This study investigates the impact of a 3-month Pilates training program on lower limb joint muscle strength in unilateral transtibial amputees (TTA), focusing on enhancing muscle function in both the intact and residual limbs.

This is a single-cohort pre-post-intervention study without a control group. Ten TTA participants, actively using prostheses for at least six months, completed a Pilates intervention with 36 sessions online, involving progressively increasing exercise intensities. Measurements of joint muscle strength in the intact limb and residual limb hip were taken at baseline, pre- and post-intervention, and at a three-month follow-up using an isokinetic dynamometer. Repeated measures ANOVA determined statistical significance (alpha level, p < 0.05); and effect size (ES) differences were determined to highlight clinical meaningfulness.

Significant muscle strength increases were observed in the intact limb ankle (45.6 % plantarflexors, 11.9 % dorsiflexors), knee (25.9 % extensors, 28.7 % flexors), hip (22.9 % flexors, 42.2 % extensors) and hip of the residual limb (23.1 % flexors, 52.1 % extensors) – all increases represented a large effect size (ES > 3.0). These improvements persisted at follow-up.

This pilot study demonstrated that Pilates training significantly improved joint muscle strength in the intact and residual limbs of the TTA participant group. These preliminary findings support Pilates as a beneficial and accessible modality for enhancing strength and mobility in lower limb amputees. However, further randomised controlled studies are required to fully determine the effects of Pilates training on functional outcomes and mobility in lower limb amputees.