This randomized controlled trial evaluated whether adding diaphragmatic breathing exercises to an eight-week supervised Pilates program improves pulmonary function, resting heart rate, and core endurance in sedentary women aged 35 years and older. Participants were randomized to Pilates combined with diaphragmatic breathing or Pilates alone. Both groups trained three times per week for eight weeks.

Participants were sedentary women aged 35 years and older who had not participated in regular structured exercise during the previous six months. Participants were randomly assigned in a 1:1 ratio to either Pilates combined with diaphragmatic breathing exercises or Pilates alone. Both groups completed supervised exercise sessions three times per week for eight weeks. Each session lasted approximately 60 minutes and included warm-up, main Pilates exercises, and cool-down. The experimental group additionally performed structured diaphragmatic and abdominal breathing exercises integrated into the Pilates sessions. Pulmonary function, cardiovascular parameters, functional performance, anthropometry, and echocardiographic safety parameters were assessed at baseline and after the intervention.

Inclusion Criteria:

• Female participants aged 35 years or older
• Sedentary status, defined as no regular structured exercise participation during the previous six months
• Non-smoker
• No diagnosed cardiovascular, pulmonary, or musculoskeletal disorder
• Not using medications known to influence cardiopulmonary function
• Provided written informed consent

Exclusion Criteria:

• Pregnancy
• Recent surgery or injury
• Participation in another structured exercise program during the study period
• Any cardiovascular, pulmonary, or musculoskeletal condition that could affect safe participation
• Use of medication known to influence cardiopulmonary function

Only individuals who self-identify as women are eligible to participate.

De-identified individual participant data underlying the results reported in the article will be made available upon reasonable request.

Beginning after publication and available for 5 years.

Data will be shared with researchers who submit a methodologically sound proposal and obtain approval from the corresponding author and, if required, the institutional ethics committee.

Outcome assessors were blinded to group allocation. Participants and exercise instructors could not be blinded because of the nature of the exercise intervention.