Instructor Interpersonal Behaviours in Classical Pilates as a Pathway to Improve Blood Pressure Control and Well-being in Hypertensive Adults

October 5, 2026 updated by: Vera Alexandra da Graça Bártolo, Instituto Politécnico de Leiria

The aim of this study is to investigate, during a Classical Pilates programme with participants suffering from high blood pressure, whether supportive communication from the instructor to the participant has any effect on the impact of the practice on physiological (blood pressure) and psychological (retention, motivation, quality of life and life satisfaction) variables, compared with neutral and routine communication.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Background: Pilates appears to have a positive impact on the management and control of blood pressure. However, studies in this field are still inconsistent, combining classical and contemporary techniques as well as equipment, and the protocols are not always clear. Furthermore, there are no studies that highlight the importance of the instructor's communication and the impact this may have on both blood pressure outcomes and psychological outcomes. This protocol aims to explore the influence, on the above-mentioned outcomes, of supportive communication based on Self-Determination Theory, used during classical Pilates classes.

Methods and Design: The study consists of a 24-week, two-arm randomised controlled trial in which adults with hypertension will practise a Classical Pilates sequence in either a control group receiving neutral feedback or an experimental group receiving supportive feedback based on Self-Determination Theory. The 50-minute sessions will take place twice a week. Outcomes will be assessed at three time points: baseline, 12 weeks and 24 weeks, and will consist of measurements of resting blood pressure, adherence, basic psychological needs, motivational regulation, quality of life and life satisfaction.

Discussion: The study will provide an understanding of the influence of supportive communication on physiological and psychological variables, and may contribute to the development of safe, low-cost intervention programmes that ensure adherence and effectiveness in clinical populations.

Study Type

Interventional

Enrollment (Estimated)

96

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Portugal
      • Tomar, Portugal
        • Pavilhão Municipal Patrícia Sampaio - Tomar
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • adults (≥18 years) with stage 1 or 2 hypertension (SBP 140-179 mmHg and/or DBP 90-119 mmHg) with confirmed diagnosis;
  • stable medication regimen for ≥4 weeks;
  • no regular Pilates practice in the last 6 months;
  • capacity to provide informed consent.

Exclusion Criteria (for safety reasons):

  • individuals with uncontrolled hypertension (SBP ≥180 or DBP ≥120 mmHg);
  • unstable cardiovascular disease;
  • significant uncompensated musculoskeletal pathology;
  • absolute contraindication to exercise;
  • recent change in antihypertensive medication (<4 weeks);
  • participation in another interventional study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Control: Classical Pilates

A group of people with high blood pressure following a predefined Classical Pilates protocol, with neutral communication from the instructors (a regular class that takes into account safety, corrections and adaptations to the exercises, but without any specific support).
Other: Control

The control group will undergo the same 24-week intervention as the experimental group, with two 50-minute sessions per week, following the same classical Pilates matwork protocol described above. There is no supportive communication in this variant, instead, communication is neutral, as usual in any class. Neutral communication refers to natural communication that includes tips, technical adjustments, answers to queries and safety advice, but without any specific concerns regarding autonomy, competence or relatedness.
Experimental: Experimental: Classical Pilates and Need Supportive Communication

A group of people with high blood pressure following a predefined Classical Pilates protocol, with communication designed to support their basic psychological needs, based on Self-Determination Theory.
Behavioral: Self-Determination Theory Based Supportive Communication

The intervention will last 24 weeks, and both groups (intervention and control) will follow a classical Pilates matwork programme, twice a week in 50-minute sessions. Lessons for the control and experimental groups will be conducted separately. The programme will consist of 50-minute sessions of classical Pilates matwork sequence, based on the original exercises by Joseph Pilates. In this experimental group, in addition to exercise, supportive communication (autonomy, competence and relatedness) will be introduced.

Other Names:
  • Interpersonal behaviours

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Blood Pressure
Time Frame: 3 times: Baseline, 12 weeks and 24 weeks

Resting SBP and diastolic blood pressure (DBP) measured with a validated automatic sphygmomanometer following 2024 ESC guidelines (three measurements, 1-2 min interval; the mean of the last two readings will be used for analysis).

Ambulatory blood pressure monitoring will not be included due to logistical and financial constraints in a small-scale study. Furthermore, as this method is uncomfortable, it may itself constitute a barrier to the study, given that three measurements must be taken within a short period of time (3 months). However, automated office blood pressure measurement, taken at rest, when carried out rigorously and in accordance with the guidelines, may offer a level of accuracy similar to that of ambulatory monitoring.
3 times: Baseline, 12 weeks and 24 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Adherence/Retention
Time Frame: 3 times: baseline, 12 weeks and 24 weeks

Attendance records (percent of sessions attended) and study completion rate.
3 times: baseline, 12 weeks and 24 weeks
Motivational Regulation: Behavioural Regulation in Exercise Questionnaire-3 (BREQ-3)
Time Frame: 3 times: baseline, 12 weeks and 24 weeks

The Portuguese version of the BREQ-3 assesses the regulation of motivation in exercise through 18 items, which are subdivided into six dimensions (amotivation, external regulation, introjected regulation, identified regulation, integrated regulation and intrinsic motivation), with responses given on a 5-point Likert scale, ranging from 0 ("I strongly disagree") to 4 ("I strongly agree").
3 times: baseline, 12 weeks and 24 weeks
Short Form Health Survey-12v2 (SF-12v2)
Time Frame: 3 times: baseline, 12 weeks and 24 weeks

The SF12v2 is a shortened version of the SF-36 (Short-Form Health Survey-36), which measures physical and mental health in relation to quality of life on a 12-item scale covering eight dimensions (physical functioning, physical role limitations, bodily pain, general health perceptions, energy/vitality, social functioning, emotional role limitations and mental health), which are summarised into two domains: the physical component summary and the mental component summary. Items are scored on a scale of 0 to 100 ("worst health state" to "best health state").
3 times: baseline, 12 weeks and 24 weeks
Satisfaction With Life Scale (SWLS)
Time Frame: 3 times: baseline, 12 weeks and 24 weeks

The SWLS is a subjective, self-reported well-being scale that assesses overall life satisfaction, including five short items rated on a 7-point Likert scale ranging from 1 ("strongly disagree") to 7 ("strongly agree").
3 times: baseline, 12 weeks and 24 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Instituto Politécnico de Leiria

Investigators

  • Study Director: Diogo M Monteiro, PhD, Universidade de Leiria e do Oeste
  • Study Director: Ana S Alves, PhD, University of Beira Interior
  • Principal Investigator: Vera A Bártolo, PhD Candidate, University of Beira Interior

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

November 1, 2026

Primary Completion (Estimated)

May 1, 2027

Study Completion (Estimated)

May 1, 2027

Study Registration Dates

First Submitted

September 30, 2026

First Submitted That Met QC Criteria

September 30, 2026

First Posted (Actual)

October 6, 2026

Study Record Updates

Last Update Posted (Actual)

October 8, 2026

Last Update Submitted That Met QC Criteria

October 5, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CE-UBI-Pj-2026_027-ID8411
  • UID/04045/2025 (Other Grant/Funding Number: FCT - Foundation for Science and Technology)
  • UID/PRR/04045/2025 (Other Grant/Funding Number: FCT - Foundation for Science and Technology)
  • UID/PRR2/04045/2025 (Other Grant/Funding Number: FCT - Foundation for Science and Technology)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified individual participant data collected during the study, including the data dictionary and analyzable dataset, will be available upon reasonable request to the corresponding author, respecting participant anonymity.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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