Effects of Diaphragmatic Breathing During Equipment-Based Pilates in Women

The Effects of Diaphragmatic Breathing Exercises on Core Stabilization Muscle Strength, Peak Expiratory Flow, and Chest Expansion in Women Performing Equipment-Based Pilates: A Randomized Controlled Trial

This randomized controlled study aims to investigate the effects of diaphragmatic breathing exercises on core stabilization muscle strength, peak expiratory flow (PEF), and chest expansion in women performing equipment-based Pilates.

A total of 44 healthy women aged 20 to 50 years who regularly participate in equipment-based Pilates exercises will be recruited and randomly assigned to one of two groups. The intervention group will receive equipment-based Pilates training combined with diaphragmatic breathing exercises, while the control group will receive equipment-based Pilates training only.

Both groups will participate in supervised exercise sessions twice weekly for 8 weeks. Core stabilization muscle strength, peak expiratory flow, and chest expansion measurements will be assessed before and after the intervention period.

The findings of this study may contribute to a better understanding of the additional effects of diaphragmatic breathing exercises on respiratory function and core stabilization in women performing Pilates.

Study Overview

• Status: Not yet recruiting
• Conditions: Diaphragmatic Breathing; Respiratory Function; Core Stability
• Intervention / Treatment: Behavioral: Diaphragmatic Breathing Exercise; Behavioral: Equipment-Based Pilates Training

Detailed Description

Pilates is a popular exercise approach that is widely used in both healthy individuals and various clinical populations to improve flexibility, muscular strength, postural control, and core stability. One of the fundamental principles of Pilates is coordinated breathing during movement. Appropriate breathing patterns may enhance trunk stabilization and optimize exercise performance.

The diaphragm is the primary muscle of respiration and also plays an important role in core stabilization through its interaction with the abdominal muscles, pelvic floor muscles, and deep spinal stabilizers. Diaphragmatic breathing exercises have been shown to improve respiratory function, chest mobility, and trunk muscle activation. However, limited evidence exists regarding the additional effects of diaphragmatic breathing exercises in women who regularly perform equipment-based Pilates exercises.

The aim of this randomized controlled study is to investigate the effects of diaphragmatic breathing exercises on core stabilization muscle strength, peak expiratory flow (PEF), and chest expansion in women performing equipment-based Pilates.

Healthy women aged 20 to 50 years who regularly participate in equipment-based Pilates exercises will be recruited. Participants who meet the eligibility criteria and provide written informed consent will be randomly assigned to one of two groups. The intervention group will receive equipment-based Pilates exercises combined with diaphragmatic breathing exercises, whereas the control group will receive equipment-based Pilates exercises only.

Both groups will participate in supervised exercise sessions twice weekly for a total of 8 weeks. Outcome assessments will be performed before and after the intervention period. Core stabilization muscle strength will be evaluated using a pressure biofeedback unit. Peak expiratory flow will be assessed using a peak flow meter, and chest expansion will be measured at different thoracic levels using a tape measure.

The primary outcome of the study is core stabilization muscle strength. Secondary outcomes include peak expiratory flow and chest expansion measurements. The findings of this study are expected to contribute to the understanding of the role of diaphragmatic breathing exercises in improving respiratory function and core stabilization in women performing equipment-based Pilates and may provide evidence for the development of more effective exercise programs.

• Study Type: Interventional
• Enrollment (Estimated): 44
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Nava Mokhtari, PT, MSc; Phone Number: +90 505 740 3209; Email: navaamokhtarii@gmail.com
• Study Contact Backup: Name: Gözde Başbuğ, PhD, PT; Phone Number: +90 535 558 89 09; Email: gozdebasbug@aydin.edu.tr

Study Locations

• Turkey (Türkiye)
  • Istanbul
    • Istanbul, Istanbul, Turkey (Türkiye)
      • Yeşim Dokuzluoğlu Private Pilates Studio

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

Female participants aged 20-50 years. Healthy individuals regularly performing equipment-based Pilates exercises. Willingness to participate voluntarily and provide informed consent. Ability to attend Pilates sessions twice weekly for 8 weeks.

Exclusion Criteria:

History of spinal trauma or surgery within the previous 6 months. Pregnancy. Diabetes mellitus or other systemic diseases. Respiratory or musculoskeletal disorders that may affect participation or outcome measurements.

Cognitive or physical limitations preventing compliance with the study protocol.

Failure to attend scheduled sessions or complete the intervention protocol. Development of pain, injury, or any medical condition requiring discontinuation during the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Pilates + Diaphragmatic Breathing; Participants received equipment-based Pilates training combined with diaphragmatic breathing exercises twice weekly for 8 weeks. Each session lasted approximately 50 minutes and was supervised by the same physiotherapist.	Behavioral: Diaphragmatic Breathing Exercise; Participants performed diaphragmatic breathing exercises twice weekly for 8 weeks under the supervision of a physiotherapist. The breathing exercises focused on diaphragmatic activation and controlled breathing patterns and were integrated into the Pilates training sessions.; Behavioral: Equipment-Based Pilates Training; Participants received equipment-based Pilates training twice weekly for 8 weeks. Each session lasted approximately 50 minutes and was supervised by the same physiotherapist. The program focused on core stabilization, posture, flexibility, and muscle strengthening.
Active Comparator: Pilates Only; Participants received equipment-based Pilates training twice weekly for 8 weeks.	Behavioral: Equipment-Based Pilates Training; Participants received equipment-based Pilates training twice weekly for 8 weeks. Each session lasted approximately 50 minutes and was supervised by the same physiotherapist. The program focused on core stabilization, posture, flexibility, and muscle strengthening.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Core Stabilization Muscle Strength	Core stabilization muscle strength assessed using a Pressure Biofeedback Unit (PBU).	Baseline and 8 weeks
Peak Expiratory Flow (PEF)	Peak expiratory flow measured using a peak flow meter and recorded in liters per minute (L/min).	Baseline and 8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Chest Expansion	Chest expansion measured at the axillary, xiphoid, and subcostal levels using a flexible measuring tape.	Baseline and 8 weeks

Collaborators and Investigators

• Sponsor: Istanbul Aydın University
• Investigators: Principal Investigator: Gözde Başbuğ, PhD, PT, Istanbul Aydın University

Study record dates

Study Major Dates

• Study Start (Estimated): June 15, 2026
• Primary Completion (Estimated): August 10, 2026
• Study Completion (Estimated): August 15, 2026

Study Registration Dates

• First Submitted: June 11, 2026
• First Submitted That Met QC Criteria: June 11, 2026
• First Posted (Actual): June 17, 2026

Study Record Updates

• Last Update Posted (Actual): June 17, 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; Core Stability; Respiratory Function; Peak Expiratory Flow; Chest Expansion; Equipment-Based Pilates
• Additional Relevant MeSH Terms: Pathologic Processes; Respiratory Tract Diseases; Respiration Disorders; Pathological Conditions, Signs and Symptoms; Respiratory Aspiration
• Other Study ID Numbers: İAU-FTR-NM-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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