Impacts of pilates versus aerobic training on pulmonary function and fitness markers in healthy older adults: a randomized controlled trial

Authors

  • Bulin Jirapongsatorn Department of Sports and Exercise Science, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
  • Decha Chinaksorn Department of Sports and Exercise Science, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
  • Kanapot Pengked Department of Orthopedics, Walailak University Hospital, Nakhon Si Thammarat, Thailand
  • Timothy D. Mickleborough Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana, USA
  • Wannaporn Tongtako Area of Exercise Physiology, Faculty of Sports Science, Chulalongkorn University, Bangkok, Thailand, Center of Excellence in Exercise Physiology for Special Populations, Chulalongkorn University, Bangkok, Thailand

DOI:

https://doi.org/10.47197/retos.v81.118322

Keywords:

Pulmonary function, Fitness, Pilates, Older adults, Flexibility

Abstract

Introduction: Pilates has been shown to improve pulmonary function and physical fitness in older adults. However, studies directly comparing Pilates with aerobic exercise remain limited and inconclusive.

Objectives: This study investigated the effects of Pilates training and aerobic exercise on pulmonary function, core muscle strength, flexibility, and cardiovascular fitness in older adults.

Methodology: Twenty-nine older adults were randomly assigned to three group such as control group, Pilates group, or aerobic group. Pilates group performed Pilates, aerobic group engaged in moderate-intensity treadmill walking, and control group maintained usual routines. Both interventions were conducted for 60 minutes, three times per week, over eight weeks. Outcomes were assessed pre- and post-intervention using two-way repeated-measures ANOVA.

Results: The results demonstrated that both Pilates and aerobic groups significantly improved pulmonary function, core muscle strength, flexibility and cardiovascular fitness performance compared with pre-test and control group (p < 0.05). Moreover, Pilates group showed a significant improvement core muscle strength by plank test compared with ATG groups (p < 0.05).

Discussion: Findings align with prior research, confirming that Pilates and aerobic training improves pulmonary function and physical fitness in older adults. However, participants who underwent Pilates training program produced more substantial gains across pulmonary function, core muscle strength, and flexibility.

Conclusion: Pilates and aerobic training enhance physical fitness in older adults, with Pilates offering broader benefits for healthy aging.

References

Adıgüzel, S., Aras, D., Gülü, M., Aldhahi, M. I., Alqahtani, A. S., & Al-Mhanna, S. B. (2023). Comparative effectiveness of 10-week equipment-based pilates and diaphragmatic breathing exercise on heart rate variability and pulmonary function in young adult healthy women with normal BMI - a quasi-experimental study. BMC sports science, medicine & rehabilitation, 15(1), 82. https://doi.org/10.1186/s13102-023-00693-5

American College of Sports Medicine. (2022). ACSM’s guidelines for exercise testing and prescription (11th ed.). Wolters Kluwer.

ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. (2002). ATS statement: guidelines for the six-minute walk test. American journal of respiratory and critical care medicine, 166(1), 111–117. https://doi.org/10.1164/ajrccm.166.1.at1102

Alvarenga, G. M., Gamba, H. R., Charkovski, S. A., & dos Santos, L. K. (2016). Effects of Pilates method in association with inspiratory muscle training in lung function in elderly women. European Respiratory Journal, 48(suppl60), PA1358. https://doi.org/10.1183/13993003.congress-2016.PA1358

Bai, X., Soh, K. G., Omar Dev, R. D., Talib, O., Xiao, W., Soh, K. L., ... & Casaru, C. (2022). Aerobic exercise combination intervention to improve physical performance among the elderly: a systematic review. Frontiers in Physiology, 12, 798068. https://doi.org/10.3389/fphys.2021.798068

Barbosa, A. W., Guedes, C. A., Bonifácio, D. N., de Fátima Silva, A., Martins, F. L., & Almeida Barbosa, M. C. (2015). The Pilates breathing technique increases the electromyographic amplitude level of the deep abdominal muscles in untrained people. Journal of bodywork and movement therapies, 19(1), 57–61. https://doi.org/10.1016/j.jbmt.2014.05.011

Bohannon, R. W., Steffl, M., Glenney, S. S., Green, M., Cashwell, L., Prajerova, K., & Bunn, J. (2018). The prone bridge test: Performance, validity, and reliability among older and younger adults. Journal of bodywork and movement therapies, 22(2), 385-389. https://doi.org/10.1016/j.jbmt.2017.07.005

Bullo, V., Bergamin, M., Gobbo, S., Sieverdes, J. C., Zaccaria, M., Neunhaeuserer, D., & Ermolao, A. (2015). The effects of Pilates exercise training on physical fitness and wellbeing in the elderly: A systematic review for future exercise prescription. Preventive medicine, 75, 1–11. https://doi.org/10.1016/j.ypmed.2015.03.002

Carrasco-Poyatos, M., Ramos-Campo, D. J., & Rubio-Arias, J. A. (2019). Pilates versus resistance training on trunk strength and balance adaptations in older women: a randomized controlled trial. PeerJ, 7, e7948. https://doi.org/10.7717/peerj.7948

Cho, H. E. (2023). Understanding changes in the respiratory system with ageing. Annals of CardioPulmonary Rehabilitation, 3(2), 27-34. https://doi.org/10.53476/acpr.2023.3.2.27

Donat Tuna, H., Ozcan Edeer, A., Malkoc, M., & Aksakoglu, G. (2009). Effect of age and physical activity level on functional fitness in older adults. European review of aging and physical activity, 6, 99-106. https://doi.org/10.1007/s11556-009-0051-z

Dos Reis, A. L., de Oliveira, L. C., & de Oliveira, R. G. (2024). Effects of stretching in a pilates program on musculoskeletal fitness: a randomized clinical trial. BMC sports science, medicine & rehabilitation, 16(1), 11. https://doi.org/10.1186/s13102-024-00808-6

Fragala, M. S., Cadore, E. L., Dorgo, S., Izquierdo, M., Kraemer, W. J., Peterson, M. D., & Ryan, E. D. (2019). Resistance training for older adults: position statement from the national strength and conditioning association. The Journal of Strength & Conditioning Research, 33(8). https://doi.org/10.1519/JSC.0000000000003230

Gaviria Chavarro, J., Rojas Padilla, I. C., Gómez Gaviria, M. L., & Zambrano Bermeo, R. N. (2025). Impact of three exercise programs on physical fitness and coping and adaptation process in elderly adults. Retos,71, 459–469. https://doi.org/10.47197/retos.v71.114005

Giacomini, M. B., da Silva, A. M. V., Weber, L. M., & Monteiro, M. B. (2016). The Pilates Method increases respiratory muscle strength and performance as well as abdominal muscle thickness. Journal of bodywork and movement therapies, 20(2), 258-264. https://doi.org/10.1016/j.jbmt.2015.11.003

Graham, B. L., Steenbruggen, I., Miller, M. R., Barjaktarevic, I. Z., Cooper, B. G., Hall, G. L., Hallstrand, T. S., Kaminsky, D. A., McCarthy, K., McCormack, M. C., Oropez, C. E., Rosenfeld, M., Stanojevic, S., Swanney, M. P., & Thompson, B. R. (2019). Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. American journal of respiratory and critical care medicine, 200(8), e70–e88. https://doi.org/10.1164/rccm.201908-1590ST

Hlaing, S. S., Puntumetakul, R., Khine, E. E., & Boucaut, R. (2021). Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC musculoskeletal disorders, 22(1), 998. https://doi.org/10.1186/s12891-021-04858-6

Hurley, B. F., & Roth, S. M. (2000). Strength training in the elderly: effects on risk factors for age-related diseases. Sports medicine, 30, 249-268. https://doi.org/10.2165/00007256-200030040-00002

Izquierdo, M., Merchant, R. A., Morley, J. E., Anker, S. D., Aprahamian, I., Arai, H., Aubertin-Leheudre, M., Bernabei, R., Cadore, E. L., Cesari, M., Chen, L. K., de Souto Barreto, P., Duque, G., Ferrucci, L., Fielding, R. A., García-Hermoso, A., Gutiérrez-Robledo, L. M., Harridge, S. D. R., Kirk, B., Kritchevsky, S., … Fiatarone Singh, M. (2021). International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. The journal of nutrition, health & aging, 25(7), 824–853. https://doi.org/10.1007/s12603-021-1665-8

Kang, T. W., Lee, J. S., & Han, D. W. (2019). The correlation between abdominal muscle strength and respiratory function in stroke patients. PNF and Movement, 17(2), 303-310. https://doi.org/10.21598/JKPNFA.2019.17.2.303

Keating, N. (2022). A research framework for the United Nations Decade of Healthy Ageing (2021–2030). European Journal of Ageing, 19(3), 775-787. https://doi.org/10.1007/s10433-021-00679-7

Kim, J., Ko, J., Lim, J., Choi, H., Seo, K., & Lee, S. (2020). Effects of a four-week core stability exercise on functional movement and balance in people with mild lower-limb discomfort. Montenegrin Journal of Sports Science and Medicine, 9(3). https://doi.org/10.26773/mjssm.200903

Kim, S. T., & Lee, J. H. (2017). The effects of Pilates breathing trainings on trunk muscle activation in healthy female subjects: a prospective study. Journal of physical therapy science, 29(2), 194–197. https://doi.org/10.1589/jpts.29.194

Lalley P. M. (2013). The aging respiratory system--pulmonary structure, function and neural control. Respiratory physiology & neurobiology, 187(3), 199–210. https://doi.org/10.1016/j.resp.2013.03.012

Lavín-Pérez, A. M., León-Llamas, J. L., Salas Costilla, F. J., Collado-Mateo, D., López de las Heras, R., Gasque Celma, P., & Villafaina, S. (2023). Validity of on-line supervised fitness tests in people with low back pain. In Healthcare, 11(7). 1019. https://doi.org/10.3390/healthcare11071019

Lim, H. S., & Yoon, S. (2017). The effects of Pilates exercise on cardiopulmonary function in the chronic stroke patients: a randomized controlled trials. Journal of physical therapy science, 29(5), 959-963. https://doi.org/10.1589/jpts.29.959

Malhotra, D., Khan, A. R., Nigam, A., & Khan, A. (2025). Effect of Antenatal Pilates on Centre of Pressure Sway Velocity and its Correlation with the Intensity of Low Back Pain. Retos, 67, 1140–1154. https://doi.org/10.47197/retos.v67.114038

Mei, N., & Chang, Y. (2023). Effect of aerobic exercise on physical function indices in the elderly. Revista Brasileira de Medicina do Esporte, 29, e2022_0236. https://doi.org/10.1590/1517-8692202329012022_0236

Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C., Macera, C. A., & Castaneda-Sceppa, C. (2007). Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Medicine and science in sports and exercise, 39(8), 1435–1445. https://doi.org/10.1249/mss.0b013e3180616aa2

Nystoriak, M. A., & Bhatnagar, A. (2018). Cardiovascular Effects and Benefits of Exercise. Frontiers in cardiovascular medicine, 5, 135. https://doi.org/10.3389/fcvm.2018.00135

Park, S., Choi, B. H., & Jee, Y. S. (2023). Effects of plank exercise on respiratory capacity, physical fitness, and immunocytes in older adults. Journal of exercise rehabilitation, 19(6), 332. https://doi.org/10.12965/jer.2346536.268

Pilates, J. H., & Miller, W. J. (2021). Return to life through contrology. Ravenio Books.

Pinckard, K., Baskin, K. K., & Stanford, K. I. (2019). Effects of Exercise to Improve Cardiovascular Health. Frontiers in cardiovascular medicine, 6, 69. https://doi.org/10.3389/fcvm.2019.00069

Ponde, K., Agrawal, R., & Chikte, N. K. (2021). Effect of core stabilization exercises on balance performance in older adults. International Journal of Contemporary Medicine, 9(1), 12-7. https://doi.org/10.37506/ijocm.v9i1.2926

Rangabprai, Y., Mitranun, W., & Mitarnun, W. (2024). Effect of 60-min single bout of resistance exercise, reformer pilates, on vascular function parameters in older adults: a randomized crossover study. Gerontology, 70(7), 764-775. https://doi.org/10.1159/000539144

Rathi MA, Muthiyan K, Joshi R, & Gazbare P. Effect of Pilates versus resistance training on physical fitness in older adults. Aging Pathobiology and Therapeutics, 2024, 6(3): 109-116. https://doi.org/10.31419/APT.2024.09.149

Rayes, A. B. R., de Lira, C. A. B., Viana, R. B., Benedito-Silva, A. A., Vancini, R. L., Mascarin, N., & Andrade, M. S. (2019). The effects of Pilates vs. aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional tasks outcomes for individuals who are overweight/obese: a clinical trial. PeerJ, 7, e6022. https://doi.org/10.7717/peerj.6022

Riebe, D., Blissmer, B. J., Greaney, M. L., Ewing Garber, C., Lees, F. D., & Clark, P. G. (2009). The relationship between obesity, physical activity, and physical function in older adults. Journal of Aging and Health, 21(8), 1159-1178. https://doi.org/10.1177/089826430935007

Schulz, K. F., Altman, D. G., Moher, D., & CONSORT Group (2010). CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ (Clinical research ed.), 340, c332. https://doi.org/10.1136/bmj.c332

Seo, J., An, S., & Kim, D. (2023). Effect of Physical Activity on Health-Related Quality of Life of Older Adults Using Newly Developed Health-Related Quality of Life Tool for the Korean Population. Healthcare (Basel, Switzerland), 11(15), 2192. https://doi.org/10.3390/healthcare11152192

Talaminos Barroso, A., Márquez Martín, E., Roa Romero, L. M., & Ortega Ruiz, F. (2018). Factors Affecting Lung Function: A Review of the Literature. Factores que afectan a la función pulmonar: una revisión bibliográfica. Archivos de bronconeumologia, 54(6), 327–332. https://doi.org/10.1016/j.arbres.2018.01.030

Tanaka, H., Monahan, K. D., & Seals, D. R. (2001). Age-predicted maximal heart rate revisited. Journal of the american college of cardiology, 37(1), 153-156. https://doi.org/10.1016/S0735-1097(00)01054-8

Tongtako, W., Klaewsongkram, J., Mickleborough, T. D., & Suksom, D. (2018). Effects of aerobic exercise and vitamin C supplementation on rhinitis symptoms in allergic rhinitis patients. Asian Pacific journal of allergy and immunology, 36(4), 222–231. https://doi.org/10.12932/AP-040417-0066

Vécseyné, M. K., Kopkáné, J. P., Bognár, J., Olvasztóné, Z. B., & Barthalos, I. (2013). Effects of Pilates and aqua fitness training on older adults' physical functioning and quality of life. Biomedical Human Kinetics, 5(1), 22. https://doi.org/10.2478/bhk-2013-0005

Woramontri, C., Chaunchaiyakul, R., Yang, A. L., Lin, Y. Y., & Masodsai, K. (2024). Effect of mat Pilates training on blood pressure, inflammatory, and oxidative profiles in hypertensive elderly. Sports, 12(5), 120. https://doi.org/10.3390/sports12050120

World Health Organization. (2020). UN decade of healthy ageing: plan of action 2021–2030. Geneva: World Health Organization, 1-31.

Downloads

Published

23-06-2026

Issue

Section

Original Research Article

How to Cite

Jirapongsatorn, B., Chinaksorn, D., Pengked, K., Mickleborough, T. D., & Tongtako, W. (2026). Impacts of pilates versus aerobic training on pulmonary function and fitness markers in healthy older adults: a randomized controlled trial. Retos, 81, 496-508. https://doi.org/10.47197/retos.v81.118322