Impact of Pilates training on gait performance in individuals with unilateral transtibial amputation

To evaluate the effects of a 3-month Pilates training program on spatiotemporal gait parameters in unilateral transtibial amputees (TTA). Ten TTA (aged 18 to 59 years) participated in a training program consisting of 36 remote, supervised mat-based Pilates sessions, assessed at baseline, pre- and post-training, and at follow-up. Spatiotemporal gait parameters were recorded using an instrumented walkway at self-selected walking speed (SSWS) and fast walking speed (FWS). Functional mobility was assessed using the Timed-up and Go (TUG) test. Statistical analyses included repeated measures ANOVA and effect size calculations. Following training prosthetic limb step length increased (<i>p</i> = 0.015). The intact side also showed increased step length (<i>p</i> = 0.009), while stance time (<i>p</i> = 0.011) and swing time (<i>p</i> = 0.005) decreased post-training. No changes in asymmetry were observed, regardless of walking speed (<i>p</i> &gt; 0.05). Walking speed increased significantly for SSWS (<i>p</i> &lt; 0.001) and FWS (<i>p</i> = 0.002). Performance on the TUG test increased post the training intervention (<i>p</i> &lt; 0.001). The 3-month Pilates program improved gait performance and functional mobility in TTA, suggesting that Pilates may be an effective rehabilitation tool. Pilates has been shown to improve strength and balance, functional capacity, and gait performance in older adults.The benefit of Pilates training in individuals with lower limb amputation is underexplored.This study showed that 3-months of Pilates training improved functional capacity and gait characteristics in a group of unilateral (non-vascular) transtibial amputees.The training used, combining in-person and remote sessions, facilitated participant retention, addressing a common challenge in longitudinal studies that ask participants to repeatedly travel to a training location. Pilates has been shown to improve strength and balance, functional capacity, and gait performance in older adults. The benefit of Pilates training in individuals with lower limb amputation is underexplored. This study showed that 3-months of Pilates training improved functional capacity and gait characteristics in a group of unilateral (non-vascular) transtibial amputees. The training used, combining in-person and remote sessions, facilitated participant retention, addressing a common challenge in longitudinal studies that ask participants to repeatedly travel to a training location. <b>Trial Registration:</b> RBR-109zf3kn