COMPARISON OF THE EFFECTS OF MAT AND REFORMER PILATES ON MUSCLE SKELETAL SYSTEM COMPLAINTS, BODY COMPOSITION AND QUALITY OF LIFE IN OBESE WOMEN: RANDOMIZED CONTROLLED STUDY

Abstract

Purpose: The purpose of this study is to examine the effects of mat pilates and reformer pilates training on musculoskeletal complaints, body composition and quality of life in obese women. Methods: A randomized controlled study included 36 obese women aged between 20-45 years with a body mass index (BMI) of 30 kg/m2 and above. Participants were divided into two groups as mat pilates group (n=18) and reformer pilates group (n=18). Pilates training was given to the cases in mat pilates and reformer pilates groups for 60 minutes per day, 3 days per week for 8 weeks. Before and after the training, the extremity and trunk circumference measurements of the cases were evaluated with Gullick strip, BMI with voit smart bluetooth digital scale, musculoskeletal complaints were evaluated with Nordic Musculoskeletal System Questionnaire and quality of life was evaluated with Obese Specific Quality of Life Questionnaire. Results: No significant difference was found between the age, height, weight and pre-pilates training BMIs of both groups (p>0.05). A significant decrease was obtained between the pre-test and post-test weight, BMI, waist circumference, hip circumference, waist/hip ratio, fat ratio, muscle ratio and visceral fat ratio values of the mat pilates group and the reformer pilates group (p<0.01). In the comparison between the groups, a significant decrease was observed only between the pre-test and post-test values of waist circumference (p<0.002), waist/hip ratio (p<0.001) and post-test muscle ratio values (p<0.031). No significant difference was found between the pre-test and post-test values of the mat pilates group’s musculoskeletal complaints (neck, shoulder, upper back, hand, arm, hip, knee, foot and elbow) (p>0.05). A significant difference was found between the pre-test and post-test values of the reformer pilates group’s musculoskeletal complaints (neck, shoulder, upper back, elbow, hand, hip and knee area) (p<0.05). While there was a significant improvement between pre-test and post-test quality of life values of the mat pilates (p<0.01) and reformer pilates groups (p<0.01), there was no significant difference between pre-test and post-test quality of life values between the groups (p>0.05). Conclusion: The results of our study showed that both pilates exercises increased body composition and quality of life, while reformer pilates was more effective than mat pilates by reducing musculoskeletal complaints.

Keywords

• Body composition
• Musculoskeletal complaints
• Obesity
• Pilates
• Quality of life

OBEZ KADINLARDA MAT VE REFORMER PİLATESİN KAS İSKELET SİSTEMİ ŞİKAYETLERİ, VÜCUT KOMPOZİSYONU VE YAŞAM KALİTESİNE ETKİSİNİN KARŞILAŞTIRILMASI: RANDOMİZE KONTROLLÜ ÇALIŞMA

Öz

Amaç: Bu çalışmanın amacı, mat pilates ve reformer pilates eğitiminin obez kadınlarda kas iskelet sistemi şikayeti, vücut kompozisyonu ve yaşam kalitesine etkilerini incelemektir. Yöntem: Randomize kontrollü çalışmaya, yaşları 20-45 arasında değişen, vücut kütle indeksi (VKİ) 30 kg/m2 ve üzeri 36 obez kadın dahil edildi. Katılımcılar mat pilates grubu (n=18) ve reformer pilates grubu (n=18) olmak üzere ikiye ayrıldı. Mat pilates ve reformer pilates grubundaki olgulara 8 hafta boyunca, haftada 3 gün, günde 60 dakika pilates eğitimi verildi. Eğitim öncesi ve sonrası olguların ekstremite ve gövde çevre ölçümleri Gullick şeridiyle, VKİ voit akıllı bluetooth dijital baskül ile, kas iskelet sistemi şikayetleri Nordic Kas İskelet Sistemi Anketi ile yaşam kaliteleri ise Obezlere Özgü Yaşam Kalitesi Anketi ile değerlendirildi. Bulgular: Her iki grubun yaş, boy, kilo ve pilates eğitimi öncesi VKİ arasında anlamlı fark bulunmadı (p>0,05). Mat pilates grubu ve reformer pilates grubu ön test -son test kilo, VKİ, bel çevresi, kalça çevresi, bel/kalça oranı, yağ oranı, kas oranı ve visseral yağ oranı değerleri arasında anlamlı derecede azalma elde edildi (p<0,01). Gruplar arası karşılaştırmada sadece bel çevresi (p<0,002), bel/kalça oranı (p<0,001) ön test-son test değerleri ile son test kas oranı değerleri arasında anlamlı azalma görüldü (p<0,031). Mat pilates grubu kas iskelet sistemi şikayetleri (boyun, omuz, üst sırt, el, kol, kalça, diz, ayak ve dirsek) ön test-son test değerleri arasında anlamlı fark bulunmadı (p>0,05). Reformer pilates grubunun ön test-son test kas iskelet sistemi şikayetleri (boyun, omuz, üst sırt, dirsek, el, kalça ve diz bölgesi) değerleri arasında anlamlı fark bulundu (p<0,05). Mat pilates (p<0,01) ve reformer pilates grubu yaşam kalitesi ön test-son test değerleri arasında anlamlı derecede iyileşme görülürken (p<0,01) gruplar arası ön test-son test yaşam kalitesi değerleri arasında anlamlı fark bulunmadı (p>0,05). Sonuç: Çalışmamızın sonuçları, her iki pilates egzersizlerinin vücut kompozisyonu ve yaşam kalitesini artırdığı, reformer pilatesin ise kas iskelet sistemi şikayetlerini azaltarak mat pilatese göre pozitif yönde daha etkili olduğunu gösterdi.

Anahtar Kelimeler

• Vücut kompozisyonu
• Kas iskelet sistemi şikayetleri
• Obezite
• Pilates
• Yaşam kalitesi

Kaynakça

1. Wharton S, Lau DC, Vallis M, Sharma AM, Biertho L, Campbell-Scherer D, et al. Obesity in adults: a clinical practice guideline. CMAJ. 2020;192(31): E875-91.
2. Obesity and overweight: fact sheet [Internet]. Geneva: WHO; 2016 [cited 2023 Dec 24]. Available from: http://www.who.int/mediacentre/factsheets/fs311/en/
3. Çukur A, Arıtı Erdem İ. The role of obesity taxes in the fight against obesity: an evaluation for Turkey. Sayıştay Dergisi. 2017;(106):121-46.
4. U.S. Department of Health and Human Services. The Surgeon General’s call to action to prevent and decrease overweight and obesity [Internet]. Washington, DC: U.S. Department of Health and Human Services; 2001 [cited 2023 Dec 24]. Available from: https://www.cdc.gov/nccdphp/dnpa/pdf/calltoaction.pdf
5. Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism. 2019;92:6-10.
6. Di Rosa C, Lattanzi G, Taylor SF, Manfrini S, Khazrai YM. Very low calorie ketogenic diets in overweight and obesity treatment: effects on anthropometric parameters, body composition, satiety, lipid profile and microbiota. Obes Res Clin Pract. 2020;14(6):491-503.
7. Schmidt-Grund R, Rheinländer B, Kaidashev E, Lorenz M, Grundmann M, Fritsch D, Schubert M, Schmidt H, Herzinger C. Influence of Pilates method on nonspecific lumbar pain. Journal of the Korean Physical Society. 2008;53(1):88.
8. Kloubec J, Banks AB. Pilates and physical education: A natural fit. Journal of Physical Education, Recreation & Dance. 2013;75(4):34-7.

9. Şimşek D, Katırcı H. The influence of pilates exercises on postural stability and sports performance: a systematic review of the literature. Nigde University Journal of Physical Education And Sport Sciences. 2011;5(2):58-70.
10. Özkan A, Köklü Y, Kayıhan G, Alemdaroğlu U, Ersöz G. The role of physical activity and exercise in prevention and treatment of obesity. Uluslararası Hakemli Akademik Spor ve Sağlık ve Tıp Bilimleri Dergisi.2013;3(7):48-63.
11. Uzun A, Demir B. Effect of pilates and reformer exercises on body composition. International Journal of Applied Exercise Physiology. 2020;9(1):148-56.
12. Rosa S, Martins D, Martins M, Guimarães B, Cabral L, Horta L. Body mass index and musculoskeletal pain: a cross-sectional study. Cureus. 2021;13(2):e13400.
13. Zadro JR, O’Leary S, Maher C, et al. The effectiveness of pilates exercise in individuals with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. Eur Spine J. 2018;27(2):267-78.
14. Karadenizli Zİ, Kambur B. The effects of reformer pilates exercises on thigh circumference and harmstring flexibility on women. Inonu University, Journal of Physical Education and Sport Sciences. 2016;3(3):48-62.
15. Tamer K. Sporda fiziksel-fizyolojik performansın ölçülmesi ve değerlendirilmesi. 2. baskı. Ankara: Bağırgan Yayımevi; 2000.
16. Şavkın R. Pilates eğitiminin vücut kompozisyonuna etkisi. Yüksek lisans tezi. Pamukkale Üniversitesi, Sağlık Bilimleri Enstitüsü, Fizik Tedavi ve Rehabilitasyon Anabilim Dalı; 2014.
17. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233-7.
18. Dawson AP, Steele EJ, Hodges PW, Stewart S. Development and test-retest reliability of an extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E): a screening instrument for musculoskeletal pain. J Pain. 2009;10(5):517-26.
19. Çıray Gündüzoğlu N, Fadıloğlu Ç, Yılmaz C. Obezlere özgü yaşam kalitesi ölçeğinin geçerlilik ve güvenirliğinin incelenmesi. Anadolu Psikiyatri Derg. 2014;15:63-8.
20. Şavkin R, Aslan UB. The effect of Pilates exercise on body composition in sedentary overweight and obese women. J Sports Med Phys Fitness. 2017;57(11):1464-70.
21. Öz B, Karataş A, Akar ZA, Koca SS. Obesity and musculoskleteal system. Firat Med J. 2018;23(Suppl):42-7.
22. Cakmakçi O. The effect of 8 week pilates exercise on body composition in obese women. Coll Antropol. 2011;35:1045-50.
23. Liman N, Atalay Güzel N. The effects of aerobic-step and pilates exercise on strength, flexibility, anaerobic power, balance and body composition. Gazi BESBD. 2008;XIII(4):3-12.
24. Vaquero-Cristóbal R, Alacid F, Esparza-Ros F, Muyor JM, López-Miñarro PÁ. Efectos de un programa de 16 semanas de pilates mat sobre las variables antropométricas y la composición corporal en mujeres adultas activas tras un corto proceso de desentrenamiento [The effects of 16-weeks pilates mat program on anthropometric variables and body composition in active adult women after a short detraining period]. Nutr Hosp. 2015;31(4):1738-47. Spanish.
25. Altıntaç D. Pilates egzersizlerinin fiziksel uygunluk üzerine etkileri. Yüksek lisans tezi. Marmara Üniversitesi, Sağlık Bilimleri Enstitüsü; 2006.
26. Wang Y, Chen Z, Wu Z, Ye X, Xu X. Pilates for overweight or obesity: a meta-analysis. Front Physiol. 2021;12:643455.
27. Schmidt AC, de Oliveira Herzinger P, Matias DP, Welling LC. Influence of pilates method on nonspecific lumbar pain. Arquivos Brasileiros de Neurocirurgia. 2020;39(4):300-5.
28. Ceylan M, Başkurt Z, Başkurt F. The effect of obesity on physical performance in patients with chronic low back pain. CBU-SBED. 2022;9(2):186-93.
29. Ray L, Lipton RB, Zimmerman ME, Katz MJ, Derby CA. Mechanisms of association between obesity and chronic pain in the elderly. Pain. 2011;152(1):53-9.
30. Okifuji A, Bradshaw DH, Olson C. Evaluating obesity in fibromyalgia: neuroendocrine biomarkers, symptoms, and functions. Clin Rheumatol. 2009;28(4):475-8.
31. Tsuritani I, Honda R, Noborisaka Y, Ishida M, Ishizaki M, Yamada Y. Impact of obesity on musculoskeletal pain and difficulty of daily movements in Japanese middle-aged women. Maturitas. 2002;42(1):23-30.
32. Bolgen-Cimen O, Arıncı-Yücel N, Karabiber M, Erdoğan C. Role of obesity in low back pain related disability. West Indian Med J. 2007;56(3):252.
33. Hansen D. Exercise therapy in adult individuals with obesity. Nova Science. 2013.
34. Han TS, Tijhuis MA, Lean ME, Seidell JC. Quality of life in relation to overweight and body fat distribution. Am J Public Health. 1998;88(12):1814-20.
35. Yıldız S, Çetinkaya F. Obesity and quality of life study in adults. Ahi Evran Med J. 2020;4(2):29-34.
36. Hassan MK, Joshi AV, Madhavan SS, Amonkar MM. Obesity and health-related quality of life: a cross-sectional analysis of the US population. Int J Obes Relat Metab Disord. 2003;27(10):1227-32.