Background: Fibromyalgia syndrome is a chronic condition characterised by widespread musculoskeletal pain, often accompanied by other psychological and physiological disorders. Treatment focuses on reducing symptoms through education, exercise, pharmacological treatment and psychotherapy. Pilates is a low-intensity form of exercise that emphasises the connection between body and mind. This study aimed to review the effects of Pilates exercise on pain, quality of life, sleep, anxiety and muscle performance in patients with fibromyalgia syndrome. Methods: Literature was searched in the PubMed database. The review included randomised controlled trials published in English. Results: Seven studies involving a total of 318 participants were included in the review. The results showed statistically significant (p < 0.05) effects of Pilates exercise on pain, quality of life and anxiety, but not on sleep quality or muscle performance. Pilates exercise was generally no more effective than other comparison therapies. Conclusions: Pilates exercise is a safe and effective non-pharmacological method for managing fibromyalgia. Its effects are comparable to those of other therapies, making Pilates a valuable addition to the range of available treatments. Future research should include a larger sample size, more male participants, and follow-up assessments.
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