Pilates Group: Mat Pilates was performed three days a week for 45 minutes. The programme included a 10-minute warm-up, 30 minutes of basic Pilates exercises (hundred, roll-up, spine stretch, single leg stretch) and a 5-minute cool-down and stretching phase. The exercises were conducted by a certified Pilates instructor.

Swimming Group: Moderate-intensity swimming was performed 3 days a week for 40 minutes. The exercises included a 5-minute warm-up, 30 minutes of freestyle and backstroke swimming, and a 5-minute cool-down phase. Participants' heart rates were maintained at 60- 70% of their maximum heart rate.

Brisk walking was performed 3 days a week for 45 minutes. The programme consisted of a 5-minute warm-up walk, 35 minutes of walking at 60-70% of maximum heart rate, and a 5-minute cool-down walk.

Sixty women aged 40-60 years with a T-score between -1.0 and -2.5 were randomly assigned to three groups (Pilates, Swimming, Walking; n=20). Participants exercised for 40-45 minutes three days a week for 12 weeks.All exercises in this group were conducted by a certified Pilates instructor. Pilates exercises were performed on a mat.Session Content:

Warm-Up (10 min): Breathing exercises, shoulder rotation, neck stretch, posterior pelvic tilt, and spinal mobilization exercises were performed.

Main Section (30 min):

Weeks 1-4: Basic movements - Hundred, Roll-Up, Single Leg Stretch, Spine Stretch Weeks 5-8: Intermediate variations - Double Leg Stretch, Rolling Like a Ball, Saw Weeks 9-12: Advanced balance-focused movements - Teaser Prep, Side Kick Series, Swimming, Leg Pull Front Cool-Down (5 min): Deep breathing exercises, hamstring stretching, and spinal Participation rates were regularly recorded, and individuals who participated below 80% of the program were excluded from the analysis.

Handgrip strength was measured using a digital hand dynamometer (Jamar Plus+, kg). Three repetitions were taken during the measurements, and the highest value was recorded. The Jamar dynamometer has high reliability in individuals with osteoporosis (ICC = 0.95).

Trunk flexor and extensor strength were assessed using isokinetic dynamometry (Biodex System 4) at a speed of 60°/s. This method has been reported as a valid measurement tool for elderly individuals and those at risk of osteoporosis.

Berg Balance Scale (BBS): A 14-item test scored between 0 and 56. The reliability coefficient in the Turkish adaptation was found to be 0.98.

Computerised posturography: Static and dynamic balance were assessed, and centre of pressure (CoP) oscillation (mm) was recorded. Posturography is a widely used objective method in the osteoporotic population.