{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:45:10Z","timestamp":1791895510793,"version":"4.3.4"},"update-to":[{"DOI":"10.12688\/f1000research.146980.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000}}],"reference-count":28,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Systemic hypertension is a global non-communicable disease that creates an essential need for alternate forms of lifestyle modifications, including exercise, to lower elevated blood pressure. Mat Pilates, a feasible form of mind-body coordinated exercise, may provide benefits with limited resources. Objective This randomized controlled trial aims to assess the efficacy of Mat Pilates on resting blood pressure and health-related quality of life in individuals with systemic hypertension. Methods A two-arm, single-blinded, block randomized controlled trial will be recruited with a total of 120 participants into control and experimental groups 60 participants in each group (1:1 ratio). Mat Pilates will be administered to the experimental group and standard care to the control group for 12 weeks. Resting and central blood pressure, health-related quality of life, and echocardiographic parameters will be measured before and after the trial. We hypothesized that Pilates may not be beneficial in lowering resting blood pressure in hypertensive patients. A repeated-measures analysis of variance (ANOVA) will test the within- and between-group effects of Mat Pilates on various outcomes. Ethics and Dissemination The trial was approved by the Institutional Research Committee, Manipal College of Health Professions, Manipal Academy of Higher Education, Kasturba Medical College, and Kasturba Hospital Institutional Ethics Committee, Manipal. Written informed consent will be obtained from all the participants. All stakeholders and committees will communicate key findings regarding the implementation of mind-body association exercises as a measure of lifestyle modification in individuals with systemic hypertension. Trial registration Clinical Trials Registry of India: CTRI\/2021\/07\/035002. Registered on July 20, 2021, http:\/\/ctri.nic.in.<\/ns3:p>","DOI":"10.12688\/f1000research.146980.2","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T04:44:07Z","timestamp":1784004247000},"page":"840","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Mat Pilates on the resting blood pressure and health related quality of life in individuals with systemic hypertension versus standard care: study protocol for a single centered single blinded randomized controlled trial"],"prefix":"10.12688","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5063-3549","authenticated-orcid":false,"given":"Nivedita S.","family":"Prabhu","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Manipal College of Health Professions Manipal Karnataka 576104 Manipal Academy of Higher Education"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Arun","family":"Maiya","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Manipal College of Health Professions Manipal Karnataka 576104 Manipal Academy of Higher Education"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5746-1682","authenticated-orcid":false,"given":"Vaishali","family":"K","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Manipal College of Health Professions Manipal Karnataka 576104 Manipal Academy of Higher Education"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2323-6964","authenticated-orcid":false,"given":"Shivashankara","family":"KN","sequence":"additional","affiliation":[{"name":"Department of Medicine, Kasturba Medical College Manipal Karnataka 576104 Manipal Academy of Higher Education"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref2","article-title":"Global action plan for the prevention and control of noncommunicable diseases 2023-2030."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3-10","DOI":"10.1056\/NEJM200101043440101","article-title":"Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. 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Phrase has been corrected.  A two-arm, single-blinded, block randomized controlled trial will be recruited with120 participants into control and experimental groups (1:1 ratio). - Is confusing. Rephrase \n<b>Response: <\/b>The statement has been rephrased. A two-arm, single-blinded, block randomized controlled trial will be recruited with a total of 120 participants with 60 participants each in the control and experimental groups.  Introduction: Epidemiological data would benefit with more up to date references. \n<b>Response: <\/b>Thank you for the valuable inputs. The data has been revised. Authors state a scarcity of studies studying the effects of pilates on blood pressure, but many studies have been published recently including systematic reviews and meta-analysis. \n<b>Response: <\/b>The scarcity of studies reported are in reference to central blood pressure parameters when the protocol was designed in 2018. Many of the studies were later published which has been revised.  Objectives - secondary outcomes Why did the authors choose &quot;Two-dimensional (2D) echocardiographic parameters included the left ventricular ejection fraction (LVEF) and end-diastolic volume&quot; as a secondary outcome for this population? Do you expect to see structural changes in the heart and ejection fraction in a 12-week mat pilates program? \n<b>Response: <\/b>&nbsp;As per the null and alternate hypothesis, we intend to explore and see if there would be any structural or functional changes of the myocardial systolic or diastolic function by measuring left ventricular end diastolic volume and ejection fraction through exercise, hence we have chosen 2D echocardiographic parameters as secondary outcomes. Existing literature suggests cardiac remodelling (structural changes) can begin and range between 3 months (12 weeks) up to 6 months (24 weeks) with regular exercise. For reference: 1) Garza MA, Wason EA, Zhang JQ. Cardiac remodeling and physical training post myocardial infarction. World J Cardiol. 2015 Feb 26;7(2):52-64. doi: 10.4330\/wjc.v7.i2.52. 2) Haykowsky M, Scott J, Esch B, Schopflocher D, Myers J, Paterson I, Warburton D, Jones L, Clark AM. A meta-analysis of the effects of exercise training on left ventricular remodeling following myocardial infarction: start early and go longer for greatest exercise benefits on remodeling. Trials. 2011 Apr 4;12:92. doi: 10.1186\/1745-6215-12-92.  Eligibility criteria Why is systolic blood pressure &gt;160 as exclusion criteria, since systolic blood pressure &lt;180 mm hg are usually eligible for exercise? \n<b>Response: <\/b>In reference to the cut off values of 160 mm Hg, data from Indian studies report smaller diameter vessels (especially coronary artery vasculature) which are at a higher risk of early occlusion and earlier risk of CVD events (Stroke, Myocardial infarction). Hereby providing the reference studies for the selected exclusion criteria as 160 mmHg of systolic pressure.  Modi, Ranjan1; Modi, Sunil2. Coronary artery morphometrics in Indians \u2013 An optical coherence tomography perspective. Journal of Current Cardiology 2(2):p 105-108, May\u2013Aug 2024. | DOI: 10.4103\/JCC.JCC_11_23 Raut BK, Patil VN, Cherian G. Coronary artery dimensions in normal Indians. Indian Heart J. 2017 Jul-Aug;69(4):512-514. doi: 10.1016\/j.ihj.2017.01.009.  In additiona, as suggested by the scientific review committees based on the above literature, 160 mm Hg was considered as the cut off value for systolic blood pressure.  Must there not be an interval before starting exercise while medication needs to be implemented. I mean, medication should be unchanged at least 1 month before starting exercise to avoid any change in blood pressure values due to medication. \n<b>Response: <\/b> Standard protocols for antihypertensive medications remain unchanged prior to the trial period for 4 weeks (1 month). However, various individual participant characteristics\/variables (non- modifiable, e. g hereditary predisposition\/familial hypertension, environmental and lifestyle related factors \u2013 humidity, temperature, hydration) additionally would need to be considered that may cause any variation in the blood pressure regulation during other times of the day.  Why was a 2mmHg difference used to estimate sample size? \n<b>Response: <\/b> The 2mm of Hg MCID was calculated from the pilot study (consisting of 10 participants) results conducted before the clinical trial in the Indian population on anti-hypertensive drug therapy.  I have some questions regarding the interventions. Will the exercise group not be taking any anti-hypertensive medication? Why is it just referred for the control group? This must be clarified. \n<b>Response: <\/b> Both the exercise and control groups will be receiving the standard medical care of antihypertensive medications during the trial. The medications are not exclusive to the control group alone. This has been revised.  How to you intend to control for anti-hypertension medication intake? and to other exercise regimes in both groups? \n<b>Response: <\/b>The antihypertensive medications will be prescribed by medical physicians of the participants. Any variation in the dosage of antihypertensive medications will be monitored and recorded during the study period. However, various individual participant characteristics\/variables (non- modifiable, e. g hereditary predisposition\/familial hypertension) additionally would need to be considered that may cause any variation in the dosage. These variables and the altered dosage of medications can be later analysed as covariates using ANCOVA.","URL":"https:\/\/f1000research.com\/articles\/13-840\/v2#referee-comment-15492","order":2,"name":"referee-comment-15492","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.196845.r527959, Chockalingam Nageswari, Galgotias University, Greater Noida, Uttar Pradesh, 10 Oct 2026, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/13-840\/v2#referee-response-527959","order":3,"name":"referee-response-527959","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}