Pilates Flashcards
Define pilates
A series of nonimpact exercises designed by Joseph Pilates to develop strength, flexibility, balance, and inner awareness
Joesph Hubertus
Creator of pilates
Childhood illness
Pilates book for HEP
Joesph wrote the book Return to Life so that he could spread his ideas and exercises at low cost
Has instructions for 34 exervises with emphasis on breath and motor control
70% are contraindicated for OP, disc pathology, and sciatica though
Proliferation of pilates
1992 - name pilates was copyrighted
2000 - pilates ruled to be generic name
Sales increased a lot 1997-2002
Goals of pilates
To stabilize the powerhouse by isometric, concentric, eccentric strengthening of abdominal, lower spine and PFM
To train the local spinal mm, incorporating breathing patterns - while inhibiting global mm
Goals of pilates - powerhouse =
Core mm strengthening
Lower spine, abdominals, scapular stabilizers, hips
Principles of pilates for rehab
Breathing - proper COSTAL and diaph breathing
Alignment
Core control - rib cage over pelvis
Motor control - precision and fluidity of mvmnts
Program design
Basic principles first Spinal alignment Movement patterns (isolated - hip dis, shld dis, hip and shld dis) Balance and proprioception Positions
Benefits of pilates
Strength
Core stabilization
Flexibility
Spinal mobility
Improvement in posture - addressing muscle imbalances when working on alignment
Body awareness - this is big - motor coordination and awareness
Getting some fascial stretching - nerve gliding too
Mental focus and clarity of mind
Empower the pt
Common diagnoses treated
Chronic neck and back pain Total knee/hip Shoulder impinge/tendonitis Hip bursitis Ankle instability MS PD Fibro Scoliosis Pediatrics Preg and post partum
Evidence for pilates
Consistent with principles of Kendall and Sarhmann
Systematic reviews shoe
Pilates superior to minimal intervention for pain relief
When compared to other exercises for pain relief or disability, did not have sig difference
Conclusion - low quality studies to compare differences with heterogenous groups
Pilates mat vs. equipment
Equipment based pilates was better nly in 6 month follow up of kinesieophobia and pt specific disability scale
Clinical predicition rule for LBP to benefit from pilates
Were similar to our usual CPR Trunk flex 70 or less S/S 6 months or less No leg symptoms in last week BMI of 25 or greater Hip rot ROM 25 or greater
3/5 - probability of success with pilates increased from 54 to 93%
Pilates for children - physical activity guidelines for children
Is good
60 minutes of daily exercise with moderate to vigorous intensity
2 times a week of strengthening
Rehab pitfalls for pilates
75% of all traditional pilates mat exercises are done in spinal flexion
Limited amount of leg strengthening
Classical ex rx is the same number of reps and springs for all exercises
Limited standing exercises
Benefits of pilates (table comparison to limitations)
Correction of faulty mvmnt
Core control facilitates inhibition of global mm used for substitutions
Breathing facilitates mvmnt
Costal breathing enhances core control, thoracic/rib mobility and improves posture
Spinal mob in all directions
Dec dependence on healthcare and more control for pt
Differences in pilates vs. yoga - Pilates
Small mvmnts progressing to larger mvmnts.
Costal breathing
Focus on forced exhalation
Limited standing exercises in mat pilates
Differences in pilates vs. yoga - yoga
Postures held at end range
Diaphrag breathing
Breath with restriction of airflow in and out to strengthen diaphragm
Includes more standing, balance, and leg strengthening
Pilates as wellness - wellness programming
Cash based programs Mat or equipment Individual sessions Group sessions - general strengthening - balance and coord for fall prevention - youth fitness - sport specific classes - OP
Pilates as wellness - benefits of pilates program for clinic
Cash based program
Increased referrals
Community programs - service to community
Pt engagement with your clinic and then they have continued engagement with your clinic - you become their therapist for life (the only one they think of referring friends/family to)
Can also help with using your flex space - so using your equipment and space for other things
Pilates as wellness - special considerations (what pt populations)
OP Herniated disc Spondy Total hip.knee Pregnancy Fibro Neuro conditions (vertigo, MS, PD)
Clinical take home message
Pilates ex may be an effective intervention for chronic LBP when provided by a pilates certified PT
Inc literature on various pop from children, chronic conditions, ortho, neuro, geriatric - More objective studies needed but HRQOL reports show no difference
Good exercise program for health individuals to improve flexibility, dynamic balance, and muscle endurance
Local muscles
Control of stiffness and intervertebral relationship of spinal segments and posture of lumbar spine
Essential for stability, but dont control spinal segment orientation
Originate on vertebrae and attach on hip or shoulder
Global muscles
Torque generators that control spinal orientation
Balance external load and transfer of load from thorax to pelvis
Cannot fine tune motion
Level 1 muscles fire 5 to 100 times faster than can be recruited consciously
Local stabilizer
Many type 1 fibers Deep, close to axis of mvmnt Control neutral zone Anticipatory - respond irrespective of load direction Highly proprioceptive Recruited by low loads, slow mvmnt Dysfunction from reflex inhibition, endurance, force, improper recruitment Abnormal movement at 1 segment
Local stabilizers - lumbar spine
Pelvic floor Diaphragm TA Multifidus Segmental psoas
Local stabilizers - throacic spine
Multifidus
Intercostalis
Interspinalis
Deep rotators
Local stabilizers - Cervical spine
DNF Suboccipitals Longus coli LOngus capitus Multifidus
Local stabilizers - scapula
Low trap
MId trap
Loval stabilizers - GH joint
RTC
Biceps - long head
Local stabilizers - Hip
Psoas major
Deep ER
Glut med
Adductors
Global stabilizers
Many type IIa fibers Deep or superficial Spans one joint Postural, primarily eccentric Activity is direction dependent Highly proprioceptive Recruited by low to mod load, slow mvmnt Dysfunction as low force production, reflex inhibition, altered recruitment Problems across several joint segments
Global stabilizers - lumbar
Int and Ext obliques Spinalis Glut max, med, min Superficial psoas Add magnus, brevis Pectineus
Global stabilizers - thoracic
Obliques
Semispinalis
Multifidus
Global stabilizers - cervical
Upper, middle, lower trap
Global stabilizers - scapula
Upper and middle trap
SA
Global stabilizers - GH
Teres major
Deltoid
Coracobrachialis
Global stabilizers - Hip
Iliacus Psoas major Glut mm Adductor magnus and brevis Pectineus
Global mobilizers
Many type IIb fibers Superficial, span multipl joints Primarily concentric Activity is direction dependent Few proprioceptors Recruited by high load, high speed Dysfunction as tightness, spasm, become responsive to low freq stimulation Problems at adjacent vertebrae or region
Global mobilizers - lumbar
RA Hams Iliocostalis QL TFL Add longus Gracilis Rectus femoris Lat
Global mobilizers - THoracic
RA Erector spinae Scalenes Rhomboids Pec maj and min
Global mobilizers - Cervical
Scalenes SCM Splenius Erector spinae Hypoids
Global mobilizers - Scapula
Rhomboids
Pec minor
Levator scap
Lat
Global mobilizers - GH
Pec minor
Biceps short head
Triceps long head
Lat
Global mobilizers - Hip
TFL Adducotr longus Sartorius Gracilis Hams Rectus femoris
Stability of system - form closure
Stability due to inert structures of the body - bones, lig, capsules, CT, Shape of pelvis, sacrum
Compromised “form” - torn ligaments, OA structures
PT cannot affect this
Stability of the system - force closure
Stability provided by the mm system
Five lumbopelvic local stabilizers
Motor learning
4 stages of skill development
Unconscious use of stabilizers
Conscious use of stabilizers
Consciously learn to recruit the stabilizers
Integrate the use of stabilizers in activities and use them unconsciously
