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This randomized controlled trial aims to compare the effects of mat Pilates combined with paced breathing versus mat Pilates combined with diaphragmatic breathing on stress, anxiety, cardiopulmonary endurance, dyspnea, and quality of life in patients with Stage II hypertension. Participants will be recruited from the Physiotherapy Department of the University of Lahore Teaching Hospital. Outcome measures will include DASS-21, 6-Minute Walk Test (6MWT), Modified Borg Dyspnea Scale, and SF-12 Health Survey. The intervention will be conducted three times per week for six weeks.
This study is a randomized controlled trial conducted at the Physiotherapy Department of the University of Lahore Teaching Hospital, Lahore. A total of 63 hypertensive patients will be screened from the Outpatient Department (OPD) after clinical diagnosis by a qualified medical specialist.
Eligible participants who meet inclusion criteria and provide written informed consent will be enrolled using a non-probability purposive sampling technique. Participants will be randomly allocated into two parallel groups using a sealed envelope method to ensure allocation concealment.
Participants in:
Group A:
Will receive mat Pilates exercises combined with paced breathing training.
Group B:
Will receive mat Pilates exercises combined with diaphragmatic breathing training.
Both groups will undergo supervised intervention sessions three times per week on alternate days for a total duration of six weeks. Each session will last approximately 45-60 minutes.
Outcome measures will be assessed at baseline and at the end of the six-week intervention period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mat Pilates + Paced Breathing | Experimental | Participants assigned to this arm will receive a supervised mat Pilates program combined with paced breathing exercises, performed three times per week on alternate days for six weeks. Each session will last approximately 45-60 minutes. |
|
| Mat Pilates + Diaphragmatic Breathing | Experimental | Participants assigned to this arm will receive a supervised mat Pilates program combined with diaphragmatic breathing exercises, performed three times per week on alternate days for six weeks. Each session will last approximately 45-60 minutes. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mat Pilates | Other | Standardized mat-based Pilates exercises focusing on breathing control, core stability, postural alignment, flexibility, and strengthening. Sessions will be supervised and conducted three times per week on alternate days for six weeks, with each session lasting approximately 45-60 minutes. |
| Measure | Description | Time Frame |
|---|---|---|
| Stress and Anxiety Levels (DASS-21) | Stress and anxiety levels will be assessed using the Depression Anxiety Stress Scale - 21 items (DASS-21). Each subscale consists of 7 items scored on a 4-point Likert scale (0 = Did not apply to me at all to 3 = Applied to me very much or most of the time). Scores are multiplied by 2 to calculate final subscale scores. Higher scores indicate greater psychological distress. | Baseline and at 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Cardiopulmonary Endurance (6-Minute Walk Test) | Cardiopulmonary endurance will be measured using the 6-Minute Walk Test (6MWT). The total distance walked in meters over six minutes will be recorded. Higher distance indicates improved cardiopulmonary endurance. | Baseline and at 6 weeks |
| Dyspnea Severity (Modified Borg Dyspnea Scale) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Lahore Teaching Hospital | Lahore | Punjab Province | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35642490 | Background | Batista JP, Tavares JB, Goncalves LF, de Souza TCF, Mariano IM, Amaral AL, Rodrigues ML, Matias LAS, Magalhaes Resende AP, Puga GM. Mat Pilates training reduces blood pressure in both well-controlled hypertensive and normotensive postmenopausal women: a controlled clinical trial study. Clin Exp Hypertens. 2022 Aug 18;44(6):548-556. doi: 10.1080/10641963.2022.2079670. Epub 2022 Jun 1. | |
| Background | Bartolain, T. (2024). Short-Term Pilates Exercise Intervention and Its Impact on Functional Movement in Healthy Middle-Aged Adults. | ||
| 36630953 |
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Individual participant data (IPD) will not be shared. This study is being conducted as an academic research project. The informed consent obtained from participants does not include provisions for public data sharing, and the dataset contains sensitive personal health information. Data will be stored securely and used only for academic and research purposes in accordance with institutional ethics approval.
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| D000075222 | Essential Hypertension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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Participants will be randomly assigned into two parallel groups to receive either mat Pilates combined with paced breathing or mat Pilates combined with diaphragmatic breathing for six weeks.
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Participants and care providers will not be blinded due to the nature of the interventions.
|
| Paced Breathing | Behavioral | Participants will perform paced breathing exercises using a controlled respiratory rate guided by therapist instruction during sessions. Paced breathing will be integrated with mat Pilates sessions, three times per week for six weeks. |
|
Dyspnea will be assessed using the Modified Borg Dyspnea Scale, a numerical rating scale ranging from 0 (no breathlessness) to 10 (maximal breathlessness). Higher scores indicate more severe dyspnea. |
| Baseline and at 6 weeks |
| Health-Related Quality of Life (SF-12) | Quality of life will be assessed using the 12-Item Short Form Health Survey (SF-12), which evaluates physical and mental health domains. Higher scores indicate better perceived health status. | Baseline and at 6 weeks |
| Background |
| Balban MY, Neri E, Kogon MM, Weed L, Nouriani B, Jo B, Holl G, Zeitzer JM, Spiegel D, Huberman AD. Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Rep Med. 2023 Jan 17;4(1):100895. doi: 10.1016/j.xcrm.2022.100895. Epub 2023 Jan 10. |
| Background | BAKIR, N., VURAL, P. I., & DEMİR, C. (2024). The Effects of Diaphragmatic Breathing Exercise on Hot Flashes in Menopausal Women during the COVID-19 Pandemic Period: A Randomized Controlled Trial. Gümüshane Üniversitesi Saglik Bilimleri Dergisi, 13(3). |
| Background | Amaral, A. L., Batista, J., Goncalves, L., Tavares, J., Souza, T. C., Mariano, I., Rodrigues, M., Junior, J. C., Araujo, K., & Ribeiro, P. (2021). EFFECTS OF MAT PILATES TRAINING ON BODY COMPOSITION AND CARDIOMETABOLIC MARKERS IN POSTMENOPAUSAL WOMEN WITH MULTIMORBIDITY. Journal of hypertension, 39, e416-e417. |
| 36078292 | Background | Almeida IDS, Andrade LS, Sousa AMM, Junior GC, Catai AM, Mota YL, Durigan JLQ. Is the Combination of Aerobic Exercise with Mat Pilates Better than Mat Pilates Training Alone on Autonomic Modulation Related to Functional Outcomes in Hypertensive Women? Secondary Analysis of a Randomized Controlled Trial. Int J Environ Res Public Health. 2022 Aug 25;19(17):10577. doi: 10.3390/ijerph191710577. |
| Background | Akpama, T. G. (2024). Study on the influence of socioeconomic factors on hypertension prevalence. |
| Background | Adawiyah, R., & Sinaga, W. (2024). HUBUNGAN GENETIK DAN USIA DENGAN PENYAKIT HIPERTENSI DI PUSKESMAS PASAR MINGGU JAKARTA SELATAN. Mayapada Nursing Journal, 1(1), 15-20. |