Investigating the Effects of Pilates Exercises on Gait Parameters in Pregnant Women: a Randomized Controlled Trial

Pregnancy is a physiological process that begins with fertilization and lasts until birth. The pregnancy period typically spans approximately 40 weeks and is divided into three trimesters, each lasting three months. During this process, various critical anatomical, physiological, psychological, and social changes occur in the mother to meet fetal and maternal needs. If the mother's body cannot adequately adapt to these changes, potential health issues that may arise could threaten the health of both mother and fetus.

Pregnancy is a substantial load on the human body, particularly the musculoskeletal system. Pregnancy-related changes in the center of gravity create mechanical stress on the body, accompanied by hormonal changes, increased joint laxity, body weight gain, postural changes, and alterations in the abdominal and pelvic regions. These changes may contribute to postural adaptations, dysfunctions in the lumbar and pelvic regions, and weakening of abdominal muscles.

Regular physical activity significantly benefits pregnant women classified as low-risk with no medical or obstetric complications. Therefore, increasing physical activity levels and regular exercise during pregnancy are recommended in guidelines from the American College of Obstetricians and Gynecologists on physical activity and exercise during pregnancy and the postpartum period. The benefits of regular physical activity and exercise during pregnancy include maintaining and improving physical fitness, preventing excessive gestational weight gain, reducing the risk of preeclampsia and preterm birth, lowering the prevalence of back pain, improving sleep quality, reducing anxiety and depressive symptoms, and enhancing health perception and body image. Based on the results of systematic reviews, regular physical activity and exercise during pregnancy are known to reduce the risk of GDM by 38%, preeclampsia by 41%, gestational hypertension by 39%, macrosomia by 39%, and prenatal depression by 67%. Because of these beneficial effects, it is recommended that pregnant women engage in moderate-intensity aerobic exercise for at least 30 minutes a day, five days a week. However, only about 15% of pregnant women meet the minimum physical activity recommendations (at least 150 minutes of moderate-intensity physical activity per week).

Pilates is an exercise method developed by Joseph Hubertus Pilates that activates all muscular functions of the body, particularly core muscles, increases the endurance, flexibility, and strength of body muscles, and improves balance systems while also enhancing dynamic postural control. Joseph Pilates developed over 600 exercises suitable for all levels and types, with the primary goal of strengthening the core muscles, also known as the "powerhouse" in Pilates, which includes the multifidus, transversus abdominis, pelvic floor, and diaphragm muscles. His aim was to enhance stabilization and distribute the strength generated by these muscles throughout the body, improving the strength, endurance, and flexibility of all muscles, ligaments, and fascia for overall body health. When performed correctly, Pilates exercises enhance physical health and support mental and social well-being.

Due to their training, physiotherapists create personalized exercise programs tailored to each patient, considering the type, intensity, and duration of the activity to prevent potential risks to both the mother and fetus. The stage of pregnancy is crucial in determining these parameters. Pregnancy exercise training programs consist of three phases: warm-up, main exercise, and cool-down phases. These programs are specifically tailored based on a comprehensive biopsychosocial assessment of each individual's needs.