Proposed Physical-Functional Assessment for Pilates Practitioners Based on the Concepts of the International Classification of Functioning, Disability and Health (ICF)
By: Flavia Lima de Almeida
STRUCTURED ABSTRACT
Background:
Pilates has been widely adopted by physiotherapists for the treatment of musculoskeletal disorders, particularly since the popularization of “Clinical Pilates” in the early 2000s. Although evidence supports its effectiveness in reducing pain and disability, there is no consensus regarding specific assessment methods tailored to Pilates practice. This gap highlights the need for a biopsychosocial assessment framework aligned with the International Classification of Functioning, Disability and Health (ICF).
Objective:
To identify assessment methods used by physiotherapists working with Pilates and to support the development of a standardized, ICF-based assessment tool. Additionally, to characterize Pilates practitioners physically and functionally, considering psychosocial and quality-of-life variables.
Methods:
This is a cross-sectional observational correlational study conducted in two private clinics in Brazil. Adults practicing Pilates for at least six months are being evaluated using body composition measures, pain numerical rating scale, Timed Up and Go (TUG), handgrip dynamometry, bioimpedance analysis, SF-12 (quality of life), and DASS-21 (mental health), according to ICF domains.
The first stage consisted of an electronic survey distributed to physiotherapists registered at CREFITO-3 to investigate clinical assessment practices. Data are organized using REDCap.
Results (Survey – Partial Data):
A total of 171 responses were collected; 101 were eligible (97 physiotherapists and 4 dual-degree professionals), and 91 reported active clinical practice with Pilates. The mean age was 39.0 ± 8.2 years; 77% were from Southeast Brazil. Most held specialization degrees (60%), and 44% had more than 10 years of experience.
Eighty-four percent reported performing pre-intervention assessments; however, 60% used non-standardized approaches, and only 19% reported using validated instruments. The most frequently assessed domains were pain (70%), muscle strength (66%), flexibility (65%), posture (65%), and range of motion (62%). Although 93% reported investigating limitations in daily activities, standardized functional instruments were underutilized (Roland-Morris 10%, TUG 16%, SF-36 7%).
Mental health assessment was rare, with minimal use of validated questionnaires (≤2%). Quality-of-life measures were reported by only 18.9% of participants.
Importantly, 84% expressed the need for a specific standardized assessment tool for Pilates-based physiotherapy.
Conclusion:
Preliminary findings reveal alignment between clinically valued domains and those described in the literature; however, there is low adherence to standardized assessment instruments, particularly in psychosocial and quality-of-life domains. These results support the development of an ICF-based standardized assessment model to bridge the gap between scientific evidence and clinical practice in Pilates rehabilitation.
