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- DissertaçãoAcesso aberto (Open Access)Adesão às recomendações de atividade física e status de peso associados à função física e à qualidade de vida em mulheres com câncer de mama(Universidade Estadual do Norte do Paraná, 2026) Silva, Mariana Somini Fernandes da; Cella, Paola Sanches; https://orcid.org/0000-0003-1023-0961; http://lattes.cnpq.br/3897961993964665; Cella, Paola Sanches; https://orcid.org/0000-0003-1023-0961; http://lattes.cnpq.br/3897961993964665; Rosa, Thiago dos Santos; https://orcid.org/0000-0003-0418-0945; http://lattes.cnpq.br/7914454583840134; Kalinke, Luciana Puchalski; https://orcid.org/0000-0003-4868-8193; http://lattes.cnpq.br/5678749615109042Introduction: Physical activity and body weight status are modifiable factors associated with physical function and quality of life in women with breast cancer. However, few studies have examined the combined association of these factors with functional and perceptual outcomes while considering different phases of cancer treatment. Objective: To investigate the association between adherence to physical activity recommendations and body weight status with physical function, symptoms, and quality of life in women with breast cancer. Methods: This cross-sectional observational study included 132 women diagnosed with breast cancer. Participants were classified according to adherence to World Health Organization physical activity recommendations and body weight status, forming four combined groups. Physical function, objective functional performance, symptoms (pain and fatigue), and quality of life were assessed. Analyses were adjusted for cancer treatment phase. Results: Women who did not meet physical activity recommendations and presented overweight/obesity showed worse physical function, higher pain perception, and lower quality of life compared with physically active groups. Physically active women exhibited better functional and quality of life outcomes regardless of body weight status. Conclusion: The combination of physical inactivity and overweight/obesity is associated with poorer physical function and quality of life in women with breast cancer. These findings highlight the importance of promoting physical activity as a central component of oncological care, irrespective of body weight status.
- DissertaçãoAcesso aberto (Open Access)Comparação entre treinamento muscular do assoalho pélvico e exercícios de pilates para incontinência urinária em mulheres na pós-menopausa: ensaio controlado randomizado(Universidade Estadual do Norte do Paraná, 2023) Gonzaga, Sabrina; 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; Gonçalves, Ezequiel Moreira; https://orcid.org/0000-0001-8470-9479; http://lattes.cnpq.br/3712055715302474; Oliveira, Deise Aparecida de Almeida Pires; https://orcid.org/0000-0002-5765-1897; http://lattes.cnpq.br/7663275220903598Introduction: Postmenopause is a period characterized by a series of body changes such as urogenital manifestations, which includes urinary incontinence (UI). The gold standard treatment for UI improvement is pelvic floor muscle training. It is not yet clear in the literature whether other muscle training exercise regimens, such as Pilates, can be effective in improving UI. Objective: To compare pelvic floor muscle training (PFMT) and Pilates exercises (PE) in improving UI, strength, muscle endurance and the impact of UI on the quality of life of postmenopausal women. Methods: Forty postmenopausal women were randomized into two groups: PFMT (n= 20) and PE (n= 20). Interventions for both groups occurred for 12 weeks, being performed three times a week, on non-consecutive days. The PFMT group protocol consisted of four series of ten maximum contractions, sustained for at least six seconds, and at the end of each series, five quick contractions were performed. Each series was performed in one position: 1st lying in lateral decubitus, 2nd sitting, 3rd on four supports and 4th standing. The EP group protocol consisted of 10 exercises, four specific for stretching and six for muscle strengthening. During a concentric phase of the Pilates strengthening exercises, participants in the PE group were instructed and emphasized to perform maximal targeted contraction of the pelvic floor muscles (PFM). Assessments of UI, strength, pelvic floor muscle endurance and impact of UI on quality of life were performed before and after the 12-week treatment. Shapiro Wilk tests were performed to verify normality, Student's t test and Mann Whitney U test according to parametric or non-parametric distribution, Mann-Whitney U test and Wilcoxon test for comparison between groups and intragroups, p values \< 0.05 were considered. Data were processed using the SPSS 25.0 program. For effect size calculations (Cohen's d) the GPower 3.1 program was used. Results: There was a significant intragroup improvement for both groups in the Pad-test: TMAP (p= 0.004) and EP (p= 0.009), in the Average daily urinary loss: TMAP (p= 0.003) and EP (p= 0.007), and the impact of urinary incontinence on quality of life, using the ICIQ-SF: PFMT (p= 0.000) and PE (p= 0.000). Regarding PFM strength, there was a significant improvement only in the TMAP group (p= 0.004) and for resistance, significant improvement in both groups: TMAP (p= 0.000) and PE (p= 0.001). Peak force manometry showed significant improvement only in the EP group (p= 0.018) and mean force manometry in both groups: PFMT (p= 0.043) and EP (p= 0.013); there was also an improvement in both groups in Manometry peak resistance: TMAP (p= 0.000) and EP (p= 0.005) and in Manometry mean resistance: TMAP (p= 0.000) and EP (p= 0.004). In the intergroup comparison, it was possible to identify significant results only for the muscle strength variable, in favor of the PFMT group (p= 0.027). Conclusion: There is no significant difference in the treatment of UI between PFMT and Pilates exercises when performed with the request for voluntary contraction of the PFM.
- DissertaçãoAcesso aberto (Open Access)Exercício físico como abordagem terapêutica no tratamento da sarcopenia em idosos: revisão sistemática e metanálise(Universidade Estadual do Norte do Paraná, 2025) Lucio, Maria Clara Fagundes; 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; Aguiar, Andreo Fernando; https://orcid.org/0000-0003-3337-2444; http://lattes.cnpq.br/0004657477950633; Teixeira, Denilson de Castro; https://orcid.org/0000-0002-6299-0252; http://lattes.cnpq.br/8134763463354265Introduction: Aging is associated with several physiological changes that reduce functionality and quality of life (QoL), including sarcopenia. This condition is characterized by progressive loss of muscle mass and strength, which increases the risk of falls, functional dependence, and mortality. Although physical exercise is recognized as an effective strategy for managing sarcopenia, the literature still presents heterogeneity regarding the most appropriate modalities for this population. Objective: To review randomized controlled trials (RCTs) on the effects of physical exercise on skeletal muscle mass, muscle strength, physical performance, QoL, and mortality in older adults with sarcopenia. Methods: The search was conducted in the following databases: Web of Science, Pubmed, Embase, Central, Cinahl, PEDro, SportDiscus, and Lilacs, without filtering by publication date or language, until May 26, 2025. Eligibility criteria were determined using the population, intervention, comparison, and outcome (PICO) method. The methodological quality of RCTs was assessed using the PEDro scale. Meta-analyses were conducted using the standardized mean difference (SMD) or mean difference (MD) between groups in the post-intervention period. The certainty of the evidence was classified according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). In order to verify whether studies with a high risk of bias were influencing the primary analyses, subgroup analyses were performed. Results: After screening, 77 RCTs were included in the systematic review, of which 40 had a low risk of bias. Physical exercise was superior to controls for improving skeletal muscle mass, muscle strength, and physical performance, with no significant differences in QoL. Among the modalities, resistance exercise was more effective than aerobic exercise for skeletal muscle mass, with no differences in strength. The combination of physical exercise with supplementation showed advantages over its isolated use for muscle mass, strength, and, in sensitivity analyses, also for physical performance. Mortality was not analyzed, as only one RCT reported this outcome. The quality of evidence ranged from very low to moderate. Conclusion: Physical exercise should be considered a first-line intervention for older adults with sarcopenia, with the potential to reduce disabilities, promote functionality, and promote healthier aging, despite the heterogeneity of protocols and the limitation of clinical outcomes in some studies.
- DissertaçãoAcesso aberto (Open Access)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/7663275220903598Introduction: 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.
- DissertaçãoAcesso aberto (Open Access)Efeitos isolados e combinados do pilates e do treinamento aeróbio na aptidão física em adultos jovens: um ensaio clínico randomizado(Universidade Estadual do Norte do Paraná, 2026) Oliveira, Gabriela Cristina de; Oliveira, Raphael Gonçalves de; https://orcid.org/0000-0003-0904-9305; http://lattes.cnpq.br/6247518975926252; Oliveira, Raphael Gonçalves de; https://orcid.org/0000-0003-0904-9305; http://lattes.cnpq.br/6247518975926252; Gonçalves, Ezequiel Moreira; https://orcid.org/0000-0001-8470-9479; http://lattes.cnpq.br/3712055715302474; Andrade, Marília dos Santos; https://orcid.org/0000-0002-7004-4565; http://lattes.cnpq.br/8618739762906389Introduction: Physical exercise is widely recommended as a central strategy to improve physical fitness, with direct implications for metabolic and functional health. However, the magnitude and specificity of physiological adaptations depend on the type of intervention. Aerobic training is traditionally associated with improvements in cardiorespiratory fitness and reductions in fat mass, whereas neuromuscular approaches are linked to increases in lean mass, strength, power, and flexibility. In this context, Pilates has emerged as a modality that integrates motor control, strength, and flexibility, with potential benefits for both musculoskeletal and functional outcomes. Nevertheless, evidence from randomized controlled trials directly comparing Pilates with aerobic exercise remains limited, as does evidence on whether combining these modalities enhances adaptations across different components of physical fitness. Objective: To compare the effects of 12 weeks of Pilates, aerobic training, and their combination on body composition and cardiorespiratory fitness (primary outcomes), as well as muscle strength, power, and flexibility (secondary outcomes) in previously untrained young women. Methods: A single-blind randomized controlled trial was conducted with 80 women (18–40 years), allocated into four groups (n = 20 each): Pilates, aerobic, combined, and control. Interventions were performed three times per week for 12 weeks, with 60-minute sessions. Assessments included total and segmental body composition by dual-energy X-ray absorptiometry (DXA); V̇O₂max measured by a maximal incremental test with direct gas analysis; muscle strength of knee, elbow, and trunk flexors and extensors assessed by isokinetic dynamometry; countermovement vertical jump performance (height, force, and power) measured on a force platform; and trunk flexibility (flexion and extension) assessed using a fleximeter. Session rating of perceived exertion and adverse events were monitored throughout the intervention. Results: All interventions (Pilates, aerobic, and combined) significantly improved cardiorespiratory fitness compared with the control group, with no differences between methods, indicating similar effectiveness for increasing V̇O₂max. Regarding body composition, the Pilates group showed greater increases in total lean mass compared with the aerobic group, with more pronounced gains in lower-limb lean mass. The combined group also demonstrated greater increases than the aerobic group for this outcome. No significant between-group differences were observed for fat mass. For musculoskeletal fitness, Pilates was superior to aerobic training in knee flexor peak torque and also showed greater improvements in elbow and trunk extensor strength. In addition, Pilates led to greater improvements in vertical jump performance (height and power) and trunk flexibility. These effects were accompanied by moderate to large effect sizes. The combined intervention did not provide additional benefits compared with isolated modalities, possibly due to reduced modality-specific training volume. Perceived exertion was similar across intervention groups. Serious adverse events occurred exclusively in the aerobic group and were related to musculoskeletal injuries. Conclusion: Pilates training was as effective as aerobic exercise in improving cardiorespiratory fitness and more effective in increasing lean mass, with no differential effects on fat mass. Additionally, it promoted greater gains in strength, power, and flexibility. Combining modalities did not yield additional benefits. Overall, these findings support Pilates as an effective and safe strategy to improve physical fitness in young women.