The Effect of 8 Weeks of Pilates and Vitamin D Supplementation on VEGF and KDR Levels in Men with Relapsing-Remitting Multiple Sclerosis: A Pilot Study

Abstract

Background: This pilot study investigated the potential effects of Pilates exercise and vitamin D supplementation on vascular function and multiple sclerosis (MS) symptoms. Vascular endothelial growth factor (VEGF) and its receptor, kinase insert domain receptor (KDR), are critical mediators of angiogenesis and neural repair in MS. Objectives: This study aimed to investigate the preliminary combined effects of an 8-week Pilates program and vitamin D supplementation on serum VEGF and KDR levels in men with relapsing-remitting MS. Methods: Twenty men with relapsing-remitting MS from the Ahvaz MS Association were randomly assigned using a simple randomization method (random number table) to a Pilates exercise group (n = 10) or a Pilates + vitamin D group (n = 10). Blinding was maintained for participants and assessors; however, laboratory technicians were not blinded due to resource limitations. The 8-week intervention comprised three 60 - 75-minute Pilates sessions per week, focusing on core strength, flexibility, and balance. The Pilates + vitamin D group received a weekly oral dose of 50,000 IU of vitamin D3. Serum VEGF and KDR levels were measured using ELISA 48 hours before and after the intervention. Data were analyzed using SPSS version 26, with paired t-tests used for within-group changes and analysis of covariance (ANCOVA) used for between-group differences; significance was set at P ≤ 0.05. Results: Both groups showed significant reductions in VEGF (Pilates: P = 0.009; Pilates + vitamin D: P = 0.036). The Pilates + vitamin D group exhibited a greater reduction in VEGF (P = 0.031). KDR increased slightly in the Pilates group (P = 0.003) but decreased in the Pilates + vitamin D group (P = 0.008), with a significant between-group difference (P = 0.001). Both groups showed significant reductions in body mass index (BMI) (P < 0.05), with no significant between-group differences (P > 0.05). Conclusions: This 8-week pilot study suggests that Pilates, with or without vitamin D supplementation, may reduce serum VEGF and modulate KDR levels in men with relapsing-remitting MS. The combined intervention showed greater effects on VEGF and distinct regulation of KDR levels, indicating potential benefits for vascular health and MS management.