Pilates in Heart Failure Patients: A Randomized Controlled Pilot Trial

Abstract

Background: Conventional cardiac rehabilitation program consist of 15 min of warmup, 30 min of aerobic exercise and followed by 15 min calisthenics exercise. The Pilates method has been increasingly applied for its therapeutic benefits, however little scientific evidence supports or rebukes its use as a treatment in patients with heart failure (HF). Purpose: Investigate the effects of Pilates on exercise capacity variables in HF. Methods: Sixteen pts with HF, left ventricular ejection fraction 27 ± 14%, NYHA class I-II were randomly assigned to conventional cardiac rehabilitation program (n = 8) or mat Pilates training (n = 8) for 16 weeks of 30 min of aerobic exercise followed by 20 min of the specific program. Results: At 16 weeks, pts in the mat Pilates group and conventional group showed significantly increase on exercise time 11.9 ± 2.5 to 17.8 ± 4 and 11.7 ± 3.9 to 14.2 ± 4 min, respectively. However, only the Pilates group increased significantly the ventilation (from 56 ± 20 to 69 ± 17 L/min, P = 0.02), peak VO 2 (from 20.9 ± 6 to 24.8 ± 6 mL/kg/min, P = 0.01), and O 2 pulse (from 11.9 ± 2 to 13.8 ± 3 mL/bpm, P = 0.003). The Pilates group showed significantly increase in peak VO 2 when compared with conventional group (24.8 ± 6 vs. 18.3 ± 4, P = 0.02). Conclusions: The result suggests that the Pilates method may be a beneficial adjunctive treatment that enhances functional capacity in patients with HF who are already receiving standard medical therapy. BackgroundHeart failure (HF) is considered to be the last stage of heart diseases and a worldwide cause of mortality and morbidity [1,2]. It is characterized by a persistent overactivity of the neurohormonal system [3], endothelial dysfunction [4], exercise intolerance [5,6], high mortality [7], and a poor quality of life [8].Exercise training has been recommended as an important tool in HF treatment. It improves exercise capacity [9], quality of life [10], besides reducing endothelial dysfunction [11], catecholamine levels [12], and morbity [13].Pilates is a particular exercise approach that was founded on the teachings of Joseph Pilates (1880Pilates ( -1967 and was initially practiced almost exclusively by athletes and dancers. Pilates has become a fast-growing, popular trend in rehabilitation and fitness programs in recent years. The goal of Pilates training is improvement of general body flexibility and health, emphasizing core (truncal) strength, posture, and coordination of breathing with movement. Anecdotal evidence suggests that as the Pilates method increases core strength, the natural flexibility of the spine and limbs returns [14,15,16].Despite this promising method, there is little scientific research on the effectiveness of Pilates. The purpose of this study was to investigate the effects of Pilates on exercise capacity variables in HF patients. Methods Study PopulationA total of 26 outpatients with HF were recruited from a tertiary cardiology hospital with the following criteria: clinical and optimized farmacological treatment (for at least 3...

Mat Pilates training reduced clinical and ambulatory blood pressure in hypertensive women using antihypertensive medications

“…Many studies have observed a decrease on blood pressure after a period of resistance exercise training [31][32][33][34][35]. In the present study, to our knowledge, we observed for the first time a significant decrease on BP and DP at rest in hypertensive women who participated in MP training.…”

Atualização da Diretriz Brasileira de Insuficiência Cardíaca Crônica - 2012

“…Estudo no nosso meio demonstrou que a idade não influencia a resposta ao exercício 69 . Outros métodos de treinamento têm sido utilizados como o treinamento complementar de músculos inspiratórios que pode ser indicado naqueles pacientes com IC que apresentam fraqueza da musculatura respiratória (> 70% da pressão inspiratória máxima predita) [70][71][72] ; pilates 73,74 ; treino intervalado e contínuo 66,75,76 ; eletroestimulação 77 ; e hidroterapia 78,79 . Intensidades diferentes de exercício podem ter ação diferente na fisiopatologia da IC 80 .…”

Protocolo de samba brasileiro para reabilitação cardíaca

“…Os programas de reabilitação cardíaca reduzem a morbidade e a mortalidade de coronariopatas 1,5 . No entanto, existe dificuldade em manter o entusiasmo dos pacientes, visando à aderência ao tratamento 6,7 , tornando necessárias novas estratégias, o que tem motivado pesquisas no Brasil e no exterior [8][9][10] . Nesse contexto, a dança configura-se como alternativa eficaz 11,12 , sendo uma atividade lúdica e prazerosa, capaz de proporcionar motivação para realização de atividades físicas 13 , beneficiar os aspectos social, emocional e cognitivo, comprovadamente melhorando a capacidade física e a qualidade de vida (QV) de indivíduos saudáveis 14,15 , já sendo utilizada na recuperação de pacientes com doenças crônicas não transmissíveis 11,12,[16][17][18] .…”