Pilates With Diaphragmatic Breathing in Sedentary Women (PDB-Pilates)

Effects of Pilates Combined With Diaphragmatic Breathing on Cardiopulmonary Markers in Sedentary Women: A Randomized Controlled Trial

This randomized controlled trial evaluated whether adding diaphragmatic breathing exercises to an eight-week supervised Pilates program improves pulmonary function, resting heart rate, and core endurance in sedentary women aged 35 years and older. Participants were randomized to Pilates combined with diaphragmatic breathing or Pilates alone. Both groups trained three times per week for eight weeks.

Study Overview

• Status: Completed
• Conditions: Sedentary Behavior Pulmonary Function Cardiopulmonary Fitness
• Intervention / Treatment: Behavioral: Pilates Exercise Program; Behavioral: Diaphragmatic Breathing Exercise

Detailed Description

Participants were sedentary women aged 35 years and older who had not participated in regular structured exercise during the previous six months. Participants were randomly assigned in a 1:1 ratio to either Pilates combined with diaphragmatic breathing exercises or Pilates alone. Both groups completed supervised exercise sessions three times per week for eight weeks. Each session lasted approximately 60 minutes and included warm-up, main Pilates exercises, and cool-down. The experimental group additionally performed structured diaphragmatic and abdominal breathing exercises integrated into the Pilates sessions. Pulmonary function, cardiovascular parameters, functional performance, anthropometry, and echocardiographic safety parameters were assessed at baseline and after the intervention.

• Study Type: Interventional
• Enrollment (Actual): 24
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Bandırma
    • Balıkesir, Bandırma, Turkey (Türkiye), 10010
      • Bandirma Onyedi Eylul University, Faculty of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Female participants aged 35 years or older
• Sedentary status, defined as no regular structured exercise participation during the previous six months
• Non-smoker
• No diagnosed cardiovascular, pulmonary, or musculoskeletal disorder
• Not using medications known to influence cardiopulmonary function
• Provided written informed consent

Exclusion Criteria:

• Pregnancy
• Recent surgery or injury
• Participation in another structured exercise program during the study period
• Any cardiovascular, pulmonary, or musculoskeletal condition that could affect safe participation
• Use of medication known to influence cardiopulmonary function

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Pilates Exercise Diaphragmatic Breathing Exercise; Participants completed an eight-week supervised Pilates program combined with structured diaphragmatic and abdominal breathing exercises. Sessions were performed three times per week and lasted approximately 60 minutes.	Behavioral: Pilates Exercise Program; Participants completed a supervised mat-based Pilates exercise program three times per week for eight weeks. Each session lasted approximately 60 minutes and included a warm-up phase, a main Pilates exercise component targeting core stability, flexibility, postural alignment, and muscular endurance, and a cool-down phase.; Behavioral: Diaphragmatic Breathing Exercise; Participants performed structured diaphragmatic and abdominal breathing exercises integrated into the Pilates sessions. The breathing protocol included slow nasal inhalation, controlled oral exhalation, abdominal expansion, segmental thoracic breathing, and guided breathing rhythm during selected Pilates exercises.
Active Comparator: Pilates Alone; Participants completed the same eight-week supervised Pilates program without specific diaphragmatic breathing instruction. Sessions were performed three times per week and lasted approximately 60 minutes.	Behavioral: Pilates Exercise Program; Participants completed a supervised mat-based Pilates exercise program three times per week for eight weeks. Each session lasted approximately 60 minutes and included a warm-up phase, a main Pilates exercise component targeting core stability, flexibility, postural alignment, and muscular endurance, and a cool-down phase.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Peak Expiratory Flow	Peak expiratory flow was assessed by spirometry. The change from baseline to the end of the eight-week intervention was evaluated.	Baseline and after 8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Forced Vital Capacity	Forced vital capacity was assessed by spirometry.	Baseline and after 8 weeks
Change in Forced Expiratory Volume in One Second	FEV1 was assessed by spirometry.	Baseline and after 8 weeks
Change in FEV1/FVC Ratio	The FEV1/FVC ratio was calculated from spirometric measurements.	Baseline and after 8 weeks
Change in Resting Heart Rate	Resting heart rate was measured after at least 10 minutes of seated rest.	Baseline and after 8 weeks
Change in Plank Test Performance	Core muscular endurance was assessed using the prone plank test, recorded in seconds.	Baseline and after 8 weeks
Change in Echocardiographic Safety Parameters	Echocardiographic parameters including ejection fraction, ventricular dimensions, wall thickness, and flow velocities were evaluated for safety monitoring.	Baseline and after 8 weeks

Collaborators and Investigators

• Sponsor: Bandırma Onyedi Eylül University
• Investigators: Principal Investigator: DUYGU DURMAZ, PHD, Bandirma Onyedi Eylul University, Faculty of Medicine

Study record dates

Study Major Dates

• Study Start (Actual): June 3, 2025
• Primary Completion (Actual): September 5, 2025
• Study Completion (Actual): October 7, 2025

Study Registration Dates

• First Submitted: June 11, 2026
• First Submitted That Met QC Criteria: June 11, 2026
• First Posted (Actual): June 16, 2026

Study Record Updates

• Last Update Posted (Actual): June 16, 2026
• Last Update Submitted That Met QC Criteria: June 11, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Pilates Diaphragmatic Breathing Pulmonary Function Sedentary Women Resting Heart Rate Core Endurance Peak Expiratory Flow
• Other Study ID Numbers: BANU-PILATES-DB-2025-76; Other Identifier (Other Identifier: 2025-76)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data underlying the results reported in the article will be made available upon reasonable request.
• IPD Sharing Time Frame: Beginning after publication and available for 5 years.
• IPD Sharing Access Criteria: Data will be shared with researchers who submit a methodologically sound proposal and obtain approval from the corresponding author and, if required, the institutional ethics committee.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No