Patient's Perception of the Role of Gym Activity in Abdominal Wall Herniation in Adults: A Prospective Study.

BACKGROUND: Despite significant changes in healthcare, work practices, and leisure activity, the proposed precipitating factors for abdominal wall hernias have remained largely unchanged for almost two centuries. We aimed to investigate if there have been shifts in these factors over time by examining patients' perception of precipitating factors for abdominal wall hernia development. This study was conducted in the Royal College of Surgeons In Ireland Department of Surgery, Connolly Hospital, Blanchardstown, Dublin, where patients with abdominal wall hernias completed a questionnaire  . RESULTS: A total of 277 patients (mean age 55.7; 85.6% male) with abdominal wall hernia completed the questionnaire (66.1% inguinal; 10.8% umbilical; 6.9% paraumbilical; 10.5% epigastric; 3.2% incisional; 1.4% femoral, and 1.1% port-site). One hundred and twenty patients (43.3%) believed their hernia was due to lifting, 71 (25.6%) cited gym activity and 17 (6.1%) cited other sporting activities as the precipitating factor. Traditional factors - chronic cough and constipation - were cumulatively cited only by 11 patients (4.0%), while prostatic obstruction was not cited by any. CONCLUSION: This study suggests that fitness pursuits may be an increasing contributor to the development of abdominal wall hernia. Greater attention should be paid to the proper use of gym equipment to minimise the risk of hernia development.

Effects of Electro-Muscle Stimulation Exercise Combined with Mat Pilates on Pain, Anxiety, and Strength in Sedentary Females with Fibromyalgia: A Single-Blind Randomized Controlled Trial.

BACKGROUND AND OBJECTIVES: Fibromyalgia syndrome (FM) is a chronic pain disorder that is ranked as one of the four most common rheumatological diseases in the world. This study aims to investigate the effects of an eight-week mat Pilates and electro-muscle stimulation (EMS) with combined mat Pilates exercises on pain, depression, anxiety, and strength in sedentary women. METHODS: This study is a single-blind randomized controlled trial. A total of 30 sedentary female patients (Pilates (n = 15), EMS (n = 15)) diagnosed with FM were included in the study. The patients were subjected to Beck Depression (BDIs) and Anxiety Inventories (BAIs); a Fibromyalgia Impact Questionnaire (FIQ); five different Single-Leg Hop Tests (SLHTs); modified push-up (MPU), Handgrip Strength (HGS), Deep Squat (DSQ), V-Sit Flexor, bent-arm hang (BA), sit-up and Biering-Sørensen tests; and anthropometric tests before and after the 8-week exercise program. RESULTS: The eight weeks of mat Pilates exercises combined with mat Pilates and EMS revealed significant results (p < 0.05) in anthropometric data (abdomen, lower abdomen, hips) (p < 0.05) except for the results of chest circumference measurements (p > 0.05). In addition, there were statistically significant positive results in BDIs, BAIs, FIQs, lower extremity (all SLHTs and DSQ), upper extremity (MPU, HGS, BA), and core (V-SIT, sit-up, Biering-Sørensen test) strength test findings (p < 0.05). CONCLUSIONS: Combining the mat Pilates exercises with EMS is an effective and reliable method to improve the pain, anxiety, depression, and strength of female patients diagnosed with FM.

Effect of Mat Pilates Training on Blood Pressure, Inflammatory, and Oxidative Profiles in Hypertensive Elderly.

To determine the effects of mat Pilates training on blood pressure, inflammatory, and antioxidative markers in hypertensive elderly people, 34 hypertensive subjects aged 60-75 years were randomly divided into a control group (CON; n = 17) and a mat Pilates training group (MP; n = 17). The CON participants conducted normal daily activities and participated in neither organized exercises nor sports training, while those in the MP group received mat Pilates training for 60 min three times/week for 12 weeks. Parameters including blood pressure, cardiovascular function, nitric oxide (NO), tumor necrotic factor-alpha (TNF-α), superoxide dismutase (SOD), and malonaldehyde (MDA) were collected at baseline and the end of 12 weeks. The MP group had significantly decreased blood pressure, improved cardiovascular variables, decreased MDA and TNF-α, and increased NO and SOD compared with the CON group and the pre-training period (p < 0.05). In conclusion, these findings demonstrate the positive effects of 12 weeks of mat Pilates training in terms of reducing blood pressure and increasing blood flow related to improvements in anti-inflammatory and antioxidative markers in hypertensive elderly people. Mat Pilates training might be integrated as an alternative therapeutic exercise modality in clinical practice for hypertensive elderly individuals.

How to tackle non-specific low back pain among adult patients? A systematic review with a meta-analysis to compare four interventions.

OBJECTIVE: To tackle non-specific low back pain (NSLBP) among patients and find the most effective solution and to quantitatively synthesize the overall effect of motor control training (MCT) compared with Pilates, McKenzie method, and physical therapy (PT) in pain and physical function. METHODS: Randomized controlled trials (RCTs) of four types of intervention (MCT, Pilates, McKenzie method, and PT) for LBP were collected by searching PubMed, Web of Science, EBSCOhost (Cochrane Central Register of Controlled Trials), and Scopus databases from the establishment of the database to September 30, 2023. The risk of bias was evaluated for included studies using the Revised Cochrane Risk of Bias tool for randomized trials (RoB 2.0). Taking pain and physical function in the experimental and control groups as outcome indicators, subgroup analysis was performed according to the intervention method to calculate the standardized mean difference (SMD) and 95% confidence interval (CI). RESULTS: A total of 25 RCTs, including 1253 patients, were included. Meta-analysis showed that MCT effectively relieved pain [SMD = -0.65, 95% CI (- 1.00, - 0.29), p < 0.01] and improved physical function [SMD = -0.76, 95% CI (- 1.22, - 0.31), p < 0.01] comparing with other 3 types of intervention. Subgroup analysis suggested that MCT could alleviate pain [SMD = -0.92, 95% CI (- 1.34, - 0.50), p < 0.01] and improve physical function [SMD = -1.15, 95% CI (- 1.72, - 0.57), p < 0.01] compared with PT, but it had no statistical significance compared with Pilates [pain: SMD = 0.13, 95% CI (- 0.56, 0.83), p = 0.71; physical function: SMD = 0.10, 95% CI (- 0.72, 0.91), p = 0.81] and the McKenzie method [pain: SMD = -0.03, 95% CI (- 0.75, 0.68), p = 0.93; physical function: SMD = -0.03, 95% CI (- 1.00, 0.94), p = 0.95]. CONCLUSIONS: MCT can effectively relieve pain and improve physical function in patients with NSLBP. It is more effective compared with PT for LBP, while no differences were detected between MCT and Pilates, as well as McKenzie method. Therefore, MCT, Pilates, and the McKenzie method should be encouraged as exercise interventions for NSLBP rehabilitation.

Effect of pilates on regulating menstrual cycle in females with polycystic ovarian syndrome.

Background: Polycystic Ovarian Syndrome (PCOS) is the most common genetic disorder of the endocrine gland among females during the age of reproduction with an estimated prevalence ranging from 2.2 % to 26 %. It is a typical reason for ovulatory infertility, menstrual dysfunction, and hirsutism. It is a condition in which ovarian cysts develop with a diameter of between two and nine millimeters on one or each ovaries and therefore there is an increase in the volume of one is larger than ten millimeters. Objective: To analyze the effect of pilates on pain and regulation of the menstrual cycle in females with PCOS. Research methodology: A single centered, quasi-experimental study, performed in Lovely Professional University, India on a total of 26 participants suffering from PCOS, based on inclusion and exclusion criteria. After a detailed assessment, the Pilates exercise protocol was given for 3 months i.e. 3 times per week. The readings for pain and regulation were taken at baseline, at the end of 1st, 2nd, and 3rd month using visual analog scale (VAS)and verbal multidimensional score sysem (VMSS). Results: The result findings indicates suggested that there is significant change in the pain (Wilk's Lambda =.117, F(3,23) = 58.109, P < 0.05), variable during the menstruation in PCOS over the time of three months. The menstrual cycles were regularised and the cycle was shifted towards the normal parameters. The VMSS also shows changes that signify that Pilates is effective in PCOS complications. Conclusion: This study concluded that Pilates is effective in reducing the pain in PCOS cases which improves the working ability of the females and also regulates the menstrual cycles which were irregular at the beginning of the treatment.

Effect of Integrated Yoga Program Along With Pilates in Abdominal Hysterectomy Patients: A Case Report.

Abdominal hysterectomy is a surgical procedure that involves the removal of the uterus through an incision in the abdominal wall. Hysterectomy is associated with a number of complications; hence, early mobilization and physiotherapy are necessary following surgery. This is a case report of a 45-year-old female who presented with complaints of abdominal pain associated with white discharge. Investigations showed an anterior submucosal fibroid measuring 3.2x2.7 cm and the patient underwent an abdominal hysterectomy. Early mobilization and physiotherapy were started on Day 6, which included breathing exercises, upper limb mobility, lower limb mobility, and positioning and postural advice. Yoga and pilates therapy were integrated into the protocol starting from the second week. The patient attended 30 days of therapy in two phases and was advised to continue even after discharge. We concluded that this unique approach of including pilates and yoga showed a positive impact on the patient's condition in terms of her quality of life, strength, endurance, and power, even decreasing her difficulty in performing activities of daily living.

Effectiveness of mat pilates on fatigue in women with breast cancer submitted to adjuvant radiotherapy: randomized controlled clinical trial.

PURPOSE: This clinical trial aimed to evaluate the influence of Mat Pilates and time on the change in fatigue scores in women with breast cancer undergoing adjuvant radiotherapy (RT). Additionally, assess the adherence and adverse effects of Mat Pilates sessions and the association of the level of physical activity with severe fatigue symptoms. METHODS: One hundred fifty-six patients with non-metastatic breast cancer were randomized to usual care or supervised Mat Pilates exercise. Fatigue and physical activity level were measured at baseline, end of RT, 30 days, 3 and 6 months after RT. The generalized estimating equation (GEE) with intention to treat was applied. RESULTS: A significant difference in the fatigue mean between the end of RT and the baseline was found in patients of both groups. There was no adverse effect with the practice of Mat Pilates, and it was analyzed the reduction of the symptom pain after the end of RT in women of intervention group compared to the control. There was no significant effect on fatigue between the groups. Patients with severe fatigue after 3 and 6 months of RT reported a significantly lower level of physical activity in the last periods. CONCLUSION: Fatigue levels increased at the end of RT but returned to baseline values after 6 months. A lower level of physical activity was associated with severe fatigue symptoms. Mat Pilates was safe for these women and reduced the symptom pain after treatment, but it did not successfully reduce fatigue during adjuvant RT. REGISTRATION: NCT03333993. November 7, 2017.  https://clinicaltrials.gov/ct2/show/NCT03333993?term=breast+cancer&cond=pilates&draw=2&rank=1 .

Pilates and multiple health outcomes: An umbrella review.

OBJECTIVES: To summarize the evidence of associations between Pilates and multiple health outcomes, and evaluate the strength and validity of these associations. DESIGN: Unbrella review. METHODS: PubMed, Embase, Web of Science, and the Cochrane Library were searched from inception to February, 2023. The methodological quality of included studies was assessed using A Measurement Tool to Assess Systematic Reviews, version 2 and the certainty of evidence was graded by the Grading of Recommendation, Assessment, Development and Evaluations. We recalculated each outcome using random-effects models with standardized mean difference. RESULTS: We identified 27 systematic reviews with meta-analyses in this umbrella review. 1 was rated as high quality, 1 as moderate quality, 15 as low quality, and 10 as critically low quality. These studies focused on the populations with diseases of the circulatory system, endocrine, nutritional or metabolic diseases, genitourinary system diseases, mental, behavioral, or neurodevelopmental disorder, musculoskeletal system diseases, neoplasms, nervous system diseases, sleep-wake function disorder and others. Compared with inactive/active intervention, Pilates can reduce body mass index and body fat percentage, relieve pain and disability, and improve sleep quality and balance. The certainty of evidence was very low to moderate for these outcomes. CONCLUSIONS: Pilates showed benefits on several health outcomes related with low back pain, neck pain and scoliosis. However, the certainty of the evidence was mostly low; further high quality randomized controlled trials are needed to elucidate and support these promising findings.

A resistência do fluxo inspiratório modifica a intensidade de uma sessão de pilates? / Does inspiratory flow resistance modify the intensity of a pilates session?

INTRODUÇÃO: As evidências sobre a melhora da capacidade funcional utilizando o Método Pilates não são contundentes. Uma possibilidade de melhorar o efeito de uma sessão de Pilates sobre a capacidade cardiorrespiratória de seus praticantes é utilizar a resistência de fluxo inspiratório (RFI) de forma concomitante. Esse efeito pode ser visualizado através da determinação do limiar glicêmico (LG), técnica utilizada como marcador de intensidade do exercício. OBJETIVO: Testar a hipótese de que a utilização de RFI em uma sessão de pilates antecipa o LG. MÉTODOS: Estudo crossover de corte transversal. Foram avaliados 26 indivíduos de ambos os sexos, sendo 10 do sexo masculino, sadios e com idade entre 20 e 40 anos. Os voluntários foram randomizados para dois protocolos: Protocolo RFI ­ 11 movimentos do Método Pilates com RFI utilizando 20% da pressão inspiratória máxima; e Protocolo sem RFI (SRFI) ­ 11 movimentos do Método Pilates sem RFI. Os dois protocolos foram realizados no mesmo dia, sendo um pela manhã e outro à tarde, conforme randomização feita por sorteio aleatório simples. No repouso e ao final de cada movimento coletas de sangue capilar foram realizadas para dosagem da glicemia e construção da curva glicêmica. O LG foi determinado no menor ponto da curva. RESULTADOS: O LG foi antecipado no protocolo que utilizou RFI, ou seja, no protocolo com RFI o LG foi visualizado no sexto exercício, enquanto no protocolo SRFI o LG foi visualizado no nono exercício (p<0,05). CONCLUSÃO: A RFI antecipou o LG, o que sugere que a RFI aumenta a intensidade de uma sessão de pilates. Isso aventa a hipótese de que a RFI pode proporcionar a médio e longo prazo benefícios adicionais aos praticantes do Método Pilates.

INTRODUCTION: The evidence on the improvement of functional capacity using the Pilates Method is not conclusive. One possibility to improve the effect of a Pilates session on the cardiorespiratory capacity of its practitioners is to use the inspiratory flow resistance (IFR) concomitantly. This effect can be visualized by determining the glycemic threshold (GT), a technique used as an exercise intensity marker. OBJECTIVE: To test the hypothesis that the use of IFR in a Pilates session anticipates GT. METHODS: Cross-sectional crossover study. A total of 26 individuals of both genders were evaluated, 10 of whom were male, healthy, and aged between 20 and 40 years. The volunteers were randomized to two protocols: Protocol IFR - Eleven movements of the Pilates method with IFR using 20% of the maximum inspiratory pressure, and Protocol no IFR (NIFR) - Eleven movements of the Pilates method without IFR. The two protocols were performed on the same day, one in the morning and the other in the afternoon, according to randomization by simple random draw. At rest and at the end of each movement, capillary blood collections were performed to measure blood glucose and construct the glycemic curve. GT was determined at the smallest point on the curve. RESULTS: The GT was anticipated in the protocol that used IFR; that is, in the protocol with IFR, the GT was visualized in the sixth exercise, while in the NIFR protocol, the GT was visualized in the ninth exercise (p<0.05). CONCLUSION: IFR anticipated GT, which suggests that IFR increases the intensity of a Pilates session. This suggests the hypothesis that IFR can provide additional medium and long-term benefits to Pilates method practitioners.

Effect of different postures of Pilates combined with Kegel training on pelvic floor muscle strength in post-prostatectomy incontinence.

PURPOSE: Urinary incontinence seriously affects the daily ability of older males. This study compared the effect of different postures of Pilates combined with Kegel training on pelvic floor muscle strength in post-prostatectomy incontinence. METHODS: We included 38 valid samples [group A = 13 (less than 3 months after surgery), group B = 15 (4-6 months after surgery), group C = 10 (more than 6 months after surgery)] and surface electromyography (EMG) was used to record the maximum, and root mean square values of participants in the three groups under four postures. RESULTS: There were significant differences in the maximum and mean values among the three groups. In group A, the mean values were 13.04 ± 1.56, 16.98 ± 1.76, 41.58 ± 4.17, and 24.53 ± 2.45 (P < 0.01), respectively. In group B, the mean values were 13.85 ± 1.55, 18.63 ± 1.44, 45.87 ± 3.31, and 28.63 ± 2.02 (P < 0.01), respectively. In group C, the mean values were 14.80 ± 1.32, 19.59 ± 1.55, 47.85 ± 5.05, and 30.11 ± 2.26 (P < 0.01), respectively. The mean and peak values of surface EMG in the three groups correlated with the four basic movements. R2 values were 0.76 and 0.85, 0.77 and 0.88, 0.77 and 0.91, respectively. CONCLUSIONS: Pilates with Kegel training was superior to Kegel training alone in unit recruitment ability of the pelvic floor muscles. Pilates training in different positions is recommended according to the patient's condition.

Influence of pilates training on physical coordination and stability of volleyball players / Influência do treinamento de pilates na coordenação física e estabilidade dos jogadores de voleibol / Influencia del entrenamiento de pilates en la coordinación física y en la estabilidad de los jugadores de voleibol

ABSTRACT Introduction: Pilates prioritizes the control of central muscle groups, which have a strong predilection value for volleyball training. Objective: To investigate the repercussions of Pilates training on motor coordination and stability in volleyball players. Methods: 20 athletes from a female volleyball team were randomly divided between the experimental and the control groups. Pilates intervention was performed in the experimental group. The control group followed the traditional training format, finally comparing the training results after eight weeks. Results: In the flexibility index of the experimental group, the weights increased from 23,11±5,08 times to 28,02±6,42 times; the left and right axes increased from 7,74±10,13 seconds to 8,83±8,13 seconds. In terms of the stability index, the number of intervals repeated in 20 seconds increased from 35.44±0.75 to 46.45±0.91; the lateral throw of the medicine ball was increased from 59.61±16.16 meters to 78.38±16.22 meters. The range of variation of each index is more evident than that of the control group. Conclusion: Pilates training becomes superior to usual training for the improvement of coordination and stability of volleyball players. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O Pilates prioriza o controle de grupos musculares centrais, que possuem um forte valor prediletivo para o treinamento do vôlei. Objetivo: Investigar as repercussões do treino Pilates na coordenação motora e na estabilidade das jogadoras de voleibol. Métodos: 20 atletas de uma equipe feminina de voleibol foram divididas aleatoriamente entre o grupo experimental e o grupo controle. A intervenção do Pilates foi realizada no grupo experimental. O grupo de controle obedeceu ao formato tradicional de treinamento, comparando-se finalmente os resultados do treinamento após 8 semanas. Resultados: No índice de flexibilidade do grupo experimental, os pesos elevaram-se de 23.112 ± 5.088 vezes para 28.020 ± 6.427 vezes; os eixos esquerdo e direito cresceram de 7.745 ± 10.138 segundos para 8.831 ± 8.133 segundos. Em termos de índice de estabilidade, o número de intervalos repetidos em 20 segundos aumentou de 35.444 ± 0.753 para 46.453 ± 0.919; o arremesso lateral da bola medicinal foi elevado de 59.617 ± 16.160 metros para 78.386 ± 16.221 metros. O intervalo de variação de cada índice é mais evidente do que o do grupo de controle. Conclusão: O treinamento de Pilates se torna superior ao treinamento habitual para a melhora da coordenação e estabilidade das jogadoras de vôlei. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Pilates prioriza el control de los grupos musculares centrales, que tienen un fuerte valor de predilección para el entrenamiento del voleibol. Objetivo: Investigar la repercusión del entrenamiento de Pilates sobre la coordinación motora y la estabilidad de jugadoras de voleibol. Métodos: 20 atletas de un equipo femenino de voleibol se dividieron aleatoriamente entre el grupo experimental y el grupo de control. La intervención de Pilates se realizó en el grupo experimental. El grupo de control siguió el formato de entrenamiento tradicional, comparando finalmente los resultados del entrenamiento después de 8 semanas. Resultados: En el índice de flexibilidad del grupo experimental, los pesos aumentaron de 23,11±5,08 veces a 28,02±6,42 veces; los ejes izquierdo y derecho aumentaron de 7,74±10,13 segundos a 8,83±8,13 segundos. En cuanto al índice de estabilidad, el número de intervalos repetidos en 20 segundos aumentó de 35,44±0,75 a 46,45±0,91; el lanzamiento lateral del balón medicinal aumentó de 59,61±16,16 metros a 78,38±16,22 metros. El rango de variación de cada índice es más evidente que el del grupo de control. Conclusión: El entrenamiento con Pilates llega a ser superior al entrenamiento habitual para la mejora de la coordinación y estabilidad de los jugadores de voleibol. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Influence of the spring constant change on the electromyography activity of muscles of the powerhouse and shoulder during the long stretch exercise / Influencia del cambio de la constante elástica de las muelles en la actividad electromiográfica de los músculos del powerhouse y del hombro durante el ejercicio de long stretch / Influência da mudança na constante elástica da mola na atividade eletromiográfica de músculos do powerhouse e do ombro durante o exercício de long stretch

ABSTRACT This study aimed to verify the effect of the spring constant change on the electromyographic activity of the powerhouse and shoulder muscles during the long stretch exercise. In total, 15 Pilates practitioners performed the Long Stretch exercise on the reformer with three different spring constants: (1) k=0.19kg/cm with 1 red spring; (2) k=0.27kg/cm with 1 red spring and 1 yellow; and (3) k=0.38kg/cm with 2 red springs. The Electromyographic activity of Rectus Abdominis (RA), External Oblique (EO), Internal Oblique/Transversus abdominis (OI/TS), Multifidus (MU), Iliocostalis (IC), Longissimus (LG), Lower Trapezius (LT), and Anterior Deltoid (AD) were evaluated. We observed that as the spring constant increases, the RA, OE, OI/TS muscles decrease their EMG activity, while the AD, LT, and LG increase their EMG activity. The MU and IC muscles were not influenced in their EMG activities. Therefore, we observed an influence of the change of the spring constant on the electromyographic activity of the RA, OE, OI/LG, AD, and LT muscles. However, we found no influence of the spring constant on the EMG activities of the MU and IC muscles during the long stretch.

RESUMEN El objetivo de este estudio fue evaluar el efecto del cambio de la constante de la muelle en la actividad electromiográfica (EMG) de los músculos del powerhouse y del hombro durante el ejercicio de long stretch. En el estudio participaron quince practicantes de pilates que realizaron el ejercicio long stretch en el reformer con tres constantes elásticas: (1) k=0,19kg/cm, representado por 1 muelle roja; (2) k=0,27kg/cm, representado por 1 muelle roja y 1 muelle amarilla; y (3) k=0,38kg/cm, representado por 2 muelles rojas. Se evaluaron las actividades EMG de los músculos recto abdominal (RA), oblicuo externo (OE), oblicuo interno/transverso (OI/TS), multífidos (MU), iliocostal (IC), longuissimus (LG), deltoides anterior (DA) y trapecio inferior (TI). Se pudo observar que a medida que aumenta la constante elástica de la muelle, los músculos RA, OE, OI/TS disminuyen su actividad EMG, mientras que los músculos DA, TI y LG aumentan su actividad EMG. Los músculos MU e IC no fueron influenciados en sus actividades EMG. Se puede concluir que hubo influencia del cambio en la constante elástica de la muelle sobre la actividad EMG de los músculos RA, OE, OI/TS, LG, DA y TI durante el long stretch, pero no hubo influencia en las actividades EMG de los músculos MU e IC.

RESUMO O objetivo deste estudo é verificar o efeito da mudança da constante elástica na atividade eletromiográfica (EMG) dos músculos do powerhouse e do ombro durante o exercício de long stretch. Participaram da pesquisa 15 praticantes de Pilates que executaram o exercício de long stretch no reformer com três constantes elásticas: (1) k=0,19kg/cm, representado por uma mola vermelha; (2) k=0,27kg/cm, representado por uma mola vermelha e uma mola amarela; e (3) k=0,38kg/cm, representado por duas molas vermelhas. Foram avaliadas as atividades EMGs dos músculos reto abdominal (RA), oblíquo externo (OE), oblíquo interno/transverso (OI/TS), multífidos (MU), iliocostal (IC), longuíssimo (LG), deltoide anterior (DA) e trapézio inferior (TI). Pode-se observar que, conforme a constante elástica aumenta, os músculos RA, OE, OI/TS diminuem suas atividades EMG, enquanto os músculos DA, TI e LG as aumentam. Os músculos MU e IC não foram tiveram suas atividades EMG influenciadas. Portanto, conclui-se que houve influência da mudança da constante elástica sobre as atividades EMG dos músculos RA, OE, OI/TS, LG, DA e TI durante o long stretch, mas não nas atividades EMG dos músculos MU e IC.

O método Pilates como opção terapêutica para as queixas de dores musculoesqueléticas em mulheres idosas / The Pilates method as a treatment option for musculoskeletal pain complaints in elderly women

Resumo Introdução O processo de envelhecimento está relacionado a alterações fisiológicas que podem comprometer a autonomia, a independência e a qualidade de vida dos idosos. Objetivo Avaliar a prática de exercícios físicos com o método Pilates e sua relação com a melhora da qualidade de vida e redução das queixas de dores musculoesqueléticas em um grupo de mulheres idosas. Método Participaram do estudo 31 mulheres entre 40 e 86 anos que realizaram exercícios de Pilates solo durante oito semanas. Na coleta dos dados, foram utilizados os instrumentos SF-36 e o Questionário Nórdico de Sintomas Osteomusculares. Após oito semanas, foi realizada a reavaliação com os mesmos instrumentos. Resultados O componente físico do SF-36 evoluiu de 58,5% para 90,5%, e o componente mental pontuou 93,5%, apresentando melhora evidente nestes domínios após os exercícios, e as queixas de dores musculoesqueléticas diminuíram em metade da amostra. Conclusão O Pilates foi associado com a redução das queixas de dores musculoesqueléticas e com a melhora da qualidade de vida nos domínios estudados.

Abstract Background The demographic and epidemiological profile of the world population experiences a restructuring of health policies, due to the prevalence of chronic non-transmissible diseases associated with longevity. Health promotion and quality of life contribute to active aging and change the aging paradigm associated with functional dependency and reduced autonomy. Objective To evaluate the relationship between Pilates exercise practice and improved quality of life and reduced musculoskeletal pain complaints in a group of elderly women. Method In the study, 31 women between 40 and 86 years old performed Pilates solo exercises for 8 weeks. Data were collected using SF-36 instruments and the Nordic Osteomuscular Symptoms Questionnaire. After 8 weeks, a reevaluation with the same instruments was performed. Results The SF-36 physical component evolved from 58.5% to 90.5%, and the mental component scored 93.5%, showing an evident improvement in these domains after exercise, and complaints of musculoskeletal pain decreased by half the sample. Conclusion Pilates was associated with reducing complaints of musculoskeletal pain, as well as improving the quality of life in the studied domains.

Influences of pilates training on postural balance in martial arts students / Influências do treinamento de pilates sobre o equilíbrio postural em alunos de artes marciais / Influencia del entrenamiento de pilates en el equilibrio postural de estudiantes de artes marciales

ABSTRACT Introduction: Physical stability is extremely important for student-athletes of martial arts, and it is believed that the practice of Pilates can generate benefits in this aspect. Objective: Analyze the influences of Pilates training on postural balance in martial arts students during daily training. Methods: Using the control experiment verification method, this study selected 60 martial arts students and athletes to perform the control experiment. They were randomly divided into the experimental group and the control group. In addition to the traditional daily martial arts training protocol, the experimental group underwent Pilates training, while the control group performed only daily training. Results: In the experimental Pilates training group, vertical balance time increased from 791.25 ± 158.48 ms to 695.64 ± 208.08 ms, and left-right laterality balance time increased from 1,861.04 ± 202.96 ms to 1,994.70 ± 189.67 ms, and anteroposterior balance time increased from 1243.24 ± 475.07 ms to 1419.52 ± 331.62 ms. The balance score increased from 53.16 ± 3.94 to 63.83 ± 3.12. Conclusion: Pilates training improved postural balance in martial arts students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A estabilidade física é extremamente importante para os estudantes atletas de artes marciais, acredita-se que a prática de pilates possa gerar benefícios neste aspecto. Objetivo: Analisar as influências do treinamento de Pilates sobre o equilíbrio postural em estudantes de artes marciais durante o treinamento diário. Métodos: Usando o método de verificação do experimento de controle, este trabalho selecionou 60 alunos e atletas de artes marciais escolares para realizar o experimento de controle. Eles foram divididos aleatoriamente no grupo experimental e no grupo de controle. Além do protocolo tradicional de treinamento diário de artes marciais, o grupo experimental foi submetido ao treinamento Pilates, enquanto o grupo de controle realizou apenas o treinamento diário. Resultados: No grupo experimental de treinamento Pilates, o tempo de equilíbrio vertical aumentou de 791,25 ± 158,48 ms para 695,64 ± 208,08 ms, o tempo de equilíbrio de lateralidade esquerda e direita aumentou de 1.861,04 ± 202,96 ms para 1.994,70 ± 189,67 ms, e o tempo de equilíbrio antero-posterior elevou-se de 1243,24 ± 475,07 ms para 1419,52 ± 331,62 ms. A pontuação de equilíbrio aumentou de 53,16 ± 3,94 para 63,83 ± 3,12. Conclusão: O treinamento do Pilates demonstrou melhorar o equilíbrio postural dos estudantes de artes marciais. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La estabilidad física es extremadamente importante para los estudiantes atletas de artes marciales, se cree que la práctica de Pilates puede generar beneficios en este aspecto. Objetivo: Analizar las influencias del entrenamiento de Pilates sobre el equilibrio postural en estudiantes de artes marciales durante el entrenamiento diario. Métodos: Utilizando el método de verificación del experimento de control, este estudio seleccionó a 60 estudiantes y atletas de artes marciales para realizar el experimento de control. Se dividieron aleatoriamente en el grupo experimental y en el grupo de control. Además del protocolo de entrenamiento diario tradicional de artes marciales, el grupo experimental se sometió a entrenamiento de Pilates, mientras que el grupo de control sólo realizó entrenamiento diario. Resultados: En el grupo experimental de entrenamiento de Pilates, el tiempo de equilibrio vertical aumentó de 791,25 ± 158,48 ms a 695,64 ± 208,08 ms, el tiempo de equilibrio de lateralidad izquierda y derecha aumentó de 1.861,04 ± 202,96 ms a 1.994,70 ± 189,67 ms, y el tiempo de equilibrio anteroposterior aumentó de 1.243,24 ± 475,07 ms a 1.419,52 ± 331,62 ms. La puntuación de equilibrio aumentó de 53,16 ± 3,94 a 63,83 ± 3,12. Conclusión: El entrenamiento con Pilates demostró mejorar el equilibrio postural en estudiantes de artes marciales. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Effects of pilates on aerobic performance of college students / Efeitos do pilates sobre o desempenho de aeróbica de estudantes universitários / Efectos del pilates en el rendimiento aeróbico de estudiantes universitarios

ABSTRACT Introduction: The Pilates is a training method that aims to improve body awareness for movement re-education, bringing muscular and mental balance. It is believed that these benefits can effectively improve the flexibility of female university aerobics students. Methods: 90 female college students in the optional aerobics course were selected and divided into two groups. Data from the experimental and control groups were evaluated for comparison before and after the experiment. The aerobic exercises of the two groups of female university aerobics students were scored, aiming to compare and explore which training method was more effective. Results: The baseline time and pace score in the Pilates intervention was changed from 2.35±0.71 to 2.55±0.76, a movement set changed from 3.86±0.98 to 4.01±1.07, movement performance from 1.67±0.61 to 1.72±0.57, and foot skills from 1.40±0.48 to 1.41±0.50. The mean aerobic movement performance score changed from 62.45 to 80.53, an increase of 18.08 points. Conclusion: The Pilates training can effectively improve the aerobic performance of female university students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O Pilates é um método de treinamento que visa trabalhar a consciência corporal para reeducação do movimento, trazendo equilíbrio muscular e mental. Acredita-se que esses benefícios possam efetivamente melhorar a flexibilidade das estudantes universitárias de aeróbica. Objetivo: Avaliar os efeitos do treinamento baseado em pilates sobre o desempenho esportivo de estudantes universitárias. Métodos: 90 estudantes universitárias femininas do curso opcional de aeróbica foram selecionadas e divididas em dois grupos. Os dados do grupo experimental e do grupo de controle foram avaliados para comparação antes e depois do experimento. Os exercícios aeróbicos dos dois grupos de estudantes universitárias femininas de aeróbica foram pontuados, visando a comparação e explorar qual o método de treinamento mais eficaz. Resultados: O valor de tempo e ritmo basal na intervenção com pilates foi alterado de 2,35±0,71 para 2,55±0,76, o conjunto de movimentos mudou de 3,86±0,98 para 4,01±1,07, o desempenho do movimento de 1,67±0,61 para 1,72±0,57, e as habilidades com os pés de 1,40±0,48 para 1,41±0,50. A pontuação média do desempenho do movimento aeróbico mudou de 62,45 para 80,53, um aumento de 18,08 pontos. Conclusão: O treinamento de Pilates pode efetivamente melhorar o desempenho de estudantes universitárias femininas de aeróbica. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Pilates es un método de entrenamiento que pretende trabajar la conciencia corporal para la reeducación del movimiento, aportando equilibrio muscular y mental. Se cree que estos beneficios pueden mejorar eficazmente la flexibilidad de las estudiantes universitarias de aeróbic. Objetivo: Evaluar los efectos del entrenamiento basado en pilates en el rendimiento deportivo de estudiantes universitarias. Métodos: Se seleccionaron 90 estudiantes universitarias del curso optativo de aeróbic y se dividieron en dos grupos. Se evaluaron los datos del grupo experimental y del grupo de control para compararlos antes y después del experimento. Se puntuaron los ejercicios aeróbicos de los dos grupos de estudiantes universitarias de aeróbic, con el objetivo de comparar y explorar qué método de entrenamiento era más eficaz. Resultados: La puntuación inicial de tiempo y ritmo en el experimento de pilates pasó de 2,35±0,71 a 2,55±0,76, la del conjunto de movimientos pasó de 3,86±0,98 a 4,01±1,07, la del rendimiento de los movimientos pasó de 1,67±0,61 a 1,72±0,57, y la de las habilidades con los pies pasó de 1,40±0,48 a 1,41±0,50. La puntuación media del rendimiento de los movimientos aeróbicos pasó de 1,67±0,61 a 1,72±0,57, y la de las habilidades con los pies de 1,40±0,48 a 1,41±0,50. La puntuación media del rendimiento del movimiento aeróbico pasó de 62,45 a 80,53, lo que supone un aumento de 18,08 puntos. Conclusión: El entrenamiento con Pilates puede mejorar eficazmente el rendimiento aeróbico de las estudiantes universitarias. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

The Effects of a Pilates Exercise Program on Pain, Functional Capacity, and Quality of Life in Breast Cancer Survivors One Year Postsurgery.

OBJECTIVES: To evaluate the effects of Pilates exercises on functional capacity, pain, and quality of life in breast cancer survivors one year postsurgery. SAMPLE & SETTING: 44 breast cancer survivors who participated in a 24-session Pilates exercise program at a physiotherapy clinic in Brazil. METHODS & VARIABLES: This prospective longitudinal study evaluated breast cancer survivors who performed Pilates exercises for 60 minutes twice weekly. Functional capacity was analyzed using the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and the Shoulder Pain and Disability Index (SPADI). Pain and quality of life were also analyzed. Scores were measured on admission, after 12 sessions, and after 24 sessions. RESULTS: Median DASH and SPADI scores improved by 61% after 24 Pilates exercise sessions. The average number of breast cancer survivors who performed complex tasks without difficulty after 12 sessions and 24 sessions increased considerably. Pain scores significantly decreased, and quality of life significantly improved after all sessions. IMPLICATIONS FOR NURSING: Incorporating a Pilates exercise program can decrease pain and improve functional status and quality of life among breast cancer survivors at least one year postsurgery.

Effect of fully immersive virtual reality treatment combined with exercise in fibromyalgia patients: a randomized controlled trial.

This trial was designed to evaluate the effects of fully immersive virtual reality (IVR) treatment combined with exercise training in fibromyalgia patients. Twenty patients were randomized into exercise group (EG) or IVR combined with exercise group (Exercise+IVR). The EG had combined exercise training consisted of 30 minutes of aerobic training and 30 minutes of Pilates training and Exercise+IVR group had the same protocol with EG plus 20 minutes of IVR, twice a week for 8 weeks. Visual analogue scale for pain, Modified Sensory Organization Test for balance, Tampa Scale of Kinesiophobia for kinesiophobia, Fibromyalgia Impact Questionnaire for impact of fibromyalgia, Fatigue Severity Scale for fatigue, International Physical Activity Questionnaire for level of physical activity, six-minute walk test for functional capacity, and Short-Form 36 Health Survey for quality of life were used for evaluation. Pain, balance, kinesiophobia, impact of fibromyalgia, fatigue, level of physical activity, functional exercise capacity and quality of life scores improved significantly in both groups (p < .05). Exercise+IVR group showed significant improvement compared to the EG regarding pain, kinesiophobia, fatigue, level of physical activity, and mental component of quality of life (p < .05). IVR treatment may be an effective method as an adjunctive therapy with other exercise trainings in fibromyalgia.

The effect of pilates exercises on muscle electrical activation in adults with chronic low back pain: a systematic review / Efeito dos exercícios de pilates na ativação elétrica muscular em adultos com lombalgia crónica: revisão sistemática / El efecto de los ejercicios de pilates sobre la activación eléctrica muscular en adultos con lumbalgia crónica: revisión sistemática

ABSTRACT Low back pain is one of the most prevalent orthopedic conditions, affecting around 70% to 80% of the world's population at least once during their life times. Surface electromyography is an important tool for assessing the muscle function of the lumbar stabilizers. One of the best treatment options for patients with chronic low back pain (CLBP) is physical exercise, particular lyaerobic exercise and Pilates, as these can reduce short-term pain and disability, and improve balance. This review aims to identify the state of art regarding the benefits of pilates on the population with CLBP, evaluating changes in the muscular activation of the muscles of the lumbar region. Searches were conducted on the following databases: PubMed (Medline), Science Direct, Scopus, Web of Science, Cochrane, Ebsco and Scielo; including gray literature: Google Scholar, Grey Literature, Pro Quest Dissertations & Theses. The inclusion criteria were adults with low back pain for three months or more, with or without referred pain in the lower limbs; studies that used electromyographic variables; studies with a pain assessment measure at two different times; studies with physical exercise performed only using the Pilates method. Applying these criteria, the searches retrieved 439 abstracts. Of these, 44 articles were evaluated for eligibility, and three fulfilled the qualitative and quantitative synthesis criteria. The average methodological quality score on the Downs and Black checklist was 15 out of 28. It was therefore concluded that Pilates is an excellent option for the treatment of non-specific low back pain, promoting health and helping prevent low back pain among asymptomatic individuals. Level of evidence II; Systematic Review of Level II or Level I Studies with Discrepant Results.

RESUMO: A dor lombar é uma das condições ortopédicas mais prevalentes, afetando cerca de 70% a 80% da população mundial pelo menos uma vez na vida. A eletromiografia de superfície é um importante instrumento de avaliação da função muscular dos estabilizadores lombares. Uma das melhores opções de tratamento de pacientes com dor lombar crônica (DLC) é o exercício físico, principalmente exercícios aeróbicos e Pilates, considerando que podem reduzir a dor e a incapacidade a curto prazo e melhorar o equilíbrio. Esta revisão objetivou identificar o estado da arte quanto aos benefícios do pilates para a população com DLC, por meio da avaliação das alterações da ativação muscular dos músculos da região lombar. A pesquisa foi realizada nas seguintes bases de dados: PubMed (Medline), Science Direct, Scopus, Web of Science, Cochrane, Ebsco e Scielo, incluindo também literatura cinzenta: Google Acadêmico, Grey Literature, Pro Quest Dissertations & Theses. Os critérios de inclusão foram adultos com lombalgia há três meses ou mais meses, com ou sem dor referida nos membros inferiores; estudos que que usaram variáveis eletromiográficas; estudos com medida de avaliação da dor em dois momentos distintos; estudos com exercícios físicos realizados apenas com o método Pilates. Com esses critérios, foram identificados 439 resumos. Desse total, 44 artigos foram avaliados quanto à elegibilidade e três satisfizeram os critérios de síntese qualitativa e quantitativa. A pontuação média de qualidade metodológica foi 15 de 28 na lista de verificação Downs e Black. Concluiu-se, portanto, que o Pilates é uma excelente opção no tratamento de dores lombares não específicas, resultando na promoção de saúde e na prevenção desta condição para indivíduos assintomáticos. Nível de evidência II; Revisão sistemática de Estudos de Nível II ou Nível I com resultados discrepantes.

RESUMEN: La lumbalgia es una de las afecciones ortopédicas más prevalentes, que afecta a entre el 70% y 80 % de la población mundial al menos una vez en la vida. Las electromiografía de superficie es una herramienta importante para evaluar la función muscular de los estabilizadores lumbares. Una de las mejores opciones de tratamiento para pacientes con dolor lumbar crónico (DLC) es el ejercicio físico, concretamente los ejercicios aeróbicos y el pilates, ya que pueden reducir el dolor y la discapacidad a corto plazo y mejorar el equilibrio. Esta revisión tuvo como objetivo identificar el estado del arte en cuanto a los beneficios del pilates para la población con DLC, evaluando los cambios en la activación muscular de los músculos de la región lumbar. La investigación se realizó en las siguientes bases de datos: PubMed (Medline), Science Direct, Scopus, Web of Science, Cochrane, Ebsco y Scielo; incluyendo también la literatura gris: Google Scholar, Grey Literature, Pro Quest Dissertations & Theses. Los criterios de inclusión fueron adultos con lumbalgia durante 3 meses o más, con o sin dolor referido en miembros inferiores; estudios que han utilizado variables electromiográficas; estudios con medición de la evaluación del dolor en dos momentos diferentes; estudios con ejercicios físicos realizados sólo con el método Pilates. Con estos criterios, se identificaron 439 resúmenes. De este total, se evaluó la elegibilidad de 44 artículos y 3 cumplieron los criterios de síntesis cualitativa y cuantitativa. La puntuación media de calidad metodológica fue de 15 sobre 28 en la lista de verificación de Downs y Black. Por lo tanto, se concluyó que el Método Pilates es una excelente opción en el tratamiento de la lumbalgia inespecífica, lo que resulta en la promoción de la salud y prevención de este padecimiento para individuos asintomáticos. Nivel de evidencia II, Revisión sistemática de Estudios de nivel II o Nivel I con resultados discrepantes.

The improvement of cardiorespiratory fitness in healthy women after a 12-week Classical Pilates training / A melhoria da aptidão cardiorrespiratória em mulheres saudáveis depois de 12 semanas de treinamento no Pilates Clássico

Aims: to evaluate the effects of 12 weeks of Pilates training (Classical Method) on cardiorespiratory fitness and heart rate responses of healthy sedentary women. Method: fifteen women (average age 29±4) performed 12 weeks of Pilates training for 60 minutes, three times per week (Pilates Group). Thirteen women (average age 29±5) as controls maintained their routine activities (Control Group). The exercises' introduction was by the degree of difficulty with changes in the plane of movements; smaller base of support; spinal rotations and extensions; use of abdominal muscles in prone position. Heart rate was monitored and recorded during all sessions using a heart frequency meter. Results: ANOVA analysis results revealed significant difference in Pilates Group (p < 0.05) between pre and post measures of VO2peak (+13%), fat percentage (- 3.3%), free fat mass (+ 2.8 kg), and muscular endurance in the abdominal area (+61%), lower limbs (+75%) and upper limbs (+68%). The percent of Maximum Heart Rate achieved in the 6th (79.25%) and 12th (79.86%) weeks of training increased from the first week (73.4%). Physical fitness in Control Group remained unchanged. Conclusion: twelve weeks of Pilates training positively affected overall physical fitness in previously sedentary healthy women. Furthermore, the increase in VO2peak and achieved Maximum Heart Rate was significant even with no specific aerobic training.

Objetivos: avaliar os efeitos de 12 semanas de treinamento de Pilates (Método Clássico) sobre o condicionamento cardiorrespiratório e respostas da frequência cardíaca de mulheres sedentárias saudáveis. Métodos: quinze mulheres realizaram 12 semanas de treinamento de Pilates durante 60 minutos, três vezes por semana (Grupo Pilates), com média de idade 29±4 anos. Treze mulheres com idade compatível com os controles mantiveram suas atividades rotineiras (Grupo Controle), com média de idade de 29±5 anos. A introdução dos exercícios foi pelo grau de dificuldade com mudança nos planos de movimento; menor base de suporte; rotação e extensão da coluna; e ativação da musculatura abdominal em posição de decúbito ventral. A frequência cardíaca foi monitorada e gravada durante todas as sessões usando um frequencímetro. Resultados: Os resultados da ANOVA revelaram diferença significativa no Grupo Pilates (p < 0,05) entre medidas pré e pós de VO2pico (+13%), percentual de gordura (- 3,3%), massa gorda livre (+ 2,8 kg), e resistência muscular da área abdominal (+61%), membros inferiores (+75%) e dos membros superiores (+68%). O percentual de Frequência Cardíaca Máxima alcançado na sexta (79,25%) e na décima primeira (79,86%) semanas de treinamento aumentou a partir da primeira semana (73,4%). A aptidão física do Grupo Controle permaneceu inalterada. Conclusão: doze semanas de treinamento de Pilates afetaram positivamente o condicionamento físico geral em mulheres saudáveis anteriormente sedentárias. Além disso, o aumento do VO2pico e da Frequência Cardíaca Máxima foi significativo mesmo sem treinamento aeróbico específico.

The use of Pilates for pain control in patients with fibromyalgia / O método Pilates no controle da dor em pacientes com fibromialgia

Abstract Introduction: Although the Pilates method is commonly used to treat fibromyalgia (FM) in clinical practice, research is scarce, and little is known about its real effectiveness in pain management. Objective: Systematically review the literature to determine whether Pilates affects pain control in FM patients. Methods: The PubMed, Science Direct, PEDro and Cochrane databases were searched to identify randomized controlled trials that investigated the effects of Pilates in individuals diagnosed with FM. The descriptors used were: "pilates based exercise" OR "pilates training" OR "pilates exercise" OR "pilates" AND "fibromyalgia." Independent reviewers performed abstract/full-text screening, data extraction, and methodological quality assessments using the PEDro scale. Results: The search identified 646 potential articles, four of which were used in the analysis. The Pilates method had positive effects on pain control, physical function, quality of life and biopsychosocial factors such as stress and depression in individuals with FM in four studies. However, improvement in these parameters did not differ between intervention groups in three studies. Additionally, the control group showed no significant improvement for the same parameters in one study. The PEDro scale scores of the studies ranged from 6 to 8 points. Conclusion: Evidence suggests that Pilates influences pain control in individuals with FM, and is more effective than no intervention or minimal intervention in the treatment of FM.

Resumo Introdução: Apesar de o método Pilates ser comumente utilizado para o tratamento da fibromialgia (FM) na prática clínica, o número de estudos é escasso e pouco se sabe a respeito da sua real eficácia no manejo da dor. Objetivo: Revisar sistematicamente a literatura para determinar se o Pilates afeta o controle da dor em pacientes com FM. Métodos: A busca nas bases de dados PubMed, Science Direct, PEDro e Cochrane foi realizada para identificar ensaios clínicos randomizados que investigaram os efeitos do Pilates na FM. Os descritores utilizados foram: "pilates based exercise" OR "pilates training" OR "pilates exercise" OR "pilates" AND "fibromyalgia". Revisores independentes realizaram triagem de resumo/texto completo, extração dos dados e avaliações da qualidade metodológica utilizando a escala PEDro. Resultados: A pesquisa identificou 646 artigos potenciais; quatro foram usados na análise. O Pilates teve efeitos positivos no controle da dor, na melhora da função física, da qualidade de vida e de fatores biopsicossociais como o estresse e a depressão em indivíduos com FM nos quatro estudos analisados. A melhora destes parâmetros não foi diferente entre os grupos de intervenção em três estudos. O grupo controle não apresentou melhora significativa para os mesmos parâmetros em um estudo. As pontuações na escala PEDro variaram de 6 a 8 pontos. Conclusão: As evidências sugerem que o Pilates tem influência no controle da dor em indivíduos com FM e que é mais efetivo do que a não intervenção ou a intervenção mínima no tratamento da FM.