Extended Abstract
Background and Purpose
With increasing life expectancy, advancements in health care, and declining fertility rates, an unprecedented growth in the elderly population is occurring in Iran and worldwide. Aging often leads to a decline in motor (e.g., decreased walking speed), psychological (e.g., decreased balance confidence), and cognitive functions. Cognitive impairment may result in neurodegenerative conditions such as mild cognitive impairment (MCI). Approximately 15 to 40 percent of individuals with MCI eventually develop Alzheimer's disease. Furthermore, the risk of falling and its consequences is significantly greater for these individuals. Therefore, the aim of this research was to examine the effects of two types of mind-body exercises on balance confidence, walking speed, and balance performance in elderly individuals with mild cognitive impairment.
Methods
This research method employed a quasi-experimental design with a pre-test and post-test structure. The study received ethical approval from the Ethics Committee of the Faculty of Sport and Health Sciences. For this study, 50 elderly individuals initially expressed their consent by signing a consent form to participate in the research. Following this, a brief test of cognitive status was administered. From the initial pool, thirty-four elderly individuals, aged 60 to 70 years, were selected from day care centers in Tabriz. Eligibility criteria included a cognitive test score between 21 and 24, and successful completion of a general medical examination by a physician to confirm their suitability for participation. These eligible participants were then randomly assigned to either a Pilates or a Yoga training group. After the pre-test, the participants trained for 8 weeks (three sessions per week, approximately one hour each session). Key outcome measures were assessed using the following instruments: The Activities-specific Balance Confidence (ABC) questionnaire was used to evaluate balance confidence. Walking speed was measured using the 10-meter walk test. Static balance under dual-task conditions was assessed with the Stork test, and dynamic balance under dual-task conditions was evaluated using the Timed Up and Go (TUG) test. Data were analyzed using Mixed ANOVA, independent t-test, and Mann-Whitney U tests with SPSS-27 software. The statistical significance level was set at p ≤ 0.05.
Results
The study examined the effects of Pilates and yoga training on static and dynamic balance, walking speed, in elderly women with mild cognitive impairment.
Firstly, measurement time significantly impacted static balance under a motor dual task, with results indicating a marked difference between pre-test and post-test scores (p < 0.001, η² = 0.695). However, the group effect was not statistically significant (p = 0.080, η² = 0.105), suggesting that neither Pilates nor yoga training produced significantly different outcomes in static balance. Moreover, the interaction effect between group and time was significant (p = 0.006, η² = 0.241), indicating differences in balance performance when combining these variables.
Similarly, in terms of static balance under a cognitive dual task, the effects of measurement time reached significance (p < 0.001, η² = 0.699), showing improvements from pre-test to post-test. However, the group effect again was not significant (p = 0.165, η² = 0.068), indicating equal effectiveness of both training modalities on static balance. The interaction effect of group and time was statistically significant (p = 0.010, η² = 0.215), further demonstrating the complexity of balance improvements over time.
In dynamic balance scores under a motor dual task, measurement time was significant (p < 0.007, η² = 0.232), indicating improvements between pre-test and post-test. Conversely, the group effect showed no significant difference (p = 0.655, η² = 0.007). Notably, the interaction effect of group and time was not significant (p = 0.280, η² = 0.042), suggesting that the training modalities did not differentially impact dynamic balance.
For dynamic balance under a cognitive dual task, the measurement of time again produced significant results (p < 0.001, η² = 0.518), but the group effect was not significant (p = 0.996, η² = 0.000). The interaction effect also failed to reach significance (p = 0.892, η² = 0.001).
Lastly, unhindered walking speed scores demonstrated significant changes based on measurement time (p < 0.001, η² = 0.642), whereas group differences were not statistically significant (p = 0.460, η² = 0.020). The analysis of obstacle speed and balance confidence tests revealed no significant differences between the two groups, with mean scores of 14.07 and 16.93 for obstacle speed, and 13.83 and 17.17 for balance confidence, respectively, with significance levels of 0.372 and 0.294. Overall, the results underline the importance of measurement time while suggesting that both Pilates and yoga have similar effects on balance and walking speed in this population.
Conclusion
Based on the findings of this study, both mind-body training methods of Pilates and yoga can be used to improve balance confidence, walking speed, and balance performance under cognitive and motor dual-task conditions in elderly women with mild cognitive impairment. Pilates exercises consist of stretching and strength movements that enhance flexibility and muscular strength while engaging multiple muscle groups simultaneously. This holistic approach activates the body and mind, improving balance by targeting deep muscles. Both Pilates and yoga enhance neural adaptability and facilitate sensory input, providing training opportunities that improve static and dynamic balance and balance confidence in elderly women with mild cognitive impairment. Furthermore, it is well-established that walking speed in older adults often declines, significantly impacting their independence and quality of life. The observed improvements in walking speed suggest that regular engagement in Pilates and yoga can enhance functional mobility and the ability to perform daily activities in elderly individuals.
Article Message
Pilates and yoga exercises offer a highly advantageous approach for elderly women with mild cognitive impairment, effectively enhancing motor performance, balance confidence, and overall balance. These methods are particularly beneficial due to their non-invasive, non-pharmacological, and low-cost nature. Furthermore, they are easy to perform, requiring minimal specialized equipment, and are readily adaptable to various settings, from community centers to home environments.
Ethical Considerations
This study was approved by the Ethics Committee of the Faculty of Sport and Health Sciences, University of Tehran (Ethics code: IR.UT.SPORT.REC.1402.095).
Authors' Contributions
All three authors contributed to the writing of the article. The first author was responsible for the implementation of the training programs, data collection, and statistical analysis. The second author wrote the manuscript. All three authors contributed to the final editing of the manuscript. The final editing was done by the second author.
Conflict of Interest
The authors declare that they have no conflicts of interest.
Acknowledgments
We sincerely thank the management and staff of the Chatr Sabz and Iran Tabriz Elderly Day Care Centers and all the loved ones who helped us in conducting this research.