{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:25:38Z","timestamp":1786123538863,"version":"build-2736575974"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Population aging has increased demand for scalable strategies supporting balance-oriented rehabilitation, fall-risk management, and functional independence in older adults. Pilates and technology-assisted exercise, including AR\/VR, exergaming, motion-sensing exercise, telerehabilitation, and technology-delivered Pilates, may be relevant, but comparative evidence and older-adult applicability remain uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare Pilates, technology-assisted exercise, technology-delivered Pilates, conventional exercise, and control for balance- and postural-control-related outcomes using exploratory network meta-analysis and aging-public-health applicability mapping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched eight sources through 2 May 2026. The primary network included source-verified randomized trials with eligible balance\/postural-control endpoints and extractable post-intervention arm-level data. Hedges\u2019 g used exact small-sample correction, and random-effects frequentist network meta-analysis used restricted maximum likelihood. Risk of bias and certainty were assessed using RoB2 and a conservative GRADE\/CINeMA-informed framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The primary network included 12 studies, 25 analytic arms, and 491 participants; the broader sensitivity network included 14 studies, 29 arms, and 606 participants. Estimates versus control were 0.33 (95% CI \u22120.04 to 0.69) for conventional exercise, 0.64 (0.18 to 1.09) for Pilates, 0.69 (0.38 to 1.01) for technology-assisted exercise, and 0.69 (0.14 to 1.25) for technology-delivered Pilates. Applicability mapping identified direct older-adult community evidence (4 studies, 187 participants), aging-related clinical rehabilitation evidence (6 studies, 216 participants), and indirect non-geriatric evidence (2 studies, 88 participants). Certainty was low for technology-assisted exercise and very low for other active-versus-control comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Active interventions generally favoured the intervention over control, but sparse evidence, heterogeneity, control variability, outcome-domain sensitivity, clinically fragile transitivity, and low\/very low certainty preclude a definitive hierarchy. Findings may inform risk-stratified community programmes, home-based support, digital-equity planning, and implementation trials rather than justify a single preferred intervention, platform, or automated decision-support model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261383909<\/jats:ext-link>\n                      , PROSPERO, CRD420261383909.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1899309","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:40:12Z","timestamp":1786117212000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pilates and AR\/VR-based and other technology-assisted exercise for balance and postural control in older-adult and aging-related rehabilitation contexts: a systematic review and exploratory network meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Yongheng","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Sports Coaching, Kyungil University","place":["Gyeongsan-si, Republic of Korea"]},{"name":"Wushu College, Henan University","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Jin","family":"Son","sequence":"additional","affiliation":[{"name":"Department of Taekwondo, Kyungil University","place":["Gyeongsan-si, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minhye","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Sports Coaching, Kyungil University","place":["Gyeongsan-si, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"afac205","DOI":"10.1093\/ageing\/afac205","article-title":"World guidelines for falls prevention and management for older adults: a global initiative","volume":"51","author":"Montero-Odasso","year":"2022","journal-title":"Age Ageing"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.jsams.2024.09.003","article-title":"Exercise and sports science Australia updated position statement on exercise for preventing falls in older people living in the community","volume":"28","author":"Tiedemann","year":"2025","journal-title":"J Sci Med Sport"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1209319","DOI":"10.3389\/fpubh.2023.1209319","article-title":"Effectiveness of exercise interventions on fall prevention in ambulatory community-dwelling older adults: a 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