1.    Introduction
Falls represent a major public health concern worldwide (1) and pose a significant challenge for aging populations (2). A strong association exists between the fear of falling and the actual risk of falls. Fear of falling (FOF) refers to the anticipation of a fall, which leads to heightened anxiety and the avoidance of activities perceived as risky. More broadly, it reflects a diminished sense of self-efficacy and reduced confidence in maintaining balance and performing daily tasks (3). The prevalence of FOF among community-dwelling older adults varies widely, with estimates ranging from 21% to 85% (4). Approximately one-third of individuals over the age of 65 experience at least one fall each year. The incidence of fall-related injuries increases with age, affecting nearly 40% of those over 75 and approximately 50% of individuals over 80 (1). FOF is a multifaceted phenomenon influenced by various factors. Key risk factors include female gender, a prior history of falls, and advancing age (4). Falls are the leading cause of accidental injury and mortality among the elderly (2). Studies have reported that mortality rates are about 14% higher in older adults with FOF than in those without, and this figure rises to 16% among individuals with restricted activity levels (5). These factors often contribute to unnecessary activity limitations and impaired balance, thereby increasing the risk of future falls (7). A recent systematic review of ten cross-sectional and longitudinal studies highlighted FOF as a predictor of frailty in community-dwelling older adults (8). Moreover, many elderly individuals with high levels of FOF—even in the absence of balance impairments—tend to restrict their physical activity, leading to increased sedentary behavior. This inactivity can contribute to greater body fat accumulation and loss of muscle mass (9). Physical exercise offers numerous health benefits and plays a crucial role in reducing fall risk (10). There is strong evidence that structured exercise programs can mitigate the physical consequences of aging (11). Furthermore, regular physical activity is widely recognized as an effective strategy to prevent age-related complications, including falls and related injuries (12, 13). Therefore, the aim of this study was to compare the effects of Pilates and home-based functional exercises on the fear of falling in elderly women with and without a history of falls. 
2.    Methods
This study employed a quasi-experimental pre-test–post-test design to examine the effects of functional exercises and Pilates on fear of falling among elderly women. A total of 40 women aged 70 to 80 years were selected and randomly assigned to four groups of ten: (1) home-based functional exercise with a history of falls, (2) home-based functional exercise without a history of falls, (3) Pilates with a history of falls, and (4) Pilates without a history of falls. Fall history was determined through a self-reported questionnaire. Inclusion criteria required the absence of mobility, cognitive, visual, or auditory impairments, and all participants provided written informed consent prior to participation. Fear of falling was assessed using the International Falls Efficacy Scale (IFES), a 10-item instrument with total scores ranging from 16 to 64, where higher scores indicate greater fear of falling. The intervention included two different training protocols: The Pilates program was conducted over 12 weeks with two sessions per week, while the functional exercise program lasted for 8 weeks with three sessions per week. Each session incorporated warm-up and cool-down components to ensure participant safety and program effectiveness. Data analysis was performed using SPSS version 23. The Shapiro–Wilk test was applied to examine the normality of data distribution. Between-group comparisons were conducted using one-way analysis of covariance (ANCOVA), while within-group differences between pre-test and post-test scores were evaluated using paired samples t-tests. This methodological approach was designed to enhance the accuracy, reliability, and validity of the findings.
3.    Results
The results of the within-group comparisons, as presented in Table 1, showed that both home-based functional exercises and Pilates significantly reduced fear of falling after eight weeks. This reduction was significant in the functional exercise group with a history of falls (p = 0.005), as well as in all other groups—including those performing Pilates and functional exercises—with and without a history of falls (p = 0.001).

4.    Conclusion
The current study revealed a significant difference between functional training and Pilates in reducing fear of falling among elderly women, both with and without a history of falls. Additionally, within-group analyses showed a marked reduction in fear of falling after eight weeks of either training intervention. These findings are consistent with prior research by Mueller et al. (26) and De Campos Jr. (27), who also reported beneficial effects of exercise interventions on fall-related outcomes. Similarly, Aibar-Almazán et al. (30) demonstrated that 12 weeks of Pilates training significantly reduced fear of falling in women over the age of 65. Długosz-Boś et al. (21) further confirmed the long-term efficacy of Pilates in lowering fall risk among elderly women. Supporting this, Park et al. (32) observed that a history of falls was associated with decreased physical activity and increased fear of falling. Likewise, Eskandari et al. (33) found that a 12-week square step exercise program effectively reduced fear of falling in older women. Taken together, the present study adds to the growing body of evidence suggesting that both functional and Pilates training are effective in reducing fear of falling in older adults, regardless of their fall history. Furthermore, the observed differences between the two training methods highlight their unique benefits and support their use as targeted interventions for fall prevention. In conclusion, integrating functional and Pilates-based exercises may enhance balance, boost confidence, and ultimately reduce fall risk among elderly women over the long term. 
Ethical Considerations
Compliance with ethical guidelines
This study adhered to ethical principles by ensuring participants’ right to withdraw at any time, providing them with comprehensive information about the research, and safeguarding all personal data through secure handling procedures.
Funding
This research did not receive any financial support from government, private, or non-profit organizations.
Authors' contributions
All authors contributed equally to preparing the article.
Conflicts of interest
The authors declare that there are no conflicts of interest associated with this article.