OBJECTIVE: To verify the effects of Pilates exercises on health-related quality of life (HRQoL) in postmenopausal women. METHODS: A systematic search was conducted in the following databases: PubMed, Embase, CENTRAL, CINAHL, Web of Science, LILACS, SportDiscus, Scielo, and PEDro. Randomized clinical trials (RCTs) that intervened with Pilates and had HRQoL as an outcome were eligible. The methodological quality of each RCT was assessed using the PEDro scale and the certainty of the evidence using the GRADE system. Meta-analyses were conducted by standardized mean difference (SMD). RESULTS: Initially, 760 records were located. After screening, 11 RCTs were included in the systematic review. Five studies presented low risk of bias (PEDro score >= 6). Evidence of very low to moderate certainty demonstrated significant effects in favor of Pilates exercises versus control groups for five of the nine HRQoL domains analyzed: bodily pain (SMD 0.96), physical functioning (SMD 0.85), social functioning (SMD 0.45), role physical (SMD 0.79), and role emotional (SMD 0.61). Subgroup analyzes demonstrated that Pilates had a positive impact on more domains whens administered for >= 48 sessions (eight domains) versus < 48 sessions (three domains); and when administered on equipment (seven domains) versus mat (three domains). CONCLUSION: Pilates exercises, in general, allowed significant effects to improve HRQoL in postmenopausal women, especially when performed on equipment and when administered for at least 48 sessions. However, no analysis showed high certainty of evidence, and more RCTs of high methodological quality are needed to confirm these findings.

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