Effects of Reformer Pilates on Adolescents' Posture and Trunk Endurance

This study aims to investigate the effects of reformer pilates exercises on posture, core endurance, and body awareness in adolescents. The hypothesis is that reformer pilates will improve these outcomes compared to a control group receiving only informational support. Participants will be randomized into two groups and assessed over six weeks.

This randomized controlled trial investigates the effects of reformer pilates exercises on core endurance, posture, and body awareness in adolescents aged 10-19. Participants will be randomly assigned to one of two groups: an intervention group performing reformer pilates exercises and a control group receiving educational information on posture and physical activity. Both groups will be assessed at baseline and after the 6-week intervention period.

A. Study Design

Intervention Group: Participants in this group will perform reformer pilates exercises twice a week for six weeks. The exercises will target both deep and superficial core muscles and focus on improving posture and body awareness. The program will include progressive adjustments to resistance and repetitions every two weeks.

Control Group: Participants in this group will receive educational sessions about proper posture and physical activity but will not engage in pilates exercises. They will have the option to participate in the pilates program after the study is completed.

B.Outcome Measures B.1. Trunk Endurance Extensor Endurance (Sorensen Test): Assesses the endurance of trunk extensor muscles by recording the duration the participant can hold a horizontal position against gravity.

Flexor Endurance Test: Measures the endurance of trunk flexor muscles by timing how long the participant can maintain a 60° flexion position.

B.2. Posture Analysis Postural alignment will be assessed using the Artificial Intelligence Posture Evaluation and Correction System (APECS) software, a photogrammetric tool for posture evaluation.

Markers will be placed on specific anatomical landmarks (e.g., ears, shoulders, hips, and knees) in static standing and sitting positions.

Photographs will be taken from the front, side, and back views to analyze:

Sagittal plane deviations (e.g., forward head posture, thoracic kyphosis). Frontal plane asymmetries (e.g., shoulder or pelvic tilts). Sitting posture deviations (e.g., cervical angle or slouched sitting positions).

Data will include angles and alignment deviations to quantify changes after the intervention.

B.3. Body Awareness Body Awareness Questionnaire (BAQ): Evaluates body awareness across physical, emotional, and social dimensions.

Objectified Body Consciousness Scale (OBCS): Measures dimensions of body monitoring, body shame, and appearance control beliefs.

C. Statistical Analysis Relationships between variables: Pearson's correlation coefficient will be used for normally distributed data, and Spearman's rank correlation will be applied for non-normally distributed data.

Between-group comparisons: The Independent Samples t-Test will be used for normally distributed data, and the Mann-Whitney U Test will be applied for non-parametric data.

Within-group comparisons: Paired t-Tests will be conducted for normally distributed data, and the Wilcoxon Signed Rank Test will be used for non-parametric data to assess changes from pre- to post-intervention.

Significance Level: All statistical analyses will be performed using the SPSS software package (version 26.0), with a significance level set at p \< 0.05.

Eligibility Criteria:
Inclusion Criteria:

* Aged between 10-19 years.
* Voluntary participation with signed informed consent.
* Ability to read and write in Turkish.

Exclusion Criteria:

* History of orthopedic injury within the last 3 months.
* Obesity (BMI \> 30 kg/m²).
* Being under follow-up for a scoliosis diagnosis.