Group Neuropilates Protocol: An Exploratory Study of Feasibility and Functionality in Neurological Dysfunction

Background and rationale: Neuropilates is an adaptation of Clinical Pilates principles to neurological rehabilitation, incorporating motor control, motor learning, postural stability, and individually tailored functional progression. It aims to support functional performance in people with neurological conditions through structured, supervised therapeutic exercise. Although research has reported potential benefits of Pilates-based interventions in people with neurological conditions, including improvements in balance, functional mobility, postural control, strength, coordination and health-related quality of life, considerable heterogeneity remains in intervention protocols. The lack of structured and adequately evaluated protocols for group-based Neuropilates in neurological rehabilitation limits the reproducibility of interventions and their systematic implementation in clinical practice. The present study will explore the feasibility and functional outcomes of a structured, group-based Neuropilates protocol developed and implemented at the Centro de Medicina e Reabilitação de Alcoitão (CMRA) in Portugal. The study aims to contribute to the standardisation of clinical practice and to inform the design of future research in this field. Aim and objectives: The primary aim is to evaluate the feasibility of a structured group-based Neuropilates intervention for adults with neurological conditions. Secondary objectives: To assess the effects of the Neuropilates protocol on functional outcomes, including balance, functional mobility, lower limb functional strength and health-related quality of life in people with neurological conditions; and to determine the feasibility of the protocol using non-clinical outcomes, including adherence and retention rates throughout the programme, intervention acceptability and safety. Expected outcomes and significance: The study is expected to provide preliminary information on the feasibility, acceptability and safety of delivering a structured group-based Neuropilates programme in neurological rehabilitation. It will also explore potential changes in balance, functional mobility, lower limb functional strength and health-related quality of life following the intervention and at follow-up. The findings will help identify practical considerations for implementing the protocol, inform refinements to the intervention and outcome assessment procedures, and support the planning of future studies with larger samples and more robust comparative designs. Ultimately, this research aims to contribute to the development of a more standardised, reproducible and systematically evaluated approach to group-based Neuropilates in neurological rehabilitation.