KMAN Publication Inc. International Journal of Sport Studies for Health 2588-5782 In Press 2026 07 13 Effects of Pilates Training and Vitamin D Supplementation on BMD, BDNF, and Mineral Status in Women with Osteosarcoma Effects of Pilates Training and Vitamin D Supplementation on BMD, BDNF, and Mineral Status in Women with Osteosarcoma EN Journal Article <p><strong>Objective:</strong> 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.</p> <p><strong>Methods:</strong> 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.</p> <p><strong>Results:</strong> Eight weeks of combined Pilates and vitamin D supplementation were associated with significant improvements in serum calcium (<em>p =</em> 0.003), magnesium (<em>p</em> = 0.002), phosphorus (<em>p</em> = 0.01), BDNF (<em>p</em> = 0.01), and BMD (<em>p</em> = 0.01) compared with control conditions. Post-hoc analyses indicated that the ExD group demonstrated greater improvements than control and single-intervention groups (<em>p ≤</em> 0.05).</p> <p><strong>Conclusion:</strong> 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.</p>