Pilates

Zheping Quan et al. (2026) · Frontiers in immunology

This systematic review and network meta-analysis of 16 randomized controlled trials (943 participants) explored which forms of exercise are linked to better outcomes in irritable bowel syndrome (IBS). IBS is a functional gut disorder, meaning the bowel looks normal on testing but causes recurring abdominal pain and altered bowel habits, and it often occurs alongside anxiety and depression. The authors framed the gut and brain as communicating through the brain-gut axis, with the immune system, intestinal barrier and gut microbiota also involved. A network meta-analysis is a statistical method that compares several treatments at once, even when some were never tested head to head, and ranks them using SUCRA, a percentage score where higher values mean a greater chance of being best. The included trials, published between 2004 and 2025, tested yoga, Pilates, Baduanjin (a traditional Chinese gentle movement routine), running and moderate-intensity aerobic exercise for 4 to 24 weeks. Participants were adults with constipation-predominant, diarrhea-predominant or mixed IBS, mostly in Asia, Europe and North America. Comparison groups received conventional treatment, dietary advice, probiotics or education. Researchers measured symptom severity with the IBS Symptom Severity Scale, quality of life with the IBS Quality of Life scale, and mood with anxiety and depression scores. Exercise improved several outcomes. Depression scores fell overall (SMD -0.56, a moderate-sized benefit), though heterogeneity was very high (I2 = 95%, meaning results varied widely between trials), and yoga alone was not significant. Anxiety dropped with yoga (SMD -1.82), Pilates (SMD -3.84) and aerobic exercise (SMD -6.31). Symptom severity improved with running (MD -72.68 points), Pilates (-71.32), aerobic exercise (-46.50) and Baduanjin (-16.94), with running ranked first (SUCRA 90.3%). Quality of life ranked Baduanjin first (99.9%) and yoga second (80.1%), while aerobic exercise showed no significant difference from conventional treatment. In subscale analyses, Pilates cut pain severity (MD -17.90) and aerobic exercise improved dysphoria, activity interference, body image, health worries and relationships, while yoga helped only bowel satisfaction and interference with life. Rankings differed by outcome, which the authors describe as functional specificity. The authors describe exercise as a safe, low-cost non-pharmacological option that may hold value in comprehensive IBS management, but the evidence carries clear limits. Heterogeneity was high, many trials did not clearly blind participants or assessors, and some effect sizes were unusually large, which the authors attribute to small samples. Study counts were reported inconsistently across sections, and safety was not analysed. Too few trials came from outside East Asia to judge differences across ethnic groups. The immune mechanisms remain unproven, and the authors call for trials that add immune markers, biomarkers and gut microbiome measures.

Hong Xu et al. (2024) · Menopause (New York, N.Y.)

This meta-analysis pooled 11 randomized trials testing whether mind-body exercise programs, including tai chi, yoga, Pilates, qigong, and mindfulness-based stress reduction (MBSR, an 8-week meditation and gentle-movement program), help women going through perimenopause or postmenopause, a life stage marked by declining estrogen that can weaken bones, disrupt sleep, and affect mood. These practices pair physical movement with controlled breathing and present-moment attention, offering a non-drug alternative for women wary of hormone therapy's cancer-risk profile. The review combined 11 trials from six countries, involving just over 1,000 women, comparing mind-body exercise groups against women who continued their normal daily activities without a structured exercise program. The trials varied widely, from 6-week programs to a full year, and used five different practices, so results were combined statistically using methods that account for this variety. Across the pooled data, mind-body exercise meaningfully helped on every measure studied: bone density improved (drawing on Pilates and tai chi trials), sleep quality improved (drawing on Pilates, yoga, qigong, and MBSR trials), and both anxiety and depression symptoms dropped substantially (also drawing on that same four-practice group), while fatigue eased too. The anxiety and depression improvements were the largest effects seen, though the studies contributing to them varied considerably in their findings (a statistical marker called heterogeneity was high), meaning some trials showed much bigger benefits than others. Taken together, the findings support mind-body exercise as a safe, reasonable option for managing the physical and emotional challenges of the menopause transition, giving women another evidence-based choice beyond hormone therapy. Because the analysis pooled several different practices together rather than testing each one separately with its own effect size, it shows that mind-body exercise as a category helps, without pinpointing exactly how much benefit comes from any one specific practice like yoga versus tai chi. The individual trials were also generally small and only partially blinded, since exercise programs are hard to disguise from participants.