Mat Pilates as a new approach for breast cancer patients undergoing hormone therapy: a randomized controlled clinical trial study protocol (HAPiMat Study)

Abstract

Introduction: Breast cancer and its treatments lead to several physical and psychological repercussions in the short and long term. Furthermore, breast cancer survivors (BCS) tend to present sedentary behavior, which worsens the aforementioned breast cancer treatment side effects. Physical exercise has been demonstrated to be effective for improving physical and psychological BCS aspects. Therefore, the purpose of this study is to investigate the effects of 24 weeks of supervised Mat Pilates on force production, flexibility, postural control, gait, body composition, pain, cancer related fatigue (CRF), body image, physical activity level, quality of life, and nutritional status in BCS undergoing hormone therapy. Methods and design: The HAPiMat Study is a randomized controlled clinical intervention trial comparing Mat Pilates with a control group. The primary outcomes are force production in different muscle groups, upper and lower limb flexibility, and gait and balance parameters. The secondary outcomes are quality of life, pain, cancer related fatigue, body image, sedentary behavior, functional capacity, physical activity level, nutritional intake, anthropometric measurements, and body composition. The safety of the Mat Pilates intervention and physical assessments are monitored throughout the intervention. Discussion: The strengths of this study are that the Pilates Method is mind-body training, which might ameliorate the side effects of breast cancer treatments, and that our intervention is systematized into sets, with the number of repetitions increased every eight weeks, enabling better results in the physical variables. Moreover, to date, no Pilates studies have focused on BCS undergoing hormone therapy only.

The influence of mat Pilates training adherence on strength and flexibility parameters in breast cancer survivors undergoing hormone therapy

“…The aim of this study was to analyze the influence of mat Pilates training adherence on muscle strength and flexibility, which was a secondary analysis of the HAPiMat study ( Bertoli et al, 2020 ; Bertoli et al, 2022a ). The results showed that the group with lower training adherence presented increased hip torque variables and left handgrip strength, while the group with higher training adherence presented improved left shoulder abductor TF max and RFI, and left and right upper and lower body flexibility after 24 weeks of intervention.…”

“…The participant recruitment started in February of 2019. The research protocol was published as a preprint with open access ( Bertoli et al, 2020 ).…”

“…In cases where the participant was not able to progress, she continued in the same level of exercise. The mat Pilates general planning and exercises ( Table 2 ) were based on the Bertoli et al (2020 , 2022a) study, which focused on exercise load progression according to the participants’ characteristics. This protocol is appropriate for breast cancer survivors since the exercise focuses on joint mobility, muscle strength, and flexibility, which are compromised in the short and long-term in this population due to breast cancer treatments, such as breast cancer surgery, radiotherapy, chemotherapy, and hormone therapy.…”

“…In this context, to date there are no studies about the influence of adherence to mat Pilates training on physical performance demands in breast cancer survivors undergoing hormone therapy (AIs and SMREs). Therefore, as a secondary analysis of this investigation ( Bertoli et al, 2020 ; Bertoli et al, 2022a ), the aim of this study was to analyze the influence of adherence to mat Pilates training on lower and upper body muscle strength and flexibility in breast cancer survivors undergoing hormone therapy. It was hypothesized that breast cancer survivors with higher training adherence would obtain better results than those with lower attendance.…”