We used a one-year long exercise program in the present study. An exercise program lasting one year may pose difficulty in terms of compliance. However, there were only seven drop-outs which might be considered to be a rela- tively acceptable rate. High compliance observed in the treatment group may be attributed to volunteering of the patients for an interactive and fun gym program and to their motivation stemming from gradual improvement as the study proceeded. The facts that none of the patients withdrew due to complications resulting from the exercise program and no adverse effects were observed in the remaining study population suggested that Pilates was a safe method without any adverse effects. Beneficial effects observed in the home exercise group, although being less compared to the Pilates exercise group, and the absence of any side effects associated with home exercise program suggested that it would be rational to administer such a program in patients who are not suitable for a supervised Pilates exercise program.
The limitations of the present study included relatively small sample size, drop-out of 7 patients and the lack of a control group of no intervention. Failure to perform prospective BMD measurements of the patients owing to the lack of financial support for the study can be regarded as another limitation. However, evaluation of the effects of a one-year long exercise program, which has not been previ- ously investigated in OP, was a strong feature of the present study.