Efeitos de um protocolo de exercícios do Método Pilates solo sobre a saúde mental e qualidade de vida de estudantes universitários: um ensaio clínico randomizado

Abstract

Introduction: Pilates has been shown to be effective in promoting physical and mental health, and is especially relevant in the context of university education, where students often face negative impacts on their mental health and well-being. Objective: To evaluate the effects of practicing the Pilates mat method on the levels of anxiety, depression, stress and quality of life of university students. Method: Randomized, blinded clinical trial conducted at the Federal University of Triângulo Mineiro (FUTM), in accordance with the Consolidated Standards of Reporting Trials (CONSORT) and Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines, registered in the Brazilian Registry of Clinical Trials (REBEC), code RBR- 8xzpdbc. A mat Pilates protocol was developed, consisting of 12 exercises and evaluated by five physical therapists with doctorates. After a pilot study, a sample size calculation was performed including 58 participants per group, with 20% losses. Inclusion criteria: being enrolled in undergraduate health courses at UFTM, age ≥18 years, with no history of pregnancy/childbirth or contact with Pilates in the last three months. Exclusion criteria: health conditions that would prevent intervention, such as musculoskeletal injuries, pathologies or structural deformities in the spine or upper and lower limbs, systemic diseases and presence of acute pain. Randomization was performed via www.randomization.com, allocating participants into an experimental group (EG), which performed mat Pilates for eight weeks (16 40-minute sessions, twice a week) or a control group (CG). The intervention was conducted by a physiotherapist experienced in Pilates, from May/2023 to September/2024. Assessments were performed at baseline (T1) and after eight weeks (T2), using the Depression Anxiety and Stress Scale (DASS-21) for depression, anxiety and stress, the World Health Organization Quality of Life-Bref (WHOQOL-BREF) for quality of life and a sociodemographic and clinical questionnaire. Data were analyzed in SPSS 20.0, with α=0.05. The paired t-test was used for intragroup comparisons and the independent ttest for between-group comparisons in the DASS-21 and WHOQOL-BREF variables. For the social relations domain, due to the nonparametric distribution, the Wilcoxon (intragroup) and Mann-Whitney (between-group) tests were applied. The study was approved by the Research Ethics Committee of the aforementioned institution, under opinion 5,517,018/2022. Results: A total of 93 students participated (EG=46 and CG=47), with a mean age of 21,82 years, predominantly female (92,5%), single (95,8%), self-declared white (57%). In the intragroup analysis, the EG showed significant reductions in depression (p=0,000), anxiety (p=0,008), and stress (p=0,000), while in the CG there were no relevant changes. Regarding quality of life, the EG improved in the physical (p=0,002) and psychological (p=0,001) domains, and the CG in the social domain (p=0,003). In the intergroup comparison, there was a significant difference only for stress (p=0,006; Cohen's d=0,59). For quality of life, significant differences were observed in the physical (p=0,001), psychological (p=0,011) and social (p=0,003) domains. The environmental domain did not show significant improvement (p=0,069). Conclusion: Mat Pilates can be an effective intervention in reducing stress symptoms and promoting quality of life among university students in the health area.