Generation Z Loves Pilates Studios
According to BODYMEDIA, a German B2B trade publication covering the fitness, physical therapy, and health industries, there are now roughly 1300 Pilates studios in Germany. Over the past few years, Reformer Pilates providers have claimed an increasing share of that market. In 2023, for instance, Club Pilates — the world’s largest network of Reformer Pilates studios and operated by the LifeFit Group — opened its first location in Germany.
In Reformer Pilates, unlike traditional Pilates, so-called Reformer machines are used to perform exercises against adjustable resistance. On social media, influencers regularly showcase the seemingly miraculous results of their Reformer training and promote select Reformer Pilates studios.
What health benefits does Reformer Pilates offer over Mat Pilates? Which of the health benefits of Reformer Pilates touted by influencers are supported by current research?
Reformer Pilates Has Deep Roots
The origins of Reformer Pilates date back further than its popularity on social media.
As early as World War I, Joseph Hubertus Pilates (1883-1967), a German citizen interned in England, developed a training method that used the springs from hospital beds as a resistance system. His goal was to provide an effective training method for the injured and bedridden. Building on these experiences, he established a studio in 1926 after emigrating to the US with his wife Clara, where he offered rehabilitation training for injured dancers.
To perform his approximately 500 exercises for strengthening and stretching the (core) muscles, Pilates invented five pieces of equipment: the Reformer, the Cadillac, the Chair, the Barrel, and the Spine Corrector. In Pilates’ view, beginners should practice on the equipment, while advanced practitioners could use a mat as their sole training tool.
Nevertheless, it was the equipment-free form of the training — which had by then become known as Pilates — that first gained popularity abroad. In Germany, the first Mat Pilates classes emerged in the early 2000s.
Toward the end of the COVID pandemic, small studios — which were able to control participant numbers and thus the risk for infection — found it easier to recruit members than large chain studios. This competitive advantage, along with other pandemic-related factors — such as the greater importance that Generation Z placed on health and longevity in the post-COVID era compared to pure fitness or their growing desire to view their own workouts not as a chore but as an experience beyond the workplace and home — contributed to the disproportionately high growth of high-end boutique studios relative to the broader market in the 2020s. Reformer Pilates studios also benefited.
Evidence Remains Limited
Studies have shown that Mat Pilates training is associated with moderate improvements in chronic back pain, balance in older adults, and quality of life for certain patient groups. However, the sample sizes of these studies were small to moderate. Conflicting data and study results exist. Furthermore, compared to conventional forms of exercise — such as weight training — the health benefits are not significant.
Since Reformer Pilates has only been practiced by the general public for a few years, the evidence regarding its benefits is even more limited than that for Mat Pilates.
Nilay Şahan and colleagues were able to show in a randomized controlled trial that a twice-weekly, 45-minute Reformer Pilates training program led to a significant reduction in fear of movement after 6 weeks in women aged 30-50 years with chronic back pain. However, the effect size with regard to various pain parameters, fatigue, and sleep quality was modest.
Direct scientific comparisons between Mat and Reformer Pilates do exist. However, these studies also involved small to moderate sample sizes.
Özge Gökalp and colleagues found in 2025 that women aged 30-60 years with overweight who completed Reformer Pilates training three times a week for 8 weeks significantly improved their body composition, upper-body strength, endurance, and levels of depression and anxiety compared to a control group.
I. Bulgurolgu and colleagues compared the effects of Mat Pilates and Reformer Pilates on core muscle strength, functional mobility, balance, fatigue, and subjective quality of life in patients with multiple sclerosis as early as 2017. Both types of training yielded benefits across all parameters. However, Reformer Pilates significantly improved trunk muscle strength more than Mat Pilates.
David Cruz-Díaz and colleagues conducted a randomized controlled trial to compare the effects of Mat Pilates and Reformer Pilates on chronic lower back pain. After 12 weeks of training, both types of training led to significant reductions in pain and increases in muscle strength. However, progress occurred more rapidly in the Reformer Pilates group.
Conclusion
Current evidence confirms that Reformer Pilates training offers real health benefits. It improves mobility, balance, and muscle strength, particularly in the core and upper extremities. However, these benefits are relative to physical inactivity. When Reformer Pilates training is compared to Mat Pilates or general fitness training, the statistical significance disappears in almost all studies.
Reformer Pilates is therefore neither empty hype nor a true panacea. It contributes to a healthy lifestyle without replacing evidence-based exercise therapies.
This story was translated from Univadis Germany, part of the Medscape Professional Network.