BACKGROUND: Despite Pilates exercise’s widespread adoption in health promotion, variations in implementation protocols and targeted health outcomes have resulted in fragmented evidence. A synthesis of existing evidence is required to establish evidence-based protocols and its validated effects for women’s health outcomes. PURPOSE: The purpose of this review was to evaluate the characteristics of Pilates exercise interventions, evaluate the methodological quality of existing systematic reviews, estimate Pilates exercise effects on diverse health outcomes, and discuss future Pilates exercise research. METHODS: Two independent researchers conducted a literature search across four databases, following the PRISMA guidelines. After the screening process, eight systematic reviews were included. Additionally, the researchers investigated each systemic review’s included independent studies (n = 40). Quality of appraisal was conducted using the AMSTAR 2 tool, followed by a meta-analysis performed with R software. RESULTS: Analysis of FITT revealed substantial heterogeneity in Pilates exercise interventions. No study adopted theoretical frameworks for guiding intervention development and implementation. Methodological quality assessment rated all systematic reviews low, primarily due to inadequate statistical approaches and insufficient analysis of between-study heterogeneity. There were significant improvements in flexibility (Cohen’s d = 0.74, 95% CI [0.32, 1.16]), cardiorespiratory fitness (Cohen’s d = 0.95, 95% CI [0.41, 1.48]), and labor outcomes (pain: Cohen’s d = -1.29, 95% CI [-1.86, 0.72]; delivery time: Cohen’s d = -0.42, 95% CI [-0.77, -0.08]). CONCLUSION: There is a critical need to develop standardized Pilates exercise protocols tailored to women’s specific health outcomes.
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