Intervention

Clinical Pilates exercises were performed by a certified and experienced physiotherapist in 2 different methods (one-to-one and group-based) 2 times a week for 6 weeks.

Before starting the clinical Pilates exercise program, 5 key elements of clinical Pilates exercises were taught to all the patients breathing; focus; and placement of the rib cage, shoulder, head, and neck. Patients were encouraged to use these 5 key elements not only during exercises but also in their daily routines and activities. During clinical Pilates sessions, exercises were repeated until the correct posture was achieved in different positions according to the key elements taught on the 1^st day. First, the physiotherapist demonstrated the exercises and then asked the patients to perform the exercise correctly. In addition, the aim of each exercise was explained to the patients, and they were asked to try to make it functional in their daily life. Each exercise was performed for 8–10 repetitions and was performed on a mat in the supine/side-lying/prone and sitting positions. Increasing the number of repetitions, changing the position to level, stability balls, and therabands were used for the progression of exercises. Each patient’s stabilization ball was personal, and it was 55–65 cm in height so as to achieve a 90° angle at the hips and knees (29). The program for both the methods lasted 60 minutes, including warm up (10 minutes), clinical Pilates exercises (40 minutes), and cool down (10 minutes).

The group-based exercise program was the same as the exercise program applied to the one-to-one exercise group. However, it was performed in the form of group sessions with 6–8 people together.