## 4 Discussion  
The participants in the current research were confirmed to be frail late-stage older adults (>75 years) due to limited locomotive functions (e.g., 0.3 km/h on the treadmill and short and wide steps with long double support time) and signs of cognitive decline (e.g., average MMSE scores of 23.4). In addition, single-leg standing scores, sit and reach performance, and grip strength were below the healthy benchmark [33; 37]. Continuous engagement in physical exercise programs for frail late-stage older adults is usually challenging, but the current study tested whether they would benefit from an 8-week Pilates program. A total of eight sessions (30 min, once a week) increased MFC and attained more symmetrical swing foot clearance control, indicating a lower tripping risk [27]. Increased MFC can be attributed to more active dorsiflexion and fine-toe control, emphasized in the warm-up part of the program. [PERSON] and [PERSON] [38] reported that dorsiflexion was the most effective lower limb joint motion to increase MFC. Chronic plantarflexor contracture can be another cause of reduced MFC, which is prevalent in the inactive aged population [39]. The warm-up exercise attempted to increase ankle joint range of motion and help loosen undesirable contracture of muscles and soft tissues. Furthermore, the tactility of each toe part was stimulated by the specific warm-up repertoire, and the participants practiced fine-toe movement control for optimum swing foot clearance. Each component of every exercise was conducted for both sides, resulting in symmetrical MFC and associated reduction in the tripping risk [40]. Increased HC-B indicates greater resistance against backward balance loss when a foot slips forward [30], possibly attributable to improvements of age-associated posterior pelvic tilt known as 'backward disequilibrium' [41]. Pelvic rocking in the Pilates program emphasized correcting undesirable pelvic tilt to help align the lumbar-thoracic region to be more upright and to ensure a more anterior location of the _CoM_. In addition, activation of the pelvic floor, followed by transversus abdominis, helped strengthen the link between the pelvic region and the upper body. Although backward disequilibrium (posterior _CoM_ position) can be caused by various physical factors, co-working of the muscle groups connecting the upper and lower body enhanced overall body coordination and stabilized  
Figure 3: Two-dimensional mood scale (TDMS). CoM_. In contrast, dynamic balance at MFC (MFC-B) did not increase, but it was attainable if backward disequilibrium was corrected. In other words, postural adjustments may not assist with increasing MFC-B. Overall, the Pilates sessions seemed to help reduce the tripping risk and increase the likelihood of balance recovery in case of slipping. The cognitive functions of late-stage frail seniors did not reveal significant improvements after 8 weeks of Pilates sessions, but there was a strong trend of potential enhancement in executive functions due to a remarkable reduction in the TMT-A (67.5 s). It has recently been reported that the dual-tasking component of Pilates (e.g., breathing and movement) can enhance executive functions [21; 42]. High correlations between executive function and flexibility were previously reported [26], suggesting that further flexibility training may improve executive functions. Similarly, flexibility performance increasing MFC may prevent tripping falls [26]. [PERSON] et al. [42] reported a potential link between executive functions and fine motor control for quick and effective pre-planning skills for motor behaviors. Although studies of exercise intervention for older adults generally report high dropout rates [22], an excellent outcome was that there were no dropouts from the Pilates intervention group.