Effects of Clinical Pilates Exercises on Symptoms, Posture, Balance and Quality of Life in GERD

Inclusion Criteria: * Age 18-65 years. * Clinically confirmed diagnosis of gastroesophageal reflux disease (GERD). * Self-reported GERD symptoms (heartburn, acid regurgitation, etc.) for at least 3 months prior to enrollment. * Physiologically able to participate in low-to-moderate intensity exercise. * Provision of written informed consent. * Cognitive and psychosocial capacity to comply with the program. Exclusion Criteria: * History of upper gastrointestinal surgery (especially fundoplication). * Achalasia or severe esophageal motility disorder. * Endoscopic evidence of advanced esophagitis, Barrett's esophagus, or esophageal stricture (complicated GERD). * Active peptic ulcer disease or inflammatory bowel disease. * Uncontrolled hypertension, coronary artery disease, or severe pulmonary disease. * Severe musculoskeletal disorders (advanced scoliosis/kyphosis, acute disc herniation, severe osteoarthritis) or vestibular balance disorders. * Pregnancy or suspected pregnancy.