Effect of mat Pilates on postural control in breast cancer survivors receiving endocrine therapy: a randomized controlled clinical trial

INTRODUCTION: Although survival rates among breast cancer survivors (BCS) have improved due to early diagnosis and therapy advances, the short- and long-term side effects of chemotherapy and hormone therapy can impair postural control. These effects often increase sedentary behavior, further compromising functional capacity. PURPOSE: To evaluate the effects of a 24-week Mat Pilates intervention on postural control in BCS undergoing endocrine therapy. METHODS: Forty-three BCS (≥40 years) receiving hormone therapy were randomized into a Pilates Group (PG) or Control Group (CG). Assessments occurred at baseline (T1), after 12 weeks (T2), and after 24 weeks (T3) of the intervention. Postural control variables included mean sway amplitude, sway displacement, and mean sway velocity, measured during quiet bipedal standing with and without vision, in both anterior-posterior (AP) and mediolateral (ML) directions. Baseline characteristics were compared using Student's t-test, Chi-square, and Fisher's Exact Test. MANOVA was used to assessed postural control outcomes (p < 0.05). RESULTS: In the AP direction with vision, mean sway amplitude decreased in the PG compared to the CG at T3 (p < 0.05), with a similar reduction at T2 (p < 0.05). For ML mean sway velocity (with vision), a significant evaluation effect was observed (p = 0.01). Additionally, mean sway velocity showed an interaction effect (p = 0.004), with PG tending to sway more slowly at T3 (p = 0.08). CONCLUSIONS: These findings suggest that Mat Pilates may be a clinically effective, low-cost, and adaptable strategy for improving postural control and potentially reducing fall risk in BCS.