Manual Therapy Group:

20 people meeting the inclusion criteria were accepted. Participants received Pilates sessions twice a week, with two days between sessions. A total of 8 sessions (4 weeks) were conducted. Manual therapy was performed after each 50-minute exercise session.

20 people meeting the inclusion criteria were accepted. Participants received Pilates sessions twice a week, with two days between sessions. A total of 8 sessions (4 weeks) were conducted

The Pilates program performed by the participants was as follows:

Footwork Series, Running, Pelvic Lift, Bridge, Bridge Pose Flow, Squat, Coordination, The Hundred Twist Stomach, Leg Circles, Frog, Rowing Front Sitting Tall, T-Pull (Long Box Series), Pulling The Straps, Short Box Series, Elephant, Side Stretch, Footwork Series

The manual therapy program included:

cervical, thoracic, and lumbar manipulation, upper and lower extremity manipulation, and temporomandibular joint manipulation.

The SF-36 (Short Form) was used to assess participants' quality of life. It consists of a total of 36 items, including subgroups. The three major health domains included in the SF-36 are functional status, well-being, and general perception of health. These are: physical function (10 items), social function (2 items), role limitations due to physical problems (4 items), role limitations due to emotional problems (3 items), mental health (5 items), energy/vitality (4 items), pain (2 items), and general perception of health (5 items). An average score was calculated for each section. Scores for each section range from 0 to 100, with higher scores indicating better quality of life. Participants were asked to carefully read the questions and answer each question considering their current and past health status. Higher scores indicate higher quality of life. The Turkish version of this questionnaire was used in our study.

During the Y-balance test, it was emphasized that participants should be barefoot. Throughout the test, athletes were encouraged to stand on one leg and reach the maximum distance they could with the other leg in the anterior, posterolateral, and posteromedial directions. The test device was configured with an angle of 135° between the anterior and posterior directions, and 90° in the posterior direction. To increase the reliability of the test and reduce the learning effect, each athlete performed at least six trials with each leg. To minimize the effect of fatigue, during the actual test, three repetitions were performed in the anterior direction, followed by three repetitions each in the posteromedial and posterolateral directions with each leg. If athletes touched the ground with their other foot to maintain balance, did not return to the starting position, or removed their hands from their hips to maintain balance, the relevant trial was considered erroneous and invalidated. The

The VAS is typically presented as a 10 cm line supported by verbal descriptors such as 'no pain' and 'worst imaginable pain'. The patient is asked to mark a 100 mm line to indicate pain intensity. The score is measured from the zero point to the patient's mark. An increase in the numerical score indicates increased pain among the volunteers participating in the study, while a decrease in the score indicates decreased pain.