The effects of 24 Weeks of mat pilates on pain, anxiety, and depressive symptoms in breast cancer survivors undergoing hormone therapy: A randomized controlled trial

PURPOSE: Breast cancer survivors (BCS) undergoing hormone therapy often experience pain, anxiety, and depressive symptoms. Thus, this study aimed to explore the effects of 24 weeks of Mat Pilates on pain severity, pain interference, anxiety, and depressive symptoms in BCS undergoing hormone therapy, and to determine whether these effects differ according to the type of hormone therapy, Tamoxifen (TMX) or Aromatase Inhibitors (AIs). METHODS: This randomized controlled trial consisted of supervised 60-min Mat Pilates sessions three times per week for 24 weeks. Outcomes were assessed at baseline and post-intervention using the Brief Pain Inventory and Hospital Anxiety and Depression Scale. Generalized estimating equations were used to evaluate the effects of the intervention. RESULTS: Forty-three BCS were randomized into a control group (CG; 54.7 ± 6.6 years) and a Pilates group (PG; 55.2 ± 7.6 years). A significant group-time interaction was observed for pain severity (p = 0.031; Δ = -5.5; d = 0.50), with a reduction in the PG, and anxiety symptoms (p = 0.006; Δ = 1.7; d = 0.55), with an increase in the CG. Hormone therapy stratification showed group∗time interactions, among AI users for pain severity (p = 0.025; Δ = -6.1; d = 0.38), and anxiety symptoms (p = 0.02; Δ = -2.7; d = 0.37), with reductions in the PG for both variables. Depressive symptoms did not significantly improve. CONCLUSION: Mat Pilates improved pain severity and anxiety symptoms in BCS, particularly among AI users. However, the modest sample size limits its generalizability. Mat Pilates is a feasible, low-cost, and clinically applicable strategy that can be incorporated into supportive care in BCS.