# Efficacy of Pilates in Functional Body Composition: A Systematic Review
## 4 Discussion  
Obesity, defined as the accumulation of body fat, is a health issue that increases the risk of death associated with cardiovascular and metabolic diseases [40]. Thus, the practice of physical activity assumes a leading role in food balance and promotes healthy lifestyles that fight excess weight [3]. In the last few years, the number of Pilates practitioners [50] and the knowledge of its benefits have been increasing [9]. Therefore, our review of studies is in line with the trend of seeking the benefits of this method in the area of FBC. No differences between genders are expected, whether in these variables [12] or other variables traditionally associated with the practice of Pilates [13]. Even in traditional female pathologies, such as pelvic floor problems, advantages were found for males in neoplasms in post-prostatectomy incontinence [16]. Therefore, [PERSON] et al. (2017), using the dual X-ray photon absorptiometry (DXA) method to assess the FBC, regarded a lean mass increase and noted an increase in muscle mass in the trunk (\(p=0.028\)), abdomen (\(p=0.010\)), and arms (\(p=0.042\)). As for FM, a decrease in the lower limbs was identified. Lastly, an increase in bone density was noticed in the lumbar spine, specifically in L2, L3, and L4. This benefit should be highlighted since the sample included menopausal and sedentary women. Using another technique, the bioimpedance method, a significant decrease was identified in the values of weight, BMI, fat percentage, waist diameter, and hip and abdomen circumferences [20]. In another study using bioimpedance (Omicron BF511 body composition monitor) to assess changes in the body composition of 20 adult women, improvements were observed in all measured indicators, namely, weight and FM [21]. In another study \begin{table}
\begin{tabular}{c c c c c c c c c c} \hline \hline \multirow{2}{*}{**n**} & \multirow{2}{*}{**Authors**} & \multirow{2}{*}{**Body Mass Index (BMI)**} & \multirow{2}{*}{**Body Fat Percentage (BFP)**} & \multirow{2}{*}{**Weight**} & \multirow{2}{*}{**Lean Mass**} & Waist Circumference & Hip Circumference & Waist- Hip Ratio & Body Mass Density & Cholesterol/ Triglycerides \\ \hline \multirow{2}{*}{23} & [PERSON] et al. (2020) [12] & & & & & & & & \\  & (2020) [40] & & & & & & & & \\ \hline \multirow{2}{*}{24} & [PERSON] et al. (2020) [41] & & & & & & & & \\ \hline \multirow{2}{*}{25} & [PERSON]- & & & & & & & & & \\  & [PERSON] et al. (2020) [42] & & & & & & & & \\ \hline \multirow{2}{*}{27} & [PERSON] et al. (2020) [43] & & & & & & & & \\  & & (2021) [10] & & & & & & & \\ \hline \multirow{2}{*}{28} & [PERSON] et al. (2021) [10] & & & & & & & & \\ \hline \multirow{2}{*}{29} & [PERSON] et al. (2021) [14] & & & & & & & & \\ \hline \multirow{2}{*}{30} & [PERSON] \& & & & & & & & \\  & [PERSON] & (2021) [45] & & & & & & & \\ \hline \multirow{3}{*}{31} & [PERSON] et al. (2021) [46] & & & & & & & & \\ \hline \multirow{3}{*}{32} & [PERSON] \& & & & & & & & \\  & [PERSON] (2021) [47] & & & & & & & & \\ \hline \multirow{3}{*}{33} & [PERSON] et al. (2021) [48] & & & & & & & & \\ \hline \multicolumn{2}{c}{\(S\)_(spant test_} & \(p=0.189\) & \(p=0.008\) & \(p=0.210\) & \(p=0.109\) & \(p=0.180\) & \(p=0.453\) & \multicolumn{1}{c}{Not calculated_} \\ \hline \hline \end{tabular}
\end{table} 
Table 2: _Cont._with menopausal women practicing Pilates over 6 years, it was found that bone mineral density was higher in the Pilates group and greater than expected considering the age of participants [22]. In an intervention based on Pilates, named \"cardio-Pilates\", significant differences in fat mass percentage, fat mass weight, and hip and waist circumferences were identified [23]. The effect size of these changes was rated as moderate. In an 8 week intervention with a sample with multiple sclerosis, significant decreases were recorded in BW, BMI, FP, FM, WHC, and mid-arm muscle circumferences, as well as in the chest, abdominal, triceps, and supra-iliac skinfolds [24].