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Acute effects of mat Pilates session on heart rate and rating of perceived exertion
Journal Pre-proof ACUTE EFFECTS OF MAT PILATES SESSION ON HEART RATE AND RATING OF PERCEIVED EXERTION Bárbara Carlin de Ramos do Espírito Santo, BSc, Leandro Garcias, MSc, Josefina Bertoli, MSc, Affonso Celso Kulevicz da Silva, MSc, Cíntia de la Rocha Freitas, PhD PII:
S1360-8592(19)30314-6
DOI:
https://doi.org/10.1016/j.jbmt.2019.10.004
Reference:
YJBMT 1886
To appear in:
Journal of Bodywork & Movement Therapies
Received Date: 2 July 2019 Accepted Date: 2 October 2019
Please cite this article as: Carlin de Ramos do Espírito Santo, B., Garcias, L., Bertoli, J., Kulevicz da Silva, A.C., Freitas, C.d.l.R., ACUTE EFFECTS OF MAT PILATES SESSION ON HEART RATE AND RATING OF PERCEIVED EXERTION, Journal of Bodywork & Movement Therapies, https:// doi.org/10.1016/j.jbmt.2019.10.004. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2019 Elsevier Ltd. All rights reserved.
ACUTE EFFECTS OF MAT PILATES SESSION ON HEART RATE AND RATING OF PERCEIVED EXERTION
Bárbara Carlin de Ramos do Espírito Santo, BSc1, Leandro Garcias, MSc1, Josefina Bertoli, MSc1,2, Affonso Celso Kulevicz da Silva, MSc3, Cíntia de la Rocha Freitas, PhD1*.
1
*Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Florianópolis-SC, Brazil,
2
Centro de Estudo e Laboratório de Avaliação e Prescrição de Atividade Motora, Universidade Estadual
Paulista, Faculdade de Ciência e Tecnologia, Presidente Prudente-SP, Brazil 3
Laboratório de Biomecânica Aquática, Universidade do Estado de Santa Catarina, Florianópolis-SC,
Brazil.
Correspondence to: Josefina Bertoli1,2 Universidade Estadual Paulista, Faculdade de Ciência e Tecnologia Rua Roberto Símonsen, 305 – Centro Educacional, Pres. Prudente - SP, 19060-900 E-mail: [email protected] Tel.: +55 (018) 3229-5828 Cel: +55 (018) 98195 6988
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ACUTE EFFECTS OF MAT PILATES SESSION ON HEART RATE AND RATING
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OF PERCEIVED EXERTION
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ABSTRACT
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The aim of this study was to analyze the acute effects of Heart Rate (HR) and Rating of
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Perceived Exertion (RPE) for 21 of 34 original Mat Pilates (MP) exercises, to estimate
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maximum oxygen consumption (VO2max), and energy expenditure (EE) of a MP session.
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Ten participants volunteered (26.30 ± 3.98 yrs.) to measure the intensity of each
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exercise; HR and RPE were monitored immediately after the end of each exercise.
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VO2max was estimated using the Astrand-Ryhming step submaximal test, and EE by a
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linear regression equation. HR and RPE mean values and standard deviations were
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calculated for each exercise. The maximum value for each participant normalized the
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EE and VO2max values, which were ranked from highest to lowest. The percentage of the
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mean values of HRmax and RPEmax in each exercise showed significant, strong and
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positive correlation (p=0.82; p=0.001). In 10 exercises, HR was 60% higher than HRmax.
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The mean values of EE and VO2max were 213.71 ± (76.41) Kcal and 34.69ml (Kg.min)-1
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(±3.5), respectively, for the entire MP session. According to American College of
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Sports Medicine (ACSM) recommendations, half of the exercises achieved moderate
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intensity in HR with low estimated VO2max during the whole MP session. However, if
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the MP session of this study was practiced five times per week, it would meet the
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weekly ACSM EE recommendations. The 21 MP exercises monitored in this study
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promote considerably acute and high increments in HR and RPE.
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Key words: Energy Expenditure; Maximum Oxygen Consumption; Exercise Intensity; Mat Pilates; Heart Rate.
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INTRODUCTION
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In the early 1930s and 1940s, Pilates Method began to be used by Broadway
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dance teachers and choreographers as a technique to promote the rehabilitation of
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dancers injured by excessive practice. Their justification was that they were the only
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movements that allowed the patient to execute them with continuity, offering the
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dancers the necessary assistance for injury prevention and rehabilitation (Anderson;
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Spector, 2000).
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Currently, Pilates Method has been widely practiced by different populations,
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such as children, young and older adults, athletes, among others, in order to improve
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quality of life (Mikalački et al., 2017). The health benefits of Pilates are well established
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in the literature, increasing abdominal strength, enhanced flexibility (Kao et al., 2015),
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postural alignment (Sinzato et al., 2013), improving range of motion and motor control
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(Blum, 2002; Lange et al., 2000; Sacco et al., 2005), functional capacity (Bertoli et al.,
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2017a) and isokinetic parameters (Bertoli et al., 2018). Moreover, Pilates Method was
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ranked seventh by American College of Sports Medicine (ACSM) in 2008 and 2009 as
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an emerging physical activity, and it achieved 10.5 million practitioners in the United
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States in 2004 (Mikalački et al., 2017).
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The first publication about Pilates Method was Return to Life Through
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Contrology, published in 1945 by Joseph Hubertus Pilates, who created the method with
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J.W. Millar (Latey, 2001). In this book, 34 exercises created by Pilates are explained
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with illustrations, which, according to the author, can be practiced at home (Latey,
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2001).The method consists of more than 500 exercises split into two categories: those
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practiced on mats, called Mat Pilates (MP), and those practiced using different types of
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equipment. Both modalities aim to improve flexibility, muscle force and coordination.
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Pilates is based on fundamental principles (control, centering, concentration, flow,
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precision and breathing) that must be followed during every exercise (Anderson and
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Spector, 2000; Muscolino and Cipriani, 2004a). These principles were defined directly
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by instructors Gail Eisen and Philip Friedman in The Pilates Method of Physical and
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Mental Conditioning in 1984. They studied with Romana Kryzanowska, Pilates's direct
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disciple and guardian of the method (Gallagher et al. 1999). Pilates sessions last
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between 45 to 60 minutes (Miyamoto et al., 2011; Oliveira et al., 2015), and the
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exercise intensity can be controlled by the number of repetitions, varying from 6 to 10.
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According to Kryzanowska and Gallagher (1999b), the categories of Pilates exercise
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practitioners are beginner, intermediate and advanced.
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Although methods for increasing the difficulty of Pilates exercises are well
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known, there has been a lack of data until now, not only about the intensity of the
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original exercises, but also about the acute effects on intensity parameters of an entire
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MP session. Considering the importance of measuring these parameters to prescribe
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MP, this study aimed to evaluate the acute effect of 21of the 34 original MP exercises
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on HR and RPE of Pilates practitioners, as well as to estimate the maximum oxygen
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uptake (VO2max) and energy expenditure (EE) of an entire MP session.
METHODS
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Participants
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The present study was performed from a sample for convenience, so a sensitivity
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analysis was conducted, adopting 5% level of significance, a statistical power of 80% in
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= 10 (G * Power Version 3.1.9.4, Franz Faul, Universität Kiel, Germany). From this,
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the smallest effect that could be detected with high correlation is equal to an r-value =
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0.65.
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In this way, ten participants (26.30 ± 3.98 yrs.; 71.70 ± 17.0 kg; 1.70 ± 0.13 m),
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5 men and 5 women, were intentionally recruited and volunteered for this study. All
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subjects had to be trained in the Pilates Classic Method for at least one year before this
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study. They were excluded from the sample in case of musculoskeletal disorders,
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cardiovascular illnesses, and/or use of medication that could affect HR and blood
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pressure. This study was approved by the local Ethics Committee of the Federal
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University of Santa Catarina (number 155034). The data collection was carried out on 2
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different days. On the first visit, the participants answered a questionnaire about gender,
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age, and lifestyle, they also performed the Âstrand-Ryhming step test to estimate
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VO2max (Astrand, 1960). During the second visit, a 45-minute MP session was
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conducted.
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Mat Pilates Session
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The Pilates session consisted of 21 exercises (see Figure 1), selected from the
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34 original exercises of Joseph Pilates’ book (Return to Life). Ten repetitions of each
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exercise were performed, 10 for each side in unilateral exercises, without pausing to
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change from one exercise to another. Even though the book was not followed, the order
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of the exercises was prescribed to prepare the body for the exercises to follow, as an
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original session of the Pilates Method. Only 21 exercises were chosen because of the
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high degree of difficulty of the other exercises, in addition to avoid an MP session
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longer than 45-60 minutes. Before the session, a poster with all exercises illustrated was
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shown to each participant to ensure the knowledge of the movements that would be
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developed along the session. If there were any doubts, explanations were given before
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the beginning of the MP session. Because of this procedure, the entire exercise routine
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was performed without interruption, with fluidity, control and precision, from the
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beginning to the end.
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*** PLACE FIGURE 1 HERE ***
Rating of Perceived Exertion and Heart Rate
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To evaluate the intensity of each exercise during the MP session, HR was
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assessed using a heart rate monitor (Polar®, T31) and RPE was measured with the
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modified Borg Scale (Cavallazzi et al., 2005),which is used to indicate effort intensity
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related to HR (Cabral et al., 2017). At the time of the anamnesis, participants were
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already familiar with the Borg scale and they had access to a table that contained the
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figures of the 21 exercises of the one session intervention, ensuring all the movements
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were familiar to them. Before the beginning of Pilates session, we carefully collected
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HR and RPE from each subject and the measures were repeated in the end of the
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execution of each exercise. The time it took for the subject to answer Borg scale was
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around one second. The question about Borg scale was registered while participants had
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already adjusted their postures for the next exercise. Furthermore, as mentioned in the
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method, the subjects used an HR monitor allowing direct access to the HR values, not
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requiring the movement to stop while registering the RP.
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VO2max Estimation
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For obtaining VO2 values at rest, a convention of 3.5 mL.kg-1.min-1was
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adopted for all subjects. VO2max was calculated by Astrand-Ryhming bench protocol,
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and the final HR value and body weight were met on the AstrandNomogram(Astrand,
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1960) after the test, indirectly offering the value of VO2max. An overall mean of
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achieved VO2max values was presented.
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Energy Expenditure Estimation
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The values of resting expenditure over 24h were considered for energy
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expenditure (EE) measurements, and those values were determined through the Harris-
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Benedict equations (Harris; Benedict, 1918), which take into account body mass, height
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and age. Through the values of HR rest, energy expenditure during rest, maximum HR
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and VO2max (transformed into maximum expenditure by the ratio of 1liter of O2 = 5
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kcal), a regression equation was generated, allowing the expenditure estimation for the
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different HR of exercise and thus, approximating its total energy expenditure.
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Statistical Analysis
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Mean and standard deviations were calculated for HR, RPE, EE and VO2max in
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each exercise during the MP session. In order to classify each exercise’s intensity
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according to HR and RPE, the values were normalized by the maximum result achieved
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by each participant and ranked in a decreasing order. To verify the association between
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HR and RPE in each exercise, Pearson correlation was calculated (r=1, perfect
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correlation; 0.8≤ r ˂ 1, strong correlation; 0.5 ≤ r ˂ 0.8 [moderate correlation] and, 0.1 ≤
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r ˂0.5 [weak correlation]). Significance was accepted when p < 0.05. Statistical
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software SPSS 18.0 (SPSS, Inc., Chicago, Illinois, USA) was used.
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RESULTS
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The acute exercise effect concerning HR and RPE showed that the percentage of
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the mean values of HRmax and RPEmax in each exercise had a strong and significant
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correlation (r=0.82; p=0.001). When each exercise was observed separately, most
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showed a correlation between HR and RPE (see Figure 2).
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*** PLACE FIGURE 2 HERE ***
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The percentage of HRmax achieved after each exercise was the criteria used to
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rank the MP exercises. The percentage of RPEmax was also presented together with
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HRmax (see Table 1). The reached HR rate was higher than 60% of HRmax in 10 of the 21
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exercises performed in this study.
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*** PLACE TABLE 1 HERE ***
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The complete MP session showed an EE mean value of 213.71 (±76.41) Kcal and a VO2max mean value of 34.69 (ml/Kg/min) (±3.5).
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DISCUSSION
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The present study evaluated the acute effects of a MP session through HR and
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RPE during the performance of each exercise and estimated VO2max and EE resulting
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from an entire MP session. According to the ranking obtained by HR, half of the
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exercises attained moderate intensity in this study. The entire MP session reached low
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EE and estimated VO2max.A strong and significant correlation was observed between
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HR and RPE, which could be due to both variables having a tendency of correlation
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(Cabral et al., 2017; Graef and Kruel, 2006). Hence, 10 of the 21 proposed exercises in
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the session achieved more than 60% of HRmax.
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According to ACSM, moderate activities and/or vigorous exercises that reach
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60% to 95% of HRmax are recommended to improve cardiorespiratory fitness levels in
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most of the adult population (Pescatello, 2014). In this sense, the percentage of HRmax
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obtained during each exercise facilitates the prescription of MP for cardiorespiratory
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fitness, making it possible to control intensity according to pre-established objectives.
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Among the 10 exercises classified as more intense, 9 of them were performed lying in
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the dorsal or ventral decubitus position. Exercise 17 (The Spine Twist) is the only one
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that differs, which is performed in the seated position. The Spine Twist requires the
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isometric contractions of the upper limbs, especially the stabilizing muscles of the
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shoulders and deltoids, which increases the degree of difficulty.
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Miranda et al. (2005) assessed the behavior of HR during the bench press in the
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sitting and dorsal decubitus positions and did not find significant differences in HR,
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although it was higher in the sitting position. Even though these findings were observed
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in weight training exercises, they are consistent with this study, providing evidence of
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incremental increases in HR during exercises performed in the sitting position.
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However, there is a lack of evidence documenting HR during resistance exercises in
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different positions (Miranda et al., 2005).
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The exercises that were classified as less intense, below 60% of HRmax, are
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similar regarding execution and present educative characteristics, focusing on
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abdominal contraction and even more so on breathing, which is related to Pilates’
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principles (Muscolino and Cipriani, 2004a, 2004b). The increment of HR during
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resistance exercises might be associated with the muscular area that is activated (Franke
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et al., 2000). The exercises that showed below 60% of HRmax involve small muscle
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groups, justifying the HR values found in this study.
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When the exercises were ranked, 10 were classified as the most intense
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according to the percentage of HRmax, and showed RPE values varying from 40% to
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68%, which represents from low intense to intense, respectively. One of the main
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characteristics of these exercises is that they demand core stabilization during isometric
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contractions, combined with involvement of the upper and lower limbs in isolation or in
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combination (upper and lower limbs working together). Exercises involving isometric
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contractions cause a greater increase in HR. During this type of muscle contraction,
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blood pressure also increases constantly if the force production achieves 15% of
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maximum voluntary contraction (Greer et al., 1984). Wiles et al. (2008) assessed an
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incremental protocol of isometric contraction in the knee extensor muscles on the
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isokinetic dynamometer, where they observed a significant correlation (r = 0.91, p <
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0.05) between muscle activation, measured with electromyography, and HR. This
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evidence reinforces the use of low cost or costless physiological variables to evaluate
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and control exercise intensity during an MP session.
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ACSM’s recommendation (Pescatello, 2014) to produce an energy expenditure
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of 1,000 kcal, progressing to 2,000 kcal per week, should include resistance exercises
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that strive to increase muscle strength and power and, thereby improve functional
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capacity to perform activities of daily living. The EE and VO2max mean values obtained
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during the MP session were 213.7 kcal and 34.69 (ml/Kg/min), respectively. Hence, if
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these 1,000 kcal were divided by five times per week, they would result in 200 kcal per
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day, which would mean that the MP session presented in this study met the weekly
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ACSM recommendations. On the other hand, participants in this study were all active
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and had practiced MP for at least one year before the data were collected. Consequently,
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a considerably increased increment of EE might be found in inexperienced participants.
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Although the present study has limiting factors, which are the indirect
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measurement of the VO2max and EE variables, and a small sample size, these findings
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are important to match MP practice to the ideal recommendations for each population.
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The variables investigated, albeit indirectly, already indicate a great deal of relevant
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information about each exercise, facilitating the possibility of MP prescription for
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professionals working in the area. In addition, submaximal exercise tests, for evaluating
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exercise tolerance, showed sensitivity to indicate changes after interventions, as they are
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more representative of daily physical activities (Kravchychyn et al., 2015).
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It is noted that the exercises were standardized during the MP session and all
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of them were the classical and original Pilates’ exercises. It is also highlighted that for
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the MP session, no equipment or other implements were utilized, which facilitates the
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reproduction of this session. In this study, although the MP was performed in a closed
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location, it can be done in open spaces and in groups, characterizing MP as an easy and
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inclusive physical activity. Therefore, this study might be reproduced in distinct ways
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and populations.
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CONCLUSION
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This study showed that an adapted version of Pilates utilizing 21 of the 34
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original MP exercises promotes considerably increased increments of HR and RPE.
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Considering the main objective of this research, we conclude that the information
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obtained is relevant to professionals who work with the Pilates Method, mainly to assist
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in exercise prescription considering the biological individuality, as well as controlling
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the exercise and session intensity from the FC and PSE information from this study.
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Clinical Relevance •
Even thoughVO2max and EE showed low values in this study, they were adequate
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for determining the EE obtained during the MP practice, enabling the MP
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exercise prescription in accordance to ACSM recommendations.
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•
It was also observed that the MP session of this study would attain the ACSM weekly recommendation of EE if practiced 5 times per week.
Acknowledgments
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The authors wish to thank the participants of the study, CAPES for the
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scholarship, and the Sports Center of the Federal University of Santa Catarina for
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providing the space for data collection.
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Conflicts of interest statement
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On behalf of all authors, the corresponding author declares there are no conflicts of interest and/or financial interests.
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H. Analysis of lower limb force in foot work exercise of Pilates. Fisioterapia em Movimento, [s.l.], v. 29, n. 4, p.669-676, dez. 2016. FapUNIFESP. http://dx.doi.org/10.1590/1980-5918.029.004.ao02. Mikalački, M., Čokorilo, N., Ruiz-Montero, P.J., Mikalački, M., Čokorilo, N., RuizMontero, P.J., 2017. The effects of a pilates-aerobic program on maximum exercise capacity of adult women. Rev. Bras. Med. do Esporte 23, 246–249. doi:10.1590/1517-869220172303156004 Miranda, H., Simão, R., Lemos, A., Lemos, A., Henrique, B., Dantas, A., Alberto, L., Novaes, J. 2005. Analysis on the cardiac rate, blood pressure and doubled-product in different bodypositions in resisted exercises Rev. Bras. Med. Esporte Niterói, 11 (3), 1806-9940. Miyamoto, G.C., Costa, L.O.P., Galvanin, T., Cabral, C.M.N., 2011. The efficacy of the addition of the Pilates method over a minimal intervention in the treatment of chronic nonspecific low back pain: a study protocol of a randomized controlled trial. J. Chiropr. Med. 10, 248–54. doi:10.1016/j.jcm.2011.06.007 Muscolino, J.E., Cipriani, S., 2004a. Pilates and the “powerhouse”—I. J. Bodyw. Mov. Ther. 8, 15–24. doi:10.1016/S1360-8592(03)00057-3 Muscolino, J.E., Cipriani, S., 2004b. Pilates and the “powerhouse”—II. J. Bodyw. Mov. Ther. 8, 122–130. doi:10.1016/S1360-8592(03)00058-5 Oliveira, L.C. de, Gonçalves de Oliveira, R., Pires-Oliveira, D.A. de A., 2015. Effects of Pilates on muscle strength, postural balance and quality of life of older adults: a randomized, controlled, clinical trial. J. Phys. Ther. Sci. 27, 871–876. doi:10.1589/jpts.27.871. Pescatello, L.S., 2014. ACSM’s Guidelines for Exercise Testing and Prescription, 9th ed. Sacco, I.C.N., Andrade, M.S., Souza, P.S., Nisiyama, M., Cantuária, A.L., Maeda, F.Y.I., Pikel, M., 2005. Método pilates em revista: aspectos biomecânicos de movimentos específicos para rCEstruturação postural – Estudos de caso. Rev. Bras. ciência e Mov. 13, 65–78. Sinzato, C.R., Taciro, C., Pio, C. de A., Toledo, A.M. de, Cardoso, J.R., Carregaro, R.L., 2013. Efeitos de 20 sessões do método Pilates no alinhamento postural e flexibilidade de mulheres jovens: estudo piloto. Fisioter. e Pesqui. 20, 143–150. doi:10.1590/S1809-29502013000200008 Wiles, J.D., Allum, S.R., Coleman, D.A., Swaine, I.L., 2008. The relationships betwCEn exercise intensity, heart rate, and blood pressure during an incremental isometric exercise test. J. Sports Sci. 26, 155–162. doi:10.1080/02640410701370655
Table 1. Exercises ranked by intensity according to percentage of HRmaxand RPE. Ranking
Exercices
Number
% HRmax
SD
% RPEmax
SD
1
Legpull-front
19
73.81
10.15
68.00
18.74
2
Swimming
11
70.26
10.34
65.00
15.81
3
The legpull
15
70.05
11.40
64.00
10.75
4
The sidekickknCEling
16
67.78
11.44
58.00
21.50
5
Sideband
18
67.62
8.64
64.00
18.38
6
The pushup
21
66.51
8.53
56.00
23.66
7
The spine twist
17
63.07
8.35
45.00
19.58
8
Jack knife
8
61.43
8.94
66.00
20.11
9
Shoulder bridge
4
60.11
9.79
49.00
20.25
10
The double-legkick
13
60.05
7.59
40.00
12.47
11
The saw
9
59.52
6.76
44.00
16.47
12
Scissors
20
58.10
6.17
48.00
18.14
13
Rolling back
10
58.04
7.56
29.50
12.57
14
The hundred
2
57.98
7.65
47.00
24.97
15
The double-legstretch
6
57.51
6.13
45.00
23.21
16
The roll over
7
56.88
8.27
60.00
23.09
17
The one-legstretch
5
55.50
7.19
36.00
19.55
18
The spinestretch
14
55.34
5.89
29.00
11.97
19
The one-legkick
12
53.44
5.65
24.50
12.57
20
Rollup
1
50.84
6.74
24.00
17.13
21
The one-legcircle
3
50.43
7.99
36.00
13.50
Mean
60.68
8.22
47.52
17.83
SD: Standard Deviation
Figure 1.Exercises performed during the MP session in the same order practiced during the study.
Figure 2. Relation between HR and RPE during MP session for each exercise.
Conflicts of Interest Statement Manuscript title:
Journal of Bodywork and Movement Therapies
ACUTE EFFECTSOF MAT PILATES SESSIONSON HEART RATEANDRATING
OF PERCEIVED EXERTION -----------------------------------------------
The authors whose names are listed immediately below certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. Author names:
Josefina Bertoli Bárbara Carlin de Ramos do Espírito Santo Cíntia de La Rocha Freitas Leandro Garcias Affonso Celso Kulevicz da Silva The authors whose names are listed immediately below report the following details of affiliation or involvement in an organization or entity with a financial or non-financial interest in the subject matter or materials discussed in this manuscript. Please specify the nature of the conflict on a separate sheet of paper if the space below is inadequate. Author names:
This statement is signed by all the authors to indicate agreement that the above information is true and correct (a photocopy of this form may be used if there are more than 10 authors):
Author's name (typed)
Author's signature
Date
Bárbara Carlin de Ramos do Espírito Santo
July 1, 2019
Josefina Bertoli
July 1, 2019
Leandro Garcias
July 1, 2019
Affonso Celso Kulevicz da Silva
July 1, 2019
Cíntia de la Rocha Freitas
July 1, 2019
S1360-8592(19)30314-6
DOI:
https://doi.org/10.1016/j.jbmt.2019.10.004
Reference:
YJBMT 1886
To appear in:
Journal of Bodywork & Movement Therapies
Received Date: 2 July 2019 Accepted Date: 2 October 2019
Please cite this article as: Carlin de Ramos do Espírito Santo, B., Garcias, L., Bertoli, J., Kulevicz da Silva, A.C., Freitas, C.d.l.R., ACUTE EFFECTS OF MAT PILATES SESSION ON HEART RATE AND RATING OF PERCEIVED EXERTION, Journal of Bodywork & Movement Therapies, https:// doi.org/10.1016/j.jbmt.2019.10.004. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2019 Elsevier Ltd. All rights reserved.
ACUTE EFFECTS OF MAT PILATES SESSION ON HEART RATE AND RATING OF PERCEIVED EXERTION
Bárbara Carlin de Ramos do Espírito Santo, BSc1, Leandro Garcias, MSc1, Josefina Bertoli, MSc1,2, Affonso Celso Kulevicz da Silva, MSc3, Cíntia de la Rocha Freitas, PhD1*.
1
*Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Florianópolis-SC, Brazil,
2
Centro de Estudo e Laboratório de Avaliação e Prescrição de Atividade Motora, Universidade Estadual
Paulista, Faculdade de Ciência e Tecnologia, Presidente Prudente-SP, Brazil 3
Laboratório de Biomecânica Aquática, Universidade do Estado de Santa Catarina, Florianópolis-SC,
Brazil.
Correspondence to: Josefina Bertoli1,2 Universidade Estadual Paulista, Faculdade de Ciência e Tecnologia Rua Roberto Símonsen, 305 – Centro Educacional, Pres. Prudente - SP, 19060-900 E-mail: [email protected] Tel.: +55 (018) 3229-5828 Cel: +55 (018) 98195 6988
1
1
ACUTE EFFECTS OF MAT PILATES SESSION ON HEART RATE AND RATING
2
OF PERCEIVED EXERTION
3
ABSTRACT
4
The aim of this study was to analyze the acute effects of Heart Rate (HR) and Rating of
5
Perceived Exertion (RPE) for 21 of 34 original Mat Pilates (MP) exercises, to estimate
6
maximum oxygen consumption (VO2max), and energy expenditure (EE) of a MP session.
7
Ten participants volunteered (26.30 ± 3.98 yrs.) to measure the intensity of each
8
exercise; HR and RPE were monitored immediately after the end of each exercise.
9
VO2max was estimated using the Astrand-Ryhming step submaximal test, and EE by a
10
linear regression equation. HR and RPE mean values and standard deviations were
11
calculated for each exercise. The maximum value for each participant normalized the
12
EE and VO2max values, which were ranked from highest to lowest. The percentage of the
13
mean values of HRmax and RPEmax in each exercise showed significant, strong and
14
positive correlation (p=0.82; p=0.001). In 10 exercises, HR was 60% higher than HRmax.
15
The mean values of EE and VO2max were 213.71 ± (76.41) Kcal and 34.69ml (Kg.min)-1
16
(±3.5), respectively, for the entire MP session. According to American College of
17
Sports Medicine (ACSM) recommendations, half of the exercises achieved moderate
18
intensity in HR with low estimated VO2max during the whole MP session. However, if
19
the MP session of this study was practiced five times per week, it would meet the
20
weekly ACSM EE recommendations. The 21 MP exercises monitored in this study
21
promote considerably acute and high increments in HR and RPE.
22 23
Key words: Energy Expenditure; Maximum Oxygen Consumption; Exercise Intensity; Mat Pilates; Heart Rate.
2
24
INTRODUCTION
25
In the early 1930s and 1940s, Pilates Method began to be used by Broadway
26
dance teachers and choreographers as a technique to promote the rehabilitation of
27
dancers injured by excessive practice. Their justification was that they were the only
28
movements that allowed the patient to execute them with continuity, offering the
29
dancers the necessary assistance for injury prevention and rehabilitation (Anderson;
30
Spector, 2000).
31
Currently, Pilates Method has been widely practiced by different populations,
32
such as children, young and older adults, athletes, among others, in order to improve
33
quality of life (Mikalački et al., 2017). The health benefits of Pilates are well established
34
in the literature, increasing abdominal strength, enhanced flexibility (Kao et al., 2015),
35
postural alignment (Sinzato et al., 2013), improving range of motion and motor control
36
(Blum, 2002; Lange et al., 2000; Sacco et al., 2005), functional capacity (Bertoli et al.,
37
2017a) and isokinetic parameters (Bertoli et al., 2018). Moreover, Pilates Method was
38
ranked seventh by American College of Sports Medicine (ACSM) in 2008 and 2009 as
39
an emerging physical activity, and it achieved 10.5 million practitioners in the United
40
States in 2004 (Mikalački et al., 2017).
41
The first publication about Pilates Method was Return to Life Through
42
Contrology, published in 1945 by Joseph Hubertus Pilates, who created the method with
43
J.W. Millar (Latey, 2001). In this book, 34 exercises created by Pilates are explained
44
with illustrations, which, according to the author, can be practiced at home (Latey,
45
2001).The method consists of more than 500 exercises split into two categories: those
46
practiced on mats, called Mat Pilates (MP), and those practiced using different types of
47
equipment. Both modalities aim to improve flexibility, muscle force and coordination.
3
48
Pilates is based on fundamental principles (control, centering, concentration, flow,
49
precision and breathing) that must be followed during every exercise (Anderson and
50
Spector, 2000; Muscolino and Cipriani, 2004a). These principles were defined directly
51
by instructors Gail Eisen and Philip Friedman in The Pilates Method of Physical and
52
Mental Conditioning in 1984. They studied with Romana Kryzanowska, Pilates's direct
53
disciple and guardian of the method (Gallagher et al. 1999). Pilates sessions last
54
between 45 to 60 minutes (Miyamoto et al., 2011; Oliveira et al., 2015), and the
55
exercise intensity can be controlled by the number of repetitions, varying from 6 to 10.
56
According to Kryzanowska and Gallagher (1999b), the categories of Pilates exercise
57
practitioners are beginner, intermediate and advanced.
58
Although methods for increasing the difficulty of Pilates exercises are well
59
known, there has been a lack of data until now, not only about the intensity of the
60
original exercises, but also about the acute effects on intensity parameters of an entire
61
MP session. Considering the importance of measuring these parameters to prescribe
62
MP, this study aimed to evaluate the acute effect of 21of the 34 original MP exercises
63
on HR and RPE of Pilates practitioners, as well as to estimate the maximum oxygen
64
uptake (VO2max) and energy expenditure (EE) of an entire MP session.
METHODS
65
66
Participants
67
The present study was performed from a sample for convenience, so a sensitivity
68
analysis was conducted, adopting 5% level of significance, a statistical power of 80% in
69
= 10 (G * Power Version 3.1.9.4, Franz Faul, Universität Kiel, Germany). From this,
4
70
the smallest effect that could be detected with high correlation is equal to an r-value =
71
0.65.
72
In this way, ten participants (26.30 ± 3.98 yrs.; 71.70 ± 17.0 kg; 1.70 ± 0.13 m),
73
5 men and 5 women, were intentionally recruited and volunteered for this study. All
74
subjects had to be trained in the Pilates Classic Method for at least one year before this
75
study. They were excluded from the sample in case of musculoskeletal disorders,
76
cardiovascular illnesses, and/or use of medication that could affect HR and blood
77
pressure. This study was approved by the local Ethics Committee of the Federal
78
University of Santa Catarina (number 155034). The data collection was carried out on 2
79
different days. On the first visit, the participants answered a questionnaire about gender,
80
age, and lifestyle, they also performed the Âstrand-Ryhming step test to estimate
81
VO2max (Astrand, 1960). During the second visit, a 45-minute MP session was
82
conducted.
83
Mat Pilates Session
84
The Pilates session consisted of 21 exercises (see Figure 1), selected from the
85
34 original exercises of Joseph Pilates’ book (Return to Life). Ten repetitions of each
86
exercise were performed, 10 for each side in unilateral exercises, without pausing to
87
change from one exercise to another. Even though the book was not followed, the order
88
of the exercises was prescribed to prepare the body for the exercises to follow, as an
89
original session of the Pilates Method. Only 21 exercises were chosen because of the
90
high degree of difficulty of the other exercises, in addition to avoid an MP session
91
longer than 45-60 minutes. Before the session, a poster with all exercises illustrated was
92
shown to each participant to ensure the knowledge of the movements that would be
93
developed along the session. If there were any doubts, explanations were given before
5
94
the beginning of the MP session. Because of this procedure, the entire exercise routine
95
was performed without interruption, with fluidity, control and precision, from the
96
beginning to the end.
97
98
*** PLACE FIGURE 1 HERE ***
Rating of Perceived Exertion and Heart Rate
99
To evaluate the intensity of each exercise during the MP session, HR was
100
assessed using a heart rate monitor (Polar®, T31) and RPE was measured with the
101
modified Borg Scale (Cavallazzi et al., 2005),which is used to indicate effort intensity
102
related to HR (Cabral et al., 2017). At the time of the anamnesis, participants were
103
already familiar with the Borg scale and they had access to a table that contained the
104
figures of the 21 exercises of the one session intervention, ensuring all the movements
105
were familiar to them. Before the beginning of Pilates session, we carefully collected
106
HR and RPE from each subject and the measures were repeated in the end of the
107
execution of each exercise. The time it took for the subject to answer Borg scale was
108
around one second. The question about Borg scale was registered while participants had
109
already adjusted their postures for the next exercise. Furthermore, as mentioned in the
110
method, the subjects used an HR monitor allowing direct access to the HR values, not
111
requiring the movement to stop while registering the RP.
112
VO2max Estimation
113 114
For obtaining VO2 values at rest, a convention of 3.5 mL.kg-1.min-1was
115
adopted for all subjects. VO2max was calculated by Astrand-Ryhming bench protocol,
116
and the final HR value and body weight were met on the AstrandNomogram(Astrand,
6
117
1960) after the test, indirectly offering the value of VO2max. An overall mean of
118
achieved VO2max values was presented.
119 120
Energy Expenditure Estimation
121
The values of resting expenditure over 24h were considered for energy
122
expenditure (EE) measurements, and those values were determined through the Harris-
123
Benedict equations (Harris; Benedict, 1918), which take into account body mass, height
124
and age. Through the values of HR rest, energy expenditure during rest, maximum HR
125
and VO2max (transformed into maximum expenditure by the ratio of 1liter of O2 = 5
126
kcal), a regression equation was generated, allowing the expenditure estimation for the
127
different HR of exercise and thus, approximating its total energy expenditure.
128 129
Statistical Analysis
130
Mean and standard deviations were calculated for HR, RPE, EE and VO2max in
131
each exercise during the MP session. In order to classify each exercise’s intensity
132
according to HR and RPE, the values were normalized by the maximum result achieved
133
by each participant and ranked in a decreasing order. To verify the association between
134
HR and RPE in each exercise, Pearson correlation was calculated (r=1, perfect
135
correlation; 0.8≤ r ˂ 1, strong correlation; 0.5 ≤ r ˂ 0.8 [moderate correlation] and, 0.1 ≤
136
r ˂0.5 [weak correlation]). Significance was accepted when p < 0.05. Statistical
137
software SPSS 18.0 (SPSS, Inc., Chicago, Illinois, USA) was used.
138
RESULTS
139
The acute exercise effect concerning HR and RPE showed that the percentage of
140
the mean values of HRmax and RPEmax in each exercise had a strong and significant
7
141
correlation (r=0.82; p=0.001). When each exercise was observed separately, most
142
showed a correlation between HR and RPE (see Figure 2).
143 144
*** PLACE FIGURE 2 HERE ***
145 146
The percentage of HRmax achieved after each exercise was the criteria used to
147
rank the MP exercises. The percentage of RPEmax was also presented together with
148
HRmax (see Table 1). The reached HR rate was higher than 60% of HRmax in 10 of the 21
149
exercises performed in this study.
150 151
*** PLACE TABLE 1 HERE ***
152 153 154
The complete MP session showed an EE mean value of 213.71 (±76.41) Kcal and a VO2max mean value of 34.69 (ml/Kg/min) (±3.5).
155
DISCUSSION
156
The present study evaluated the acute effects of a MP session through HR and
157
RPE during the performance of each exercise and estimated VO2max and EE resulting
158
from an entire MP session. According to the ranking obtained by HR, half of the
159
exercises attained moderate intensity in this study. The entire MP session reached low
160
EE and estimated VO2max.A strong and significant correlation was observed between
161
HR and RPE, which could be due to both variables having a tendency of correlation
162
(Cabral et al., 2017; Graef and Kruel, 2006). Hence, 10 of the 21 proposed exercises in
163
the session achieved more than 60% of HRmax.
8
164
According to ACSM, moderate activities and/or vigorous exercises that reach
165
60% to 95% of HRmax are recommended to improve cardiorespiratory fitness levels in
166
most of the adult population (Pescatello, 2014). In this sense, the percentage of HRmax
167
obtained during each exercise facilitates the prescription of MP for cardiorespiratory
168
fitness, making it possible to control intensity according to pre-established objectives.
169
Among the 10 exercises classified as more intense, 9 of them were performed lying in
170
the dorsal or ventral decubitus position. Exercise 17 (The Spine Twist) is the only one
171
that differs, which is performed in the seated position. The Spine Twist requires the
172
isometric contractions of the upper limbs, especially the stabilizing muscles of the
173
shoulders and deltoids, which increases the degree of difficulty.
174
Miranda et al. (2005) assessed the behavior of HR during the bench press in the
175
sitting and dorsal decubitus positions and did not find significant differences in HR,
176
although it was higher in the sitting position. Even though these findings were observed
177
in weight training exercises, they are consistent with this study, providing evidence of
178
incremental increases in HR during exercises performed in the sitting position.
179
However, there is a lack of evidence documenting HR during resistance exercises in
180
different positions (Miranda et al., 2005).
181
The exercises that were classified as less intense, below 60% of HRmax, are
182
similar regarding execution and present educative characteristics, focusing on
183
abdominal contraction and even more so on breathing, which is related to Pilates’
184
principles (Muscolino and Cipriani, 2004a, 2004b). The increment of HR during
185
resistance exercises might be associated with the muscular area that is activated (Franke
186
et al., 2000). The exercises that showed below 60% of HRmax involve small muscle
187
groups, justifying the HR values found in this study.
9
188
When the exercises were ranked, 10 were classified as the most intense
189
according to the percentage of HRmax, and showed RPE values varying from 40% to
190
68%, which represents from low intense to intense, respectively. One of the main
191
characteristics of these exercises is that they demand core stabilization during isometric
192
contractions, combined with involvement of the upper and lower limbs in isolation or in
193
combination (upper and lower limbs working together). Exercises involving isometric
194
contractions cause a greater increase in HR. During this type of muscle contraction,
195
blood pressure also increases constantly if the force production achieves 15% of
196
maximum voluntary contraction (Greer et al., 1984). Wiles et al. (2008) assessed an
197
incremental protocol of isometric contraction in the knee extensor muscles on the
198
isokinetic dynamometer, where they observed a significant correlation (r = 0.91, p <
199
0.05) between muscle activation, measured with electromyography, and HR. This
200
evidence reinforces the use of low cost or costless physiological variables to evaluate
201
and control exercise intensity during an MP session.
202
ACSM’s recommendation (Pescatello, 2014) to produce an energy expenditure
203
of 1,000 kcal, progressing to 2,000 kcal per week, should include resistance exercises
204
that strive to increase muscle strength and power and, thereby improve functional
205
capacity to perform activities of daily living. The EE and VO2max mean values obtained
206
during the MP session were 213.7 kcal and 34.69 (ml/Kg/min), respectively. Hence, if
207
these 1,000 kcal were divided by five times per week, they would result in 200 kcal per
208
day, which would mean that the MP session presented in this study met the weekly
209
ACSM recommendations. On the other hand, participants in this study were all active
210
and had practiced MP for at least one year before the data were collected. Consequently,
211
a considerably increased increment of EE might be found in inexperienced participants.
10
212
Although the present study has limiting factors, which are the indirect
213
measurement of the VO2max and EE variables, and a small sample size, these findings
214
are important to match MP practice to the ideal recommendations for each population.
215
The variables investigated, albeit indirectly, already indicate a great deal of relevant
216
information about each exercise, facilitating the possibility of MP prescription for
217
professionals working in the area. In addition, submaximal exercise tests, for evaluating
218
exercise tolerance, showed sensitivity to indicate changes after interventions, as they are
219
more representative of daily physical activities (Kravchychyn et al., 2015).
220
It is noted that the exercises were standardized during the MP session and all
221
of them were the classical and original Pilates’ exercises. It is also highlighted that for
222
the MP session, no equipment or other implements were utilized, which facilitates the
223
reproduction of this session. In this study, although the MP was performed in a closed
224
location, it can be done in open spaces and in groups, characterizing MP as an easy and
225
inclusive physical activity. Therefore, this study might be reproduced in distinct ways
226
and populations.
227
CONCLUSION
228
This study showed that an adapted version of Pilates utilizing 21 of the 34
229
original MP exercises promotes considerably increased increments of HR and RPE.
230
Considering the main objective of this research, we conclude that the information
231
obtained is relevant to professionals who work with the Pilates Method, mainly to assist
232
in exercise prescription considering the biological individuality, as well as controlling
233
the exercise and session intensity from the FC and PSE information from this study.
234
11
235 236
Clinical Relevance •
Even thoughVO2max and EE showed low values in this study, they were adequate
237
for determining the EE obtained during the MP practice, enabling the MP
238
exercise prescription in accordance to ACSM recommendations.
239 240
241
•
It was also observed that the MP session of this study would attain the ACSM weekly recommendation of EE if practiced 5 times per week.
Acknowledgments
242
The authors wish to thank the participants of the study, CAPES for the
243
scholarship, and the Sports Center of the Federal University of Santa Catarina for
244
providing the space for data collection.
245
Conflicts of interest statement
246 247
On behalf of all authors, the corresponding author declares there are no conflicts of interest and/or financial interests.
248
REFERENCES
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Table 1. Exercises ranked by intensity according to percentage of HRmaxand RPE. Ranking
Exercices
Number
% HRmax
SD
% RPEmax
SD
1
Legpull-front
19
73.81
10.15
68.00
18.74
2
Swimming
11
70.26
10.34
65.00
15.81
3
The legpull
15
70.05
11.40
64.00
10.75
4
The sidekickknCEling
16
67.78
11.44
58.00
21.50
5
Sideband
18
67.62
8.64
64.00
18.38
6
The pushup
21
66.51
8.53
56.00
23.66
7
The spine twist
17
63.07
8.35
45.00
19.58
8
Jack knife
8
61.43
8.94
66.00
20.11
9
Shoulder bridge
4
60.11
9.79
49.00
20.25
10
The double-legkick
13
60.05
7.59
40.00
12.47
11
The saw
9
59.52
6.76
44.00
16.47
12
Scissors
20
58.10
6.17
48.00
18.14
13
Rolling back
10
58.04
7.56
29.50
12.57
14
The hundred
2
57.98
7.65
47.00
24.97
15
The double-legstretch
6
57.51
6.13
45.00
23.21
16
The roll over
7
56.88
8.27
60.00
23.09
17
The one-legstretch
5
55.50
7.19
36.00
19.55
18
The spinestretch
14
55.34
5.89
29.00
11.97
19
The one-legkick
12
53.44
5.65
24.50
12.57
20
Rollup
1
50.84
6.74
24.00
17.13
21
The one-legcircle
3
50.43
7.99
36.00
13.50
Mean
60.68
8.22
47.52
17.83
SD: Standard Deviation
Figure 1.Exercises performed during the MP session in the same order practiced during the study.
Figure 2. Relation between HR and RPE during MP session for each exercise.
Conflicts of Interest Statement Manuscript title:
Journal of Bodywork and Movement Therapies
ACUTE EFFECTSOF MAT PILATES SESSIONSON HEART RATEANDRATING
OF PERCEIVED EXERTION -----------------------------------------------
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Josefina Bertoli Bárbara Carlin de Ramos do Espírito Santo Cíntia de La Rocha Freitas Leandro Garcias Affonso Celso Kulevicz da Silva The authors whose names are listed immediately below report the following details of affiliation or involvement in an organization or entity with a financial or non-financial interest in the subject matter or materials discussed in this manuscript. Please specify the nature of the conflict on a separate sheet of paper if the space below is inadequate. Author names:
This statement is signed by all the authors to indicate agreement that the above information is true and correct (a photocopy of this form may be used if there are more than 10 authors):
Author's name (typed)
Author's signature
Date
Bárbara Carlin de Ramos do Espírito Santo
July 1, 2019
Josefina Bertoli
July 1, 2019
Leandro Garcias
July 1, 2019
Affonso Celso Kulevicz da Silva
July 1, 2019
Cíntia de la Rocha Freitas
July 1, 2019