This systematic review and meta-analysis examined the impact of Pilates-based exercise on mental health, psychological well-being, and quality of life (QoL) across clinical and healthy populations. Thirty-two randomized and quasi-experimental trials (total N = 1264) were included, representing adolescents, adults, and older adults across diverse clinical and non-clinical groups. Outcomes encompassed depressive symptoms, anxiety, QoL, self-esteem, and well-being. The unadjusted random-effects model indicated a suggestive but statistically inconclusive overall effect (p = 0.061). However, adjusting for outcome type via meta-regression yielded a statistically significant pooled effect (g = 0.393, p = 0.023). Substantial heterogeneity remained across studies (I2 = 91.7%). Meta-regression identified outcome type as the only significant moderator, whereas age group, delivery mode, and clinical status did not significantly influence the pooled effect. Subgroup analyses suggested comparable benefits between remote and in-person delivery formats in general adult samples. Evidence from individual studies indicated that supervised, face-to-face instruction may be advantageous for older adults. Low-frequency programs, including once-weekly sessions, were also associated with improvements, although variability in intervention duration and structure limits conclusions regarding optimal dosage. Sensitivity analyses confirmed the stability of the pooled effect. Overall, the findings support Pilates as a feasible exercise modality with demonstrated benefits for positive psychosocial outcomes (QoL and self-esteem), while evidence for negative psychological indicators (e.g., depression, anxiety) remains limited or non-significant. Future research should standardize outcome measures, report training parameters consistently, and examine contextual factors contributing to heterogeneity in psychosocial responses.
Tsartsapakis et al. (Thu,) studied this question.