Research Impact: Therapeutic Viability of Pilates Training for Mental Health Among People With Multiple Sclerosis – Matthew P. Herring, PhD, FACSM

This past year, a series of studies, led by doctoral student, Karl Fleming, culminated in the strongest available evidence to support the therapeutic viability of Pilates, an understudied alternative exercise mode, for mental health, specifically anxiety, depression, and fatigue, among People with Multiple Sclerosis (PwMS).

This work logically progressed from their previous meta-analysis (Fleming & Herring, Comp Ther Med, 2018;37:80-95), showing Pilates-induced improvements of ~1-1.5 standard deviations in these mental health outcomes, and their feasibility pilot trial, which showed excellent retention and compliance, and moderate-to-large improvements in mental health outcomes for home-based Pilates compared to both supervised Pilates and wait-list control (Fleming, Coote & Herring, Psychol Sport Exerc, 2019;45:101573). A follow-up qualitative process evaluation, involving semi-structured interviews and thematic analysis, revealed the suitability of home-based Pilates for PwMS and benefits while participating, such that PwMS reported experiencing improved mood and indicated that home-based Pilates particularly reduced barriers regularly experienced in this population (Fleming, Herring, Coote & Tindall, Disabil Rehabil, 2021; doi: 10.1080/09638288.2021.1939446). Thus, an 8-week definitive randomized controlled trial was developed (Fleming, Coote & Herring, Ment Health Phys Act, 2020;100334) and conducted among 80 PwMS (69 females) randomized to twice-weekly home-based, DVD-guided Pilates or wait-list. Home-based Pilates significantly improved anxiety, depressive, and fatigue symptoms, including moderate-to-large, clinically meaningful improvements in depressive and fatigue symptoms (Fleming, Coote & Herring, Mult Scler J, 2021;27(14):2267-2279). Findings addressed the critical need to identify innovative, low-cost, and scalable strategies to improve exercise engagement and mental health among PwMS. Collectively, this series of studies quantitatively and qualitatively supported home-based Pilates as a safe, feasible, adaptable, and deliverable intervention to improve mental health among PwMS, including potentially clinically meaningful improvements in depression and fatigue. Findings support the potential inclusion of home-based Pilates in the recently proposed clinical toolkit of exercise options for clinicians treating PwMS.

Dr. Matthew Herring is the Course Director of the MSc Sport, Exercise and Performance Psychology & MSc Mental Skills and Mental Health in Sports and Exercise, in the Department of Physical Education & Sport Sciences, UL.

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