This study answered, "Is there a difference between core muscle endurance, depression, and quality of life development due to online and face-to-face pilates training in healthy individuals?". We found that online pilates and face-to-face pilates training improved all these parameters, and online pilates exercises were at least as practical as face-to-face pilates training.
Our study found that the core muscle endurance of healthy individuals increased in both online and face-to-face pilates groups. Although one study in the literature shows the effect of online pilates training on core muscle endurance in healthy individuals [5], many studies show that face-to-face pilates exercise improves core muscle endurance in healthy individuals [17, 18].
Keklik et al., In a study completed with 33 healthy participants, stated that 6-week online pilates training improved all core muscle endurance tests.
A systematic review included nine randomized controlled studies discussing the effect of face-to-face pilates exercises on healthy individuals. It was concluded that pilates exercises performed two or three times a week for 5–12 weeks increased core muscle endurance [17]. Another systematic review included 16 randomized controlled trials and concluded that Pilates training provides moderate evidence for improving muscular endurance in healthy individuals [18].
The endurance of the core muscles is significant in the successful performance of daily life activities and the continuation of healthy life [19]. Pilates, which provides core muscle training in three planes, focuses on trunk stabilization [20–22].
We think the increase in core endurance with pilates is related to the increase in the transversus abdominis muscle activity, which is the primary muscle of the "core" region and which we activate with the centering principle of pilates.
When we compared the gain obtained with pilates training in both pilates groups, it was observed that there was a statistically significant increase in favor of face-to-face pilates training in the Modified Biering-Sorensen test. However, no difference was found in other parameters. We think the more improvement in the face-to-face pilates training group, the closer the instructor is to the participant, although the basic principle is the same, making the person feel safe. In light of the results of our study, it was concluded that both pilates training could be used to develop core muscle endurance. Moreover, face-to-face pilates training may be more effective than online pilates training.
Our study observed that depression levels decreased in the eight weeks of pilates training.
Although our study is the first to show the effect of online pilates training on depression levels in healthy individuals, many studies show that pilates exercise reduces depression levels in healthy individuals [23–25].
A systematic review that included eight randomized controlled trials said the available evidence is that pilates training effectively promotes mental health [23]. Hassan and Amin stated in their study that the increase in serotonin levels with pilates exercises could help in reducing the symptoms associated with depressive symptoms and pessimistic attitudes [24]. Another study stated that pilates focused on breathing exercises, positively affecting emotional states such as depression in the elderly [25].
The results of all these studies are similar to our results. In our study, with both pilates training, thanks to principles such as concentration, breathing, and integrated isolation, we saw that participants' self-perceptions improved and their self-confidence increased. We think that these effects of both pilates training reduce the depression levels of participants. While the current pandemic caused people to stay away from physical activity and social participation, it also caused depression levels to increase. We think that being in contact with other participants and not feeling lonely with pilates training is also effective in reducing depression levels. In addition, regular exercise during the pandemic process may have made the participant feel safer and more robust and positively affected depression levels.
When we compared the gains in depression levels in online pilates training and face-to-face pilates training groups, it was seen that the gains in both groups were similar. This result shows us that both methods can improve depression levels in healthy individuals.
Our study improved the participants' quality of life in both pilates groups.
No studies in the literature show the effects of online pilates training on the quality of life in healthy individuals. However, it has been stated in previous studies that pilates training improves the quality of life in healthy individuals [26–29]. Studies have shown that pilates training improves the quality of life in healthy individuals and individuals with any pathology.
Similar to other studies showing improvement in our study, an increase in the quality of life of individuals in both pilates groups was observed. We think that this increase makes significant contributions to the lives of individuals. Although we think these developments are closely related to the development in the level of depression, we think that the physiological benefits of exercise and the individual's self-confidence by exercising may also be effective in this result.
When the groups' improvements in the quality of life after pilates training were compared, no significant difference was found. We think that both pilates training methods can be used to improve the physical and mental quality of life of individuals.
During the study, we had the chance to observe the advantages and disadvantages of both pilates methods. The face-to-face pilates method is a method that allows people to observe more closely and correct movement with tactile feedback when necessary. Also, the person and the trainer are closer to exercise development. Thus, further development can be achieved in the face-to-face pilates method, thanks to the trainer's assistance. However, the face-to-face pilates method is a more expensive practice and has disadvantages such as place and time.
On the other hand, the online pilates method is a method that eliminates problems such as place and time and even eliminates the need to be in the same city. Thus, it becomes easier for trainers to reach individuals. It allows individuals to do exercises in their environment. However, it is necessary to be careful, especially in exercises where tactile stimulation is required and in the development of the exercises.
One of the strengths of our study is that it is a randomized controlled evaluator blinded study. In addition, another strength of our work is that the exercises are done regularly and in small groups in both groups, in a specific discipline, at the same time every week, in company with a physiotherapist. The fact that both groups received pilates training by the same person may be a limitation of our study.