Effects of Pilates Training and Vitamin D Supplementation on BMD, BDNF, and Mineral Status in Women with Osteosarcoma

Abstract

Objective: Osteosarcoma and its treatment protocols may disrupt bone mineral homeostasis, reduce bone mineral density (BMD), and alter neurotrophic factors such as brain-derived neurotrophic factor (BDNF). This study aimed to investigate the effects of an 8-week Pilates training program combined with vitamin D supplementation on serum mineral-related biomarkers, BDNF, and BMD in women with osteosarcoma.

Methods: Fifty women with medically stable osteosarcoma (age: 29.50 ± 0.79 years; BMI: 23.65 kg/m²) participated in this randomized controlled trial. After screening and eligibility assessment, participants were randomly assigned to five groups (n = 10/group): Pilates + vitamin D (ExD), Pilates + placebo (ExP), Pilates only (Ex), vitamin D only (D), and control (CO). The Pilates intervention consisted of supervised sessions three times per week for 8 weeks (24 sessions total). Participants in supplementation groups received 5000 IU vitamin D3 weekly for 8 weeks. Supplement/placebo administration and outcome assessment were blinded.

Results: Eight weeks of combined Pilates and vitamin D supplementation were associated with significant improvements in serum calcium (p = 0.003), magnesium (p = 0.002), phosphorus (p = 0.01), BDNF (p = 0.01), and BMD (p = 0.01) compared with control conditions. Post-hoc analyses indicated that the ExD group demonstrated greater improvements than control and single-intervention groups (p ≤ 0.05).

Conclusion: Combined Pilates training and vitamin D supplementation may improve serum mineral-related biomarkers, BDNF, and BMD-related outcomes in women with osteosarcoma. Larger and longer-term studies are needed to confirm these preliminary findings.