The purpose of this study was to analyze the effect of real-time online Pilates exercise during COVID-19 on women’s body composition, blood lipids, and psychological health after childbirth. The participants were 16 pregnant women (24–28 weeks pregnant) enrolled at the C Women’s Culture Center in Seoul, South Korea, classified into online Pilates groups and non-exercise groups (PE, n = 8; CON, n = 8). The online Pilates program was conducted for 8 weeks, twice a week, and 50 min a day using a real-time video chat app. Participants visited the hospital twice for body composition and blood tests. Questionnaires on postpartum depression, sleep disorder, and stress were conducted at 6 weeks and 12 weeks after childbirth. We found a significant difference between groups in body composition. The weight, percentage of body fat, body fat mass, and BMI of the PE group decreased. Blood lipids showed significant differences between the groups in TC, TG, LDL and CRP, while insulin and HDL showed no difference. All blood lipids, insulin, and CRP in the PE group were reduced. There were significant differences between the groups in postpartum depression, sleep disorders, and perceived stress indices performed in the post-test, and the serotonin concentration in the PE group increased. Serotonin levels were significantly correlated with postpartum depression, body fat mass, and body fat rate. Pregnant women’s online Pilates in this study was effective at reducing weight and depression in women after childbirth and should be used to promote women’s mental health during COVID-19.

Pilates is effective for training the core muscles and stabilizing the hip joints, which provides relief from pelvic pain and low back pain during pregnancy. However, there are no specific guidelines on appropriate physical exercises for pregnant women due to the current pandemic. We aimed to apply the exercise standard proposed by the American College of Obstetricians and Gynecologists to home-based tele-Pilates exercise (HTPE), to determine its effect on the physical and mental health of pregnant women. We randomly divided the subjects into the following two groups who completed 8 weeks of HTPE (50 min/day, 2 days/week): (a) Pilates exercise (PE, n = 7) and (B) non-Pilates exercise (CON, n = 7). HTPE was performed by adjusting the program every 3 weeks, based on pain and physical fitness levels. We measured body composition, muscles of the hip joint, pelvic tilt, Oswestry Disability Index (ODI), and Pittsburgh Sleep Quality Index (PSQI), before and after HTPE. Following HTPE, while the percentage of body fat and body mass index had significantly decreased, the body fat mass did not change in the PE group (p < 0.05). The PE group showed an increase in strength of the left and right hip flexion and hip abduction, compared to the CON group (p < 0.01). The ODI and PSQI were significantly decreased in the PE group (p < 0.05). Therefore, the 8-week HTPE program is an effective exercise for pregnant woman that reduces body fat metabolism and strengthens muscles of the hip joint, thus alleviating pregnancy-induced low back pain and insomnia.

In this study, according to the exercise intensity (50–60% of HRmax (Maximum Heart Rate), RPE (Rating of Perceived Exertion: 11–13) proposed by The American Congress of Obstetricians and Gynecologists (ACOG) for pregnant women, mat Pilates exercise is related to body composition, lipid parameters, and pelvic stabilization. The effects on muscle and muscle damage were investigated. The subjects of this study were 16 pregnant women registered at the Cultural Center of Gyeonggi-do C Women’s Hospital, and the gestation period was 16 to 24 weeks. The mat Pilates exercise program (twice a week, 60 min per day, total 12 weeks) changed the Pilates exercise program every 6 weeks according to the subject’s pain level and physical fitness. Body composition before and after exercise, hip flexion, abduction and dilated lipids, inflammation, muscle damage, and stress hormones were measured through blood biochemical analysis. First, the difference in total body water, intracellular water, and skeletal muscle changes (post-pre) increased significantly in the Pilates exercise (PE) group compared to the control (CON) group, while the extracellular/intracellular water ratio significantly decreased. The effect of Pilates on body composition and lipid profile confirmed that, after testing, total body water (TBW), intracellular water (ICW), and extracellular water (ECW) were significantly greater than pre-test values in both groups (TBW: z = −2.286, p = 0.022, r = 0.572; ICW: z = −2.818, p = 0.005, r = 0.705; ECW: z = −1.232, p = 0.218, r = 0.308), whereas the ECW/ICW ratio decreased significantly only in the PE group (z = −2.170, p = 0.030, r = 0.543); while the increases in TBW and ICW were greater in the PE group than in the CON group, the ECW/ICW ratio decreased significantly in the PE group. Blood tests showed significant increases in body weight (BW), body fat mass (BFM), and percentage of body fat (PBF) in both groups post-test as compared to pre-test (BW: z = −1.590, p = 0.112, r = 0.398; BFM: z = −0.106, p = 0.916; PBF: z = −1.643, p = 0.100, r = 0.411). There was a slight increase in creatine kinase (CK) and lactate dehydrogenase (LDH), which are indices of muscle damage, and in the difference between the periods within the group, the CK and LDH of the CON group showed a tendency to increase significantly after inspection compared to the previous values (CK: z = −1.700, p = 0.089, r = 0.425, LDH: z = −2.603, p = 0.009, r = 0.651). Aspartate aminotransferase (AST) decreased significantly in the Pilates exercise group compared to that in the control group, and as a result of confirming the difference in the amount of change in C-reactive protein (CRP), there was no significant difference between the two groups, and the PE group showed a tendency to decrease after inspection compared to the previous period even in the difference between the periods in the group. The CON group showed an increasing trend, but no significant difference was found. Cortisol, a stress hormone, also increased significantly after inspection both groups compared to before (CON group: z = −2.201, p = 0.028; PE group: z = −2.547, p = 0.011). Therefore, the 12 week Pilates exercise program conducted in this study has a positive effect on body water balance and strengthens the muscles related to pelvic stabilization within the range of reducing muscle damage or causing muscle damage and stress in pregnant women. We think that it has an effective exercise intensity.

Purpose: This study aims to observe the effects of at home Pilates exercise, using a real-time web program in postpartum women where measurements of body composition, abdominal obesity, pelvic tilt, back pain and Oswestry Disability Index will be taken.Methods: Subjects included postpartum women under the age of 45 that were registered at the C Cultural Women’s Center in Bundang, Gyeonggi-do. All subjects were within 1 year of childbirth, had no medical opinion and were not receiving medication. A total of 16 people were enrolled in this experiment, which consisted of a Pilates Exercise group (EX, n=8) and a control group (CON, n=8). Measurements of body composition, abdominal subcutaneous fat thickness and circumference, pelvic tilt, pelvic strength, and back pain index were all assessed prior to being exposed to experimental measures. After 8 weeks of un-tact home Pilates exercise, a followup examination was conducted to observe the group-specific changes.Results: The group that participated in the un-tact home Pilates exercise showed a decrease in body fat, BMI, and visceral fat postpartum. Abdominal obesity tests showed a significant reduction in subcutaneous fat thickness, abdominal and hip circumference. The pelvic tilt test showed a reduction in the pelvic slope of the EX-group. Finally, the Oswestry Disabililty Index test showed the total score of the EX-group had decreased, confirming that Pilates exercise in this study was effective for back pain.Conclusions: Thus, un-tact home Pilates exercise using a real time web program is an effective intervention that can be used to prevent postpartum obesity by reducing abdominal and total body adiposity postpartum, assisting pelvic function, and improving muscle strength while also reducing back pain.

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