BACKGROUND: Pilates-based core stability training (PBCST) is a controlled form of exercise that may improve the transmission of torque from the upper extremities and trunk to the lower extremities by enabling the core muscles to activate effectively. OBJECTIVES: The aim of this study was to investigate the effects of PBCST given as supervised or home-based on lower extremity strength and postural control in multiple sclerosis. METHODS: Fifty individuals were enrolled and randomly allocated into two groups. Primary outcome measures were knee muscle strength and postural sway in different conditions. The supervised group received PBCST 2 days per week for 8 weeks at the clinic, and the other group performed PBCST at home. Exercises were progressed every 2 weeks in both groups. RESULTS: Between groups, the supervised group was mostly superior to the home group (p < 0.05). A significant improvement was noted in all parameters in both groups, except some sub-parameters of postural sway in home PBCST (p < 0.05). CONCLUSIONS: Supervised PBCST was determined to be more effective than home PBCST in improving strength, postural control, core stability, physical capacity, and fatigue. Although supervised training is the primary choice, home training can be recommended to patients who have limitations attending supervised sessions.

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