & Kinikli, G. İ. (2022). Effects of pilates-based exercises on functional capacity and mental health in individuals with schizophrenia: a pilot study. Physiotherapy theory and practice, 38(13), 2462-2470.

64. Eyigor, S., Karapolat, H., Yesil, H., Uslu, R., & Durmaz, B. (2010). Effects of pilates exercises on functional capacity, flexibility, fatigue, depression and quality of life in female breast cancer patients: a randomized controlled study. Eur J Phys Rehabil Med, 46(4), 481-7.

65. Nieto, M. M., Guen, S. L. E., Kieffer, B. L., Roques, B. P., & Noble, F. (2005). Physiological control of emotion-related behaviors by endogenous enkephalins involves essentially the delta opioid receptors. Neuroscience, 135(2), 305-313.

66. Crain, S., Crain, M. A., & Crain, S. M. (2013). Emotional and physical distress relief using a novel endorphinergic formulation. Journal of Behavioral and Brain Science, 2013.

67. Goldfarb, A. H. (2013). Exercise and endogenous opiates. In Endocrinology of Physical Activity and Sport: Second Edition (pp. 21-36). Totowa, NJ: Humana Press.

68. Spira, A. P., & Gottesman, R. F. (2017). Sleep disturbance: an emerging opportunity for Alzheimer's disease prevention?. International psychogeriatrics, 29(4), 529-531.

69. Makhfudli, M., Tonapa, S. I., Has, E. M., Chan, C. M., & Efendi, F. (2024). Efficacy of mind-body exercise to reduce sleep disturbance and depression among older adults: A systematic review and meta-analysis. Asian Nursing Research.

70. Persaki, D. G., Nieri, A., Apostolidis, N. G., Konstantinou, E., & Myrianthefs, P. (2024). The Effect of Pilates on Quality of Sleep, Aerobic Capacity and Anaerobic Power in Premenopausal Women. Sleep Science, 17(01), e75-e81.

71. Cabiddu, R., Cerutti, S., Viardot, G., Werner, S., & Bianchi, A. M. (2012). Modulation of the sympatho-vagal balance during sleep: frequency domain study of heart rate variability and respiration. Frontiers in physiology, 3, 45.

72. Mahalakshmi, B., Maurya, N., Lee, S. D., & Bharath Kumar, V. (2020). Possible neuroprotective mechanisms of physical exercise in neurodegeneration. International journal of molecular sciences, 21(16), 5895.

73. Zappella, M., Biamonte, F., Balzamino, B. O., Manieri, R., Cortes, M., Santucci, D., ... & Micera, A. (2021). Relaxation response in stressed volunteers: psychometric tests and neurotrophin changes in biological fluids. Frontiers in Psychiatry, 12, 655453.

74. Aoyama, S., & Shibata, S. (2017). The role of circadian rhythms in muscular and osseous physiology and their regulation by nutrition and exercise. Frontiers in neuroscience, 11, 63.

75. Aritake-Okada, S., Tanabe, K., Mochizuki, Y., Ochiai, R., Hibi, M., Kozuma, K., ... & Uchida, S. (2019). Diurnal repeated exercise promotes slow-wave activity and fast-sigma power during sleep with increase in body temperature: a human crossover trial. Journal of applied physiology, 127(1), 168-177.

76. Hower, I. M., Harper, S. A., & Buford, T. W. (2018). Circadian rhythms, exercise, and cardiovascular health. Journal of circadian rhythms, 16.

77. Nagendra, R. P., Maruthai, N., & Kutty, B. M. (2012). Meditation and its regulatory role on sleep. Frontiers in neurology, 3, 54.


DOI: https://doi.org/10.59429/esp.v9i12.3174
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