Effect of Pilates exercises on symptoms of irritable bowel syndrome in women: a randomized controlled trial.

Nobody was blinded. The women, the physiotherapist and the person assessing the outcomes all knew who was doing Pilates, and every outcome was self-reported, which is enough to inflate the Pilates group's results. The Pilates group came to the clinic twice a week for eight weeks under a physiotherapist's supervision, while the diet-only group had a single consultation. Extra attention and contact is mixed in with the exercises and cannot be separated from them. There was no power calculation before the trial because the authors found no similar study to base one on. The 99% power figure was calculated afterwards, from the trial's own data. The Pilates group started with worse symptoms (mean total IBS-SSS 312.57 versus 283.7, and 19 of 30 rated severe versus 13 of 30), which makes the between-group comparison harder to read. Only women aged 20 to 45 with a BMI of 25 to 34.9 and constipation-predominant IBS took part, so the results say nothing about men, normal-weight women, or diarrhoea-predominant IBS. Hormonal factors such as the menstrual cycle or contraceptive use were not controlled, and no waist measurement or other measure of obesity was taken. Sixty women at a single centre, treated for eight weeks with no follow-up afterwards, so it is not known whether any of the gains lasted.

The authors declare no conflict of interest, and the study received no funding.

Do not conclude that the Pilates exercises are what fixed the IBS symptoms. Dietary advice alone cut total IBS severity by 108.6 points, past the 95-point fall the paper itself calls clinically meaningful, and the trial was not blinded at any level, so expectation can account for part of the extra improvement in the Pilates group. The Pilates group also had 16 supervised clinic sessions that the diet-only group did not, and the two cannot be told apart.