BACKGROUND: Pilates exercise is often undertaken by people with multiple sclerosis (MS) with balance and mobility difficulties. OBJECTIVES: Primary aim was to compare 12 weeks Pilates with relaxation upon balance and mobility. Secondary aims were to compare (i) standardised exercises (SE) with relaxation and (ii) Pilates with SE. METHODS: Multi-centre, assessor-blinded, randomised controlled trial. Participants with Expanded Disability Status Scale (EDSS) 4.0 to 6.5 were randomly allocated to 12 weeks of Pilates, SE or relaxation. Assessments were undertaken at baseline, weeks 12 and 16 (Primary outcome; 10 metre timed walk (10MTW)). RESULTS: 100 participants (mean age 54 years, 74% female) were randomised. Six relapsed (withdrawn), leaving 94 for intention to treat analysis. There was no significant difference between Pilates and relaxation (p > 0.05) in mean 10MTW. At 12 weeks there was a mean reduction of 4.2 seconds for SE compared with relaxation (95% confidence interval (relax minus SE) 0.0 to 8.4) and 3.7 seconds compared with Pilates (95% CI (Pilates minus SE) -0.4 to 7.8). At 16 weeks, mean 10MTW for SE remained quicker than Pilates and relaxation, although non-significant (both p > 0.05). There were no significant differences between Pilates and relaxation for any secondary outcome (p > 0.05). CONCLUSION: Participants did not improve significantly either in the short term, or at four weeks follow-up, in the 10MTW after 12 weeks of Pilates when compared to 12 weeks relaxation.

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