Can Pilates Straighten the Curve? A Systematic Review of Pilates in Scoliosis Therapy

Abstract

Background: Scoliosis is a three-dimensional spinal and trunk deformity affecting 0.93% to 12% of the global population. As a progressive musculoskeletal condition, it impairs mobility and reduces quality of life. Objectives: Recent studies suggest that Pilates, which is increasingly popular amongst a wide range of people, may improve postural control, spinal flexibility, muscular balance, and pain levels in individuals with scoliosis. However, the evidence remains scattered across studies with varying designs, populations, outcome measures, and intervention protocols. As interest in integrating Pilates into clinical rehabilitation grows, a comprehensive synthesis of the current evidence is needed to assess its effectiveness, limitations, and clinical applicability. Aim: This study aimed to systematically review the current literature to determine the efficacy of Pilates as a therapeutic intervention for scoliosis. Methods: Following PRISMA guidelines and being registered in PROSPERO, a systematic search was conducted in Scopus, PubMed, Cochrane, and Springer databases to search for published articles from 2005 to 2025 to identify articles that met the inclusion criteria. Keywords were determined as “scoliosis” and “pilates.” Risk of bias and study quality was evaluated with the PEDro Scale. Results: A total of 6 randomized controlled trials studies involving 201 participants with idiopathic or functional scoliosis were included. Most studies reported improvements in Cobb angle and angle of trunk rotation after Pilates-based interventions ranging from 8 to 12 weeks. Functional outcomes such as pain reduction were also noticed, though long-term effects remain under-researched. Conclusions: Pilates appears to offer potential benefits as a conservative intervention for scoliosis by improving posture and pain. However, current evidence is limited by heterogeneity in intervention protocols and outcome measures. Further high-quality, large-scale studies are warranted to confirm the therapeutic value of Pilates in scoliosis management and to establish standardized intervention guidelines.