Effects of an 8-week prenatal pilates program on spatiotemporal gait parameters, postural alignment and pain: A dual-center randomized controlled trial

BackgroundPregnancy leads to biomechanical and postural changes that affect musculoskeletal loading, mobility, gait, alignment, and pain. Although Pilates is commonly used during pregnancy, randomized controlled studies with objective gait assessment remain limited.ObjectiveTo investigate the effects of an 8-week supervised prenatal Pilates program on spatiotemporal gait parameters, postural alignment, and pain.MethodsIn this randomized controlled trial, 53 primiparous women (16-20 weeks' gestation) were allocated to a Pilates group (PG; n = 27) or control group (CG; n = 26). The PG performed supervised 60-min sessions twice weekly for 8 weeks. Gait and pelvic kinematics were assessed using BTS G-Walk, and postural alignment (NYPAM) and pain (VAS) were evaluated at baseline, week 4, and week 8. Mixed-model repeated-measures ANOVA with Bonferroni adjustment was used.ResultsSignificant group × time interactions (ηp² ≥ 0.14) were observed for stride length, stance phase, swing phase, double-support phase, pelvic tilt, pelvic obliquity, pain, and postural alignment. Gait was preserved in the Pilates group, whereas controls deteriorated (all p < 0.05). At week 8, the Pilates group showed more favorable outcomes in stride length (Δ = 0.14 m), stance phase (Δ = -6.22%), pelvic tilt (Δ = 24.54°), and pain (Δ = -2.43 cm). Postural alignment declined in controls but was preserved in Pilates (Δ = 15.13; p = 0.006).ConclusionsAn 8-week supervised prenatal Pilates program may help preserve gait, support postural alignment, and reduce pain during mid-pregnancy. Prenatal Pilates may be a feasible non-pharmacological option in prenatal musculoskeletal care.