This study investigated the impacts of online and face-to-face Mat Pilates training in adults with persistent symptoms of long COVID on health outcomes. Forty-nine patients (52 ± 5.85 yr.) diagnosed with long COVID related to fatigue symptoms were randomly included in three groups: online Mat Pilates training (n = 16), face-to-face Mat Pilates training (n = 15), and a control group (n = 18) without training. Mat Pilates training was conducted three times a week for 12 weeks. Fatigue, functional capacity, anthropometrics, body composition, and cardiometabolic markers were assessed before and after the interventions. Two-factor Generalized Estimating Equation analyses identified significant differences with Bonferroni post hoc testing (p < 0.05). After the intervention, only the face-to-face Mat Pilates training group had an improved total, physical and mental fatigue, trunk isometric strength, upper limb muscle endurance strength, and aerobic capacity (p < 0.05). No changes were found in fat mass, muscle mass, free fat mass, % of fat, body mass, body mass index, or waist and hip circumferences. No significant changes were observed in blood glucose, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, or blood pressure (p > 0.05). Our results highlight the potential of face-to-face Mat Pilates training as an effective intervention to mitigate persistent symptoms of long COVID related to fatigue and functional capacities.

Although the relationship between risk factors and disease patterns still remains poorly understood, arterial hypertension in climacteric women is a substantial risk factor for multimorbidity. This cross-sectional study analyzed data from 1003 women aged ≥40 years attending Brazilian Basic Health Units to assess multimorbidity (≥2 chronic conditions) and its patterns (cardiometabolic, musculoskeletal, and neuropsychological). An adjusted logistic regression revealed that postmenopausal status (OR: 2.17; 95% CI: 1.05–4.48) and an age of ≥70 years (OR: 2.85; 95% CI: 1.16–6.99) were key risk factors for multimorbidity. Notably, 86% of hypertensive women had multimorbidity, most frequently dyslipidemia (50%), type 2 diabetes (37%), and thyroid disorders (18%). The cardiometabolic pattern (86% prevalence) was strongly associated with hypertension, especially among women aged ≥50 years (OR: 2.10; 95% CI: 1.10–3.98) and those with obesity grade I+ (OR: 2.30; 95% CI: 1.36–3.89). Musculoskeletal disorders were associated with postmenopausal status (OR: 2.41; 95% CI: 1.05–5.51) and obesity (OR: 1.92; 95% CI: 1.08–3.43), while neuropsychological diseases showed no significant associations. These findings highlight that hypertensive climacteric women—especially postmenopausal, older, or those with obesity—face elevated risks of cardiometabolic and musculoskeletal multimorbidity, underscoring the need for targeted preventive strategies in this population.

Cardiometabolic multimorbidity is highly prevalent among postmenopausal women and is associated with adverse metabolic outcomes and a greater burden of climacteric symptoms. This secondary analysis of a quasi-experimental controlled clinical trial investigated the effects of a 12-week aerobic training program on climacteric symptoms, menopause-related quality of life, body composition, and cardiometabolic biomarkers in postmenopausal women with and without cardiometabolic multimorbidity. Forty-one postmenopausal women (50–70 years) were allocated to a single-cardiometabolic-condition group (SINGLE, n = 18) or a multimorbidity group (MULTI, n = 23) and completed supervised walking/jogging aerobic exercise three times per week at 65–75% of heart rate reserve. Climacteric symptoms, quality of life, anthropometric measures, body composition, and biochemical markers were assessed before and after the intervention. Generalized Estimating Equations (GEEs) with Bonferroni post hoc adjustment were used to compare group, time and group*time interactions with alpha of 5%. Significant group-by-time interactions were observed for the Menopause Rating Scale total score and psychological symptoms, as well as for the Cervantes Scale total score, indicating greater improvements among women with multimorbidity. The MULTI group demonstrated significant reductions in overall menopausal symptoms, psychological symptoms, and menopause-related quality of life scores following training. Body weight, triglycerides, and very-low-density lipoprotein cholesterol also decreased significantly only in the MULTI group, whereas several body composition parameters improved over time regardless of cardiometabolic burden. These findings indicate that aerobic training may be associated with improvements in menopausal symptoms, quality of life, body composition, and selected cardiometabolic markers in postmenopausal women, with some outcomes showing greater changes among women with cardiometabolic multimorbidity.