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    Efeitos dos exercícios de pilates na qualidade de vida em mulheres na pós-menopausa: revisão sistemática e metanálise
    (Universidade Estadual do Norte do Paraná, 2023) Almeida, Priscila Peruzzolo de; Oliveira, Laís Campos de; https://orcid.org/0000-0002-9853-7337; http://lattes.cnpq.br/1621658942171919; Oliveira, Laís Campos de; https://orcid.org/0000-0002-9853-7337; http://lattes.cnpq.br/1621658942171919; Lirani, Luciana da Silva; https://orcid.org/0000-0001-8270-5394; http://lattes.cnpq.br/7980787316560409; Oliveira, Deise Aparecida de Almeida Pires; https://orcid.org/0000-0002-5765-1897; http://lattes.cnpq.br/7663275220903598
    Introduction: Postmenopause is a process that begins 12 months after the last menstrual period and can lead to deficits in several body systems, and consecutively, compromise the quality of life of this population. To alleviate deficits and improve quality of life, regular physical exercise is recommended. Pilates is a possibility of exercises that have been sought after by postmenopausal women and seem to contribute to improving their quality of life, however, the results of Pilates exercises for the quality of life of this population are not yet clear in the literature. Objective: To verify studies of the type of controlled and randomized trials regarding the effects of Pilates exercises in improving the quality of life of postmenopausal women. Methods: a systematic search in the literature and a statistical meta-analysis procedure was carried out. Studies that used Pilates exercises as an intervention and an assessment of quality of life in postmenopausal women were considered eligible. Searches were performed in the following databases: PubMed; BASE; CENTRAL; CINAHL; Web of Science; LILACS; SportDiscus; Pedro; Risk of bias and methodological quality were assessed using the PEDro scale. The quality/certainty of the evidence was observed using the GRADE system. Meta-analysis calculations were performed using the standardized mean difference (SMD) or the mean difference (MD) between the Pilates vs. control groups, or Pilates vs. other forms of exercise. Heterogeneity was quantified by I2 statistics and Cochran's Q test. Effect sizes were considered statistically significant when p \< 0.05 and classified as small (0.2), medium (0.5) or large (0.8) magnitude. All analyzes were performed using the Review Manager program (RevMan), version 5.3 (The Cochrane Collaboration). Results: Initially, 760 records were located. After the screening process, 11 RCTs were included in the systematic review. The qualitative analysis showed that the studies used samples containing 20 to 60 participants per group. With regard to the assessment of quality of life, there were a variety of questionnaires used in the studies; Leipad Questionnaire; WHOQOL-OLD; WHOQOL-BREF; Short Form Health Survey (SF-36); Subjective Well-Being Scale (SWS); CASP19; QUALEFFO-41. Most controlled and randomized trials used the SF-36 questionnaire (54.54%). The methodological quality assessment showed that of the 11 included studies, five were of high quality (PEDro score ≥ 6 points), with a mean score between studies of 5.18 ± 1.40. In the quantitative analysis, our primary analysis demonstrated a statistical significance in favor of the Pilates group vs. control groups for five domains of quality of life (pain, functional capacity, social aspects, physical aspects and emotional aspects) among nine. The sensitivity analysis showed the same results as the primary analysis. In the analysis of subgroups where studies that applied intervention time longer than 4 months were considered, there were significant findings in favor of Pilates for eight quality of life domains, among nine, only the mental health domain was not significant. For comparison analysis between Pilates vs. other exercises, there was a significant difference in favor of Pilates only for the functional capacity domain. For comparison analysis between Mat Pilates vs. Pilates on equipment, Pilates on equipment obtained significant findings for seven domains of quality of life, among eight, while Mat Pilates presented significant results for only four domains. For most of the analyses, the evidence was of very low to low quality, eventually being considered moderate, evaluated by the GRADE system. Conclusion: Pilates exercises, in general, provided a significant result in improving the QoL of postmenopausal women, especially when performed on equipment and for an intervention time of more than four months. However, for professionals to be able to use Pilates for this outcome, more robust RCTs with high methodological quality are needed.