Pilates in the Workplace: A Systematic Review and Meta-Analysis of Physical, Psychological, and Functional Outcomes in Employees.

Background: Work-related musculoskeletal disorders impose substantial global burdens. Although Pilates is a recognized biopsychosocial intervention, a quantitative synthesis evaluating its occupational efficacy remains limited. Objective: To compute the pooled effect sizes of workplace Pilates interventions on musculoskeletal pain intensity, functional disability, muscular endurance, and health-related quality of life (QoL). Methods: Twelve randomized controlled trials (14 reports) involving diverse occupational cohorts were analyzed. Data dependency was resolved via outcome aggregation. Random-effects models calculated pooled effect sizes (Hedges' g), 95% confidence intervals (CI), and 95% prediction intervals (PI). Risk of bias was assessed using RoB 2. Results: The meta-analysis demonstrated a moderate, statistically significant reduction in functional disability (g = -0.660, 95% CI [-1.091, -0.229], p = 0.011). Conversely, pooled estimates for pain intensity (g = -0.461, p = 0.360), muscular endurance (g = 1.354, p = 0.223), and QoL (g = -0.146, p = 0.815) were non-significant. Substantial heterogeneity was observed (I2: 32.02-98.25%), and all prediction intervals crossed the null, indicating high uncertainty regarding future effects. Conclusions: Workplace Pilates consistently mitigates functional disability, but current evidence does not support significant pooled improvements in absolute pain, endurance, or QoL. This divergence between functional recovery and pain reduction aligns with biopsychosocial frameworks, suggesting improved work capacity despite variable pain relief. Given the high heterogeneity and wide prediction intervals, findings must be interpreted cautiously, highlighting the need for rigorously standardized trials.