Comparative Effects of Clinical Pilates Training and Aerobic Exercise on Menopausal Symptoms, Quality of Life, Sleep and Depression: A Randomised Controlled Trial

Abstract

Objective: To examine the effects of Clinical Pilates (CP) training and aerobic exercise (AE) on menopausal symptoms, depressive symptoms, quality of life (QoL), and sleep quality in postmenopausal women. Design: Parallel-group randomised controlled trial. Setting: A Healthy Life Center in Bitlis, Turkey. Population or Sample: Thirty postmenopausal women were randomly allocated to CP (n = 15) or AE (n = 15) groups. Method: Both exercise interventions were performed twice weekly for 8 weeks (40-min/session). Assessments were conducted before and after the intervention period. Main Outcome Measures: The primary outcome was menopausal symptom severity assessed using the Menopause Rating Scale (MRS). Secondary outcomes included sleep quality, depressive symptom severity, and health-related QoL, assessed using the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and Short Form-36 (SF-36), respectively. Results: Baseline characteristics were comparable between groups (p > 0.05), although BMI was significantly higher in the CP group (p < 0.05). Both groups demonstrated improvements in depressive symptoms, sleep quality, and several QoL subdomains post-intervention. No significant between-group differences were observed in pre- to post-change scores for primary or secondary outcomes. Effect size analysis indicated greater reductions in menopausal symptom severity in the CP group, while changes in urogenital symptoms were minimal in both groups. Improvements in depressive symptoms and sleep quality were comparable. Conclusion: Both CP and AE demonstrated improvements in psychological outcomes, QoL, and sleep quality in postmenopausal women. Pilates may offer additional short-term benefits for the management of menopausal symptoms. Exercise selection may be guided by individual preference and accessibility. Larger long-term trials are needed to clarify comparative effects. Trial Registration: Clinical.gov: NCT05764031.