Aquatic Pilates Is Associated with Improved Spinal Alignment and Functional Performance in Women Aged 55–65 Years with Thoracic Kyphosis

Objectives: Thoracic kyphosis is a common postural condition associated with impaired functional performance, reduced balance, and lower levels of physical activity. Women may be particularly susceptible due to age-related musculoskeletal and hormonal changes. This study investigated the effects of a 12-week aquatic Pilates program on thoracic alignment, functional performance, and self-reported physical activity in women aged 55–65 years with thoracic kyphosis. Methods: Twenty women aged 55–65 years with thoracic kyphosis were randomly allocated to an Aquatic Pilates intervention group (n = 10) or a non-exercising control group (n = 10). Participants in the intervention group completed supervised aquatic Pilates sessions twice weekly for 12 weeks, while the control group maintained their usual daily activities. Pre- and post-intervention assessments included thoracic kyphosis angle measured using a DeBrunner kyphometer, the Modified Physical Performance Test (mPPT), and the Physical Activity Scale for the Elderly (PASE). Data were analyzed using 2 × 2 mixed-design repeated-measures ANOVA. The trial was registered retrospectively at ClinicalTrials.gov (NCT07674251). Results: A significant group × time interaction was observed for thoracic kyphosis angle, F_1,18 = 66.31, p < 0.001, partial η² = 0.786), with the Aquatic Pilates group showing a reduction from 42.6° ± 3.4° to 40.7° ± 3.1°. Significant improvements were also observed in the analyzed mPPT functional tasks (all p < 0.001). PASE scores showed a statistically significant group × time interaction (F_1,18 = 9.48, p = 0.006, partial η² = 0.345), with the Aquatic Pilates group showing an increase compared to the control group. Conclusions: Participation in a 12-week aquatic Pilates program was associated with improvements in thoracic kyphosis, functional performance as assessed by the mPPT, and self-reported physical activity in women aged 55–65 years with thoracic kyphosis.