Pilates uses a combination of approximately 50 simple, repetitive exercises to create muscular exertion. Advocates of this system of exercise claim that exercises can be adapted to provide either gentle strength training for rehabilitation or a strenuous workout vigorous enough to challenge skilled athletes. The exercises are designed to increase muscle strength and endurance, as well as flexibility and to improve posture and balance. There is cautious support for the effectiveness of Pilates in improving flexibility, abdominal and lumbo-pelvic stability and muscular activity. Stronger support cannot be given at this point in time primarily due to the limited number of studies and the lack of sound methodology in the published research. However, current research does indicate that there may be applications for this type of intervention in certain clinical populations that are worthy of continued investigation.
pilates; muscles exercises
The purpose of this study was to determine if Pilates exercise could improve dynamic balance, flexibility, reaction time and muscle strength in order to reduce the number of falls among older women. 60 female volunteers over the age of 65 from a residential home in Ankara participated in this study. Participants joined a 12-week series of 1-hour Pilates sessions three times per week. Dynamic balance, flexibility, reaction time and muscle strength were measured before and after the program. The number of falls before and during the 12-week period was also recorded. Dynamic balance, flexibility, reaction time and muscle strength improved (p < 0. 05) in the exercise group when compared to the non-exercise group. In conclusion, Pilates exercises are effective in improving dynamic balance, flexibility, reaction time, and muscle strength as well as decreasing the propensity to fall in older women.
Key pointsPilates-based exercises improve dynamic balance, reaction time and muscle strength in the elderly.Pilates exercise may reduce the number of falls in elderly women by increasing these fitness parameters.
Pilates; elderly women; balance; reaction time; muscle strength
There is little high-quality evidence on the efficacy of the Pilates-based exercises for the treatment of chronic nonspecific low back pain. Therefore, the objective of this paper is to present a study protocol to investigate the efficacy of adding Pilates-based exercises to a minimum intervention in patients with chronic non-specific low back pain.
This randomized controlled trial will recruit 86 patients of both sexes, aged between 18 and 60 years, with chronic non-specific low back pain. The participants will be randomly allocated into 2 treatment groups: the Booklet Group, which will receive a booklet with postural orientations, and the Pilates Group, which will receive the same booklet in addition to a Pilates-based exercises program. The general and specific functional capacities of the patient, kinesiophobia, pain intensity, and the global perceived effect will be evaluated by a blinded assessor before randomization and at 6 weeks and 6 months after randomization. In addition, the expectations of the participants and their confidence in the treatment will be evaluated before the randomization and after the first treatment session, respectively.
It is hoped that the results of this study will provide high-quality evidence on the usefulness of Pilates-based exercises in the treatment of chronic non-specific low back pain.
Randomized controlled trial; Exercise movement techniques; Low back pain; Patient education as topic; Disability evaluation
Objective: This study aimed to determine the effects of mat Pilates on resting heart rate, resting blood pressure and fasting blood glucose, cholesterol and triglycerides in elderly women.
Methodology: Fifty sedentary, apparently healthy females aged 60 and older were randomly assigned into a control (CG, n = 25) or an intervention (IG, n = 25) group. The IG took part in an eight-week progressive mat Pilates exercise program, three times weekly while the CG did not take part in any structured exercises throughout the eight-week period. All subjects underwent pre- and post-tests in which cardiometabolic parameters were assessed.
Results: In the eight-week mat Pilates program, the IG only demonstrated a significant (p ≤ 0.05) decrease in systolic BP (p = 0.040) from 135.84 ± 14.66mmHg to 128.80 ± 16.36mmHg and a significant increase in blood glucose (p = 0.000) from 5.07 ± 0.46mmol.L-1 to 5.83 ± 0.57mmol.L-1, whereas resting HR (p = 0.148) (from 68.80 ± 12.58beats.min-1 to 73.20 ± 11.46beats.min-1), resting diastolic BP (p = 0.342) (from 75.64 ± 10.10mmHg to 77.44 ± 9.32mmHg), blood TC (p = 0.073) (from 5.37 ± 0.99mmol.L-1 to 5.67 ± 1.04mmol.L-1) and blood TG (p = 0.384) (from 1.77 ± 0.88mmol.L-1 to 1.92 ± 0.87mmol.L-1) did not produce any significant changes.
Conclusion: Due to the contradictory nature of the cardiometabolic variables (except systolic BP) with the findings of previous studies, it is difficult to establish a case for using Pilates as a substitute for more conventional forms of exercising when exclusively attempting to favourably alter cardiometabolic parameters at least among the elderly women in our sample.
Pilates program; Resting heart rate; Resting blood pressure; Fasting blood glucose; Cholesterol; Triglycerides; Elderly women
Multiple Sclerosis (MS) is a disabling chronic disease of the nervous system in which the myelin system of the central nervous system is deteriorated. The objective of this study is to understand the effect of Pilates exercises and aquatic training for a 12 week period on the dynamic balance of MS patients.
The research method is semi-experimental. As a result, among the female patients visiting the MS clinic of Kashani hospital in Esfahan, 57 patients with disease intensity levels between 0 and 4.5 were taken as samples. The average length of the disease was 8 ± 2 years, 20;40 years old, and they were randomly divided into three groups of Pilates exercise group, aquatic training group, and the control group. The exercise schedule for the experiment groups consisted of 12 weeks, three sessions per week, and 1 hour for each session. The dynamic balance of the patients, before and after the exercises was measured by Six Spot Step Test.
The adjusted mean differences of Timed Up and Go Test (TUGT) scores of the experimental groups are significantly different (P<0.05). Therefore, it can be said that Pilates exercise interventions and aquatic training can significantly increase the dynamic balance of the examinees in the post-experiment stage.
Performing the Pilate exercises and aquatic training increases dynamic balance of the MS patients. Considering the role of dynamic balance on physical fitness and enabling the person in doing is daily chores and routines, and its direct effect on the quality of life, it leads the specialists in applying these exercises as a supplementary treatment along with the medicinal treatments for MS patients.
Aquatic training; dynamic balance; multiple sclerosis; pilates
Chronic low back pain is an expensive and difficult condition to treat. One of the interventions widely used by physiotherapists in the treatment of chronic non-specific low back pain is exercise therapy based upon the Pilates principles. Pilates exercises can be performed with or without specific equipment. These two types of Pilates exercises have never been compared on a high-quality randomised controlled trial.
This randomised controlled trial with a blinded assessor will evaluate eighty six patients of both genders with chronic low back pain, aged between 18 and 60 years, from one Brazilian private physiotherapy clinic. The patients will be randomly allocated into two groups: Mat Group will perform the exercises on the ground while the Equipment-based Group will perform the Pilates method exercises on the following equipment: Cadillac, Reformer, Ladder Barrel, and Step Chair. The general and specific disability of the patient, kinesiophobia, pain intensity and global perceived effect will be evaluated by a blinded assessor before randomisation and at six weeks and six months after randomisation. In addition, the expectation of the participants and their confidence with the treatment will be evaluated before randomisation and after the first treatment session, respectively.
This will be the first study aiming to compare the effectiveness of Mat and Equipment-based Pilates exercises in patients with chronic non-specific low back pain. The results may help health-care professionals in clinical decision-making and could potentially reduce the treatment costs of this condition.
Brazilian Registry of Clinical Trials RBR-7tyg5j
Pilates-based exercises; Low back pain; Disability
Baseball pitchers need trunk strength to maximize performance. The Pilates method of exercise is gaining popularity throughout the country as a fitness and rehabilitation method of exercise. However, very few studies exist that examine the effects of the Pilates method of exercise on trunk strength or performance.
Using a single subject, multiple baseline across subjects design, this study examines the effects of the Pilates method of exercise on performance of double leg lowering, star excursion balance test, and throwing velocity in college-aged baseball pitchers.
A convenience sample of three college baseball pitchers served as the subjects for this single subject design study. For each subject, double leg lowering, star excursion balance test, and throwing speed were measured prior to the introduction of the intervention. When baseline test values showed consistent performance, the intervention was introduced to one subject at a time. Intervention was introduced to the other subjects over a period of 4 weeks as they also demonstrated consistent performance on the baseline tests. Intervention was continued with periodic tests for the remainder of the 10 week trial.
Each subject improved in performance on double leg lowering (increased 24.43-32.7%) and star excursion balance test (increased 4.63-17.84%) after introduction of the intervention. Throwing speed improved in two of the three subjects (up to 5.61%).
Discussion and Conclusions
The Pilates method of exercise may contribute to improved performance in double leg lowering, star excursion balance tests, and throwing speed in college baseball pitchers.
trunk strength; throwing speed; core stability
People with Multiple Sclerosis (MS) frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK) provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect.
This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of:
1 Establishing the effectiveness of core stability training
2 Comparing core stability training with standardised physiotherapy exercise
3 Exploring underlying mechanisms of change associated with this intervention
This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control). All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12), the Functional Reach (forwards and lateral), a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC) Scale. In addition, ultrasound imaging of the abdominal muscles will be performed before and after intervention to assess changes in abdominal musculature at one of the four centres (Plymouth).
This pragmatic trial will assess the effect of these exercise programmes on ambulatory people with MS. It may not be possible to extrapolate the conclusions to those who are non-ambulatory.
Multiple sclerosis; Mobility; Balance; Exercise; Physiotherapy; Core stability
Negative symptoms of schizophrenia are frequently associated with poor long term outcomes. Established interventions have little, if any, positive effects on negative symptoms. Arts Therapies such as Body Psychotherapy (BPT) have been suggested to reduce negative symptoms, but the existing evidence is limited. In a small exploratory trial a manualised form of group BPT led to significantly lower negative symptom levels both at the end of treatment and at 4 months follow-up as compared to supportive counseling. We designed a large multi-site trial to assess the effectiveness of a manualised BPT intervention in reducing negative symptoms, compared to an active control.
In a randomised controlled trial, 256 schizophrenic outpatients with negative symptoms will be randomly allocated either to BPT or Pilates groups. In both conditions, patients will be offered two 90 minutes sessions per week in groups of about 8 patients over a period of 10 weeks. Outcomes are assessed at the end of treatment and at six months follow-up. The primary outcome is severity of negative symptoms, as measured by the Positive and Negative Symptom Scale (PANSS), whilst a range of secondary outcome measures include general psychopathology, social contacts, and quality of life. We will also assess the cost-effectiveness of the intervention.
The study aims to evaluate the effectiveness of a promising form of group therapy which may help alleviate negative symptoms that are associated with unfavourable long-term outcomes and have so far been difficult to treat. If the trial is successful, it will add a new and effective option in the treatment of negative symptoms. Group BPT is manualised, might be attractive to many patients because of its unusual approach, and could potentially be rolled out to services at relatively little additional cost.
Current Controlled Trials ISRCTN84216587
For older adults, hospitalization frequently results in deterioration of mobility and function. Nevertheless, there are little data about how older adults exercise in the hospital and definitive studies are not yet available to determine what type of physical activity will prevent hospital related decline. Strengthening exercise may prevent deconditioning and Pilates exercise, which focuses on proper body mechanics and posture, may promote safety.
A hospital-based resistance exercise program, which incorporates principles of resistance training and Pilates exercise, was developed and administered to intervention subjects to determine whether acutely-ill older patients can perform resistance exercise while in the hospital. Exercises were designed to be reproducible and easily performed in bed. The primary outcome measures were adherence and participation.
Thirty-nine ill patients, recently admitted to an acute care hospital, who were over age 70 [mean age of 82.0 (SD= 7.3)] and ambulatory prior to admission, were randomized to the resistance exercise group (19) or passive range of motion (ROM) group (20). For the resistance exercise group, participation was 71% (p = 0.004) and adherence was 63% (p = 0.020). Participation and adherence for ROM exercises was 96% and 95%, respectively.
Using a standardized and simple exercise regimen, selected, ill, older adults in the hospital are able to comply with resistance exercise. Further studies are needed to determine if resistance exercise can prevent or treat hospital-related deterioration in mobility and function.
exercise; resistance; strengthening; deconditioning; geriatrics
The purpose of this study was to examine the differences in anthropometric measurements using an aerobic and Pilates exercise program which lasted 24 weeks.
This was a clinical intervention study of 303 women over the age of 60 living in Novi Sad, Serbia. Changes in body mass index and skinfold thickness were estimated through height, weight, and anthropometric measurements. The program comprised Pilates exercises for upper- and lower-body strength, agility, and aerobic capacity.
Fat mass (FM) improved significantly (pre-test, 32.89%, 8.65; post-test, 28.25%, 6.58; P<0.01). Bone diameters and muscle perimeters showed no significant changes pre- and post-test (P>0.05), but there was a higher correlation between FM (%) and waist–hip ratio (rho, 0.80; P<0.01).
A mixed program of aerobics and Pilates, controls and improves baseline muscle mass and decreases FM values, without causing deterioration during practice and follow-up exercises.
lean body mass; anthropometric measures; educative program
In this study, the effect of Pilates training on the brain function was investigated through five case studies. Alpha rhythm changes during the Pilates training over the different regions and the whole brain were mainly analyzed, including power spectral density and global synchronization index (GSI). It was found that the neural network of the brain was more active, and the synchronization strength reduced in the frontal and temporal regions due to the Pilates training. These results supported that the Pilates training is very beneficial for improving brain function or intelligence. These findings maybe give us some line evidence to suggest that the Pilates training is very helpful for the intervention of brain degenerative diseases and cogitative dysfunction rehabilitation.
The interest and popularity of Pilates is increasing worldwide. In addition to being used in fitness programs, it is being used in some rehabilitation programs.
This review summarizes level III evidence from 1995 to 2009 obtained from PubMed (MEDLINE), CINAHL, and the Internet. Meta-analyses, systematic reviews, randomized controlled trials, and controlled trials published in peer-reviewed journals were retrieved for appraisal. The keywords searched were Pilates and core stabilization.
Ninety articles were identified in MEDLINE and CINAHL; 9 articles satisfied the inclusion criteria for level III evidence.
There is a scientific basis for the effectiveness of Pilates exercise, with limited evidence to support it as a rehabilitative intervention.
Pilates; rehabilitation; core strengthening
The aim of this study was to investigate the effects of 10 weeks of strength training with different number of sets and their influence on flexibility of young men. Sixty men were divided into three groups as follows: group that trained 1 set per exercise (G1S), group that trained 3 sets per exercise (G3S) and control group (CG). The training lasted 10 weeks, totaling 30 training sessions. The training groups performed 8 to 12 repetitions per set for each exercise. The flexibility at Sit and Reach Test was evaluated pre and post-training. Both trained groups showed significant increase in flexibility when compared to pre-training and the G3S showed significant difference when compared to CG post-training. According to this study, the strength training carried out without flexibility training promotes flexibility gains regardless the number of sets.
resistance training; training volume; stretching
Microgravity and inactivity due to prolonged bed rest have been shown to result in atrophy of spinal extensor muscles such as the multifidus, and either no atrophy or hypertrophy of flexor muscles such as the abdominal group and psoas muscle. These effects are long-lasting after bed rest and the potential effects of rehabilitation are unknown. This two-group intervention study aimed to investigate the effects of two rehabilitation programs on the recovery of lumbo-pelvic musculature following prolonged bed rest. 24 subjects underwent 60 days of head down tilt bed rest as part of the 2nd Berlin BedRest Study (BBR2-2). After bed rest, they underwent one of two exercise programs, trunk flexor and general strength (TFS) training or specific motor control (SMC) training. Magnetic resonance imaging of the lumbo-pelvic region was conducted at the start and end of bed rest and during the recovery period (14 and 90 days after re-ambulation). Cross-sectional areas (CSAs) of the multifidus, psoas, lumbar erector spinae and quadratus lumborum muscles were measured from L1 to L5. Morphological changes including disc volume, spinal length, lordosis angle and disc height were also measured. Both exercise programs restored the multifidus muscle to pre-bed-rest size, but further increases in psoas muscle size were seen in the TFS group up to 14 days after bed rest. There was no significant difference in the number of low back pain reports for the two rehabilitation groups (p = .59). The TFS program resulted in greater decreases in disc volume and anterior disc height. The SMC training program may be preferable to TFS training after bed rest as it restored the CSA of the multifidus muscle without generating potentially harmful compressive forces through the spine.
Bed rest; Magnetic resonance imaging; Gravity; Multifidus muscle; Psoas muscle; Rehabilitation
An important aspect of neuromuscular control at the lumbo-pelvic region is stabilization. Subjects with low back pain (LBP) have been shown to exhibit impairments in motor control of key muscles which contribute to stabilization of the lumbo-pelvic region. However, a test of automatic recruitment that relates to function has been lacking. A previous study used ultrasound imaging to show that healthy subjects automatically recruited the transversus abdominis (TrA) and internal oblique (IO) muscles in response to a simulated weight-bearing task. This task has not been investigated in subjects with LBP. The aim of this study was to compare the automatic recruitment of the abdominal muscles among subjects with and without LBP in response to the simulated weight-bearing task. Twenty subjects with and without LBP were tested. Real-time ultrasound imaging was used to assess changes in thickness of the TrA and internal oblique IO muscles as well as lateral movement (“slide”) of the anterior fascial insertion of the TrA muscle. Results showed that subjects with LBP showed significantly less shortening of the TrA muscle (P < 0.0001) and greater increases in thickness of the IO muscle (P = 0.002) with the simulated weight-bearing task. There was no significant difference between groups for changes in TrA muscle thickness (P = 0.055). This study provides evidence of changes in motor control of the abdominal muscles in subjects with LBP. This test may provide a functionally relevant and non-invasive method to investigate the automatic recruitment of the abdominal muscles in people with and without LBP.
Low back pain; Ultrasound imaging; Motor control; Weight-bearing; Functional testing; Transversus abdominis muscle
To examine associations between participating in mind-body activities (yoga/Pilates) and body dissatisfaction and disordered eating (unhealthy and extreme weight control practices and binge eating) in a population-based sample of young adults.
The sample included 1030 young men and 1257 young women (mean age: 25.3 years, SD=1.7) who participated in Project EAT-III (Eating and Activity in Teens and Young Adults).
Among women, disordered eating was prevalent in yoga/Pilates participants and non-participants, with no differences between the groups. Men participating in yoga/Pilates were more likely to use extreme weight control behaviors (18.6% vs. 6.8%, p=.006) and binge eating (11.6% vs. 4.2%, p=.023), and marginally more likely to use unhealthy weight control behaviors (49.1% vs. 34.5%; p=.053), than non-participants after adjusting for sociodemographics, weight status, and overall physical activity.
Findings suggest the importance of helping yoga/Pilates instructors recognize that their students may be at risk for disordered eating.
The present study was conducted to characterize the nature and pattern of serum and secretory antibody responses to N. gonorrhoeae by haemagglutination inhibition, opsonization, and immunofluorescence techniques in male and female patients with different clinical manifestations of gonorrhoea. Most male patients with acute gonococcal infection developed serum IgG and, less frequently, IgM antibodies against pilated gonococci within 2 weeks of infection and these antibodies declined to normal levels 1 to 2 months after treatment. This response was not noticeably different from the responses developed in male patients with subacute infection and female patients with chronic infection. Immunological analyses of the seminal plasmas and cervical fluids from these patients showed that antibodies reactive with both pilated and non-pilated N. gonorrhoeae are present in some of the cases. A small percentage of male patients who recovered from subacute gonococcal infection but not from acute infection possessed low levels of IgG and, less frequently, IgA antibodies to gonococcal antigens in their seminal plasmas. In contrast, more than half of the females with gonorrhoea had IgG antigonococcal antibodies in the cervical fluid. However, a small number of samples also showed the presence of IgA and IgM antibodies. IgA antibody in most of these IgA-positive samples was of the secretory type. The presence of secretory IgA (SIgA) in secretions and the lack of correlation between the antibody titres in serum and in secretions of these patients suggest that infection with N. gonorrhoeae may independently stimulate both a systemic and a local humoral immune response.
[Purpose] The purpose of this study was to investigate the effects of six weeks of
visual biofeedback training for prevention of falling in the elderly. The Tetrax system
was used for visual biofeedback training. [Subjects and Methods] Thirty elderly persons
(experimental group=15, control group=15) who were above 70 and under 80 years of age
participated in biofeedback training. They were trained for 15 minutes a day, three times
per week. We measured the weight distribution index, stability index, and fall index in
the subjects using the Tetrax system, and paired t-tests were used to evaluate the changes
before and after intervention. The difference between the groups was compared using an
independent t-test. [Results] The experimental group showed significant differences in
weight distribution index, stability index, and fall index. The control group showed no
significant differences. According to the comparison of training effects between the two
groups, the variables of stability index and fall index revealed a statistically
significant difference. [Conclusion] The method of visual biofeedback training used in
this study should be considered a therapeutic method for the elderly to improve weight
distribution, stability, and effectiveness in preventing falls.
Biofeedback; Elderly; Fall prevention
Fall-related injuries associated with aging are a serious clinical and economic problem. The Flo-Dynamics Movement System© (FDMS), which consists of eight movements with a water-filled device, may be a useful low-impact exercise suited for older persons. This study investigated the effects of the FDMS regimen with the Wun-Jo™ trainer on measures of strength, flexibility, and balance in older individuals.
In a quasi-experimental study, 15 healthy subjects aged 61–79 years participated in an FDMS exercise program with the Wun-Jo trainer, consisting of three weekly 30-minute sessions. The following measures were assessed pretraining and after 8 weeks of training: knee flexor and extensor isokinetic strength; grip strength; the Short Physical Performance Battery; functional reach; and low back and hamstring flexibility. Data were analyzed using repeated measures analysis of variance, with statistical significance set at the P ≤ 0.05 confidence level.
Sit and reach test scores significantly increased (+21%) from baseline to week 8 (P < 0.001). Forward-left functional reach testing significantly increased (P = 0.012), while forward-right functional reach testing did not change (P = 0.474). Both left-lateral (P = 0.012) and right-lateral (P = 0.036) functional reach scores improved. Grip strength increased in both the left (+11.9%) and right (+14.5%) hands (P < 0.001 for each). Isokinetic knee extension at 60° per second increased for the left (+15.6%) and right (+17.6%) significantly (P = 0.001 for each). Isokinetic knee flexion at 60° per second significantly increased for both the left (+43.2%, P = 0.010) and right (+41.7%, P < 0.001). Time to complete the ten-repetition chair stand decreased significantly (−31%, P = 0.004). The 8-feet walk time also significantly decreased (−21.6%, P < 0.001).
Participating in the FDMS with the Wun-Jo device may improve balance, low back and hamstring flexibility, walking speed, and knee extensor/flexor and grip strength in older individuals. FDMS training provides an alternative to traditional exercise and offers an effective strategy to increase functional ability in the elderly.
exercise; aging; balance
Survivors of breast cancer are faced with a multitude of medical and psychological impairments during and after treatment and throughout their lifespan. Physical exercise has been shown to improve survival and recurrence in this population. Mind-body interventions combine a light-moderate intensity physical exercise with mindfulness, thus having the potential to improve both physical and psychological sequelae of breast cancer treatments. We conducted a review of mindfulness-based physical exercise interventions which included yoga, tai chi chuan, Pilates, and qigong, in breast cancer survivors. Among the mindfulness-based interventions, yoga was significantly more studied in this population as compared to tai chi chuan, Pilates, and qigong. The participants and the outcomes of the majority of the studies reviewed were heterogeneous, and the population included was generally not selected for symptoms. Yoga was shown to improve fatigue in a few methodologically strong studies, providing reasonable evidence for benefit in this population. Improvements were also seen in sleep, anxiety, depression, distress, quality of life, and postchemotherapy nausea and vomiting in the yoga studies. Tai chi chuan, Pilates, and qigong were not studied sufficiently in breast cancer survivors in order to be implemented in clinical practice.
To determine whether biofeedback is more effective than diazepam or placebo in a randomized controlled trial for patients with pelvic floor dyssynergia-type constipation, and whether instrumented biofeedback is necessary for successful training.
One hundred seventeen patients participated in a 4-week run-in (education and medical management). The 84 who remained constipated were randomized to Biofeedback (n=30); Diazepam (n=30); or Placebo (n=24). All patients were trained to do pelvic floor muscle exercises to correct pelvic floor dyssynergia during 6 biweekly 1-hour sessions, but only Biofeedback patients received electromyography feedback. All other patients received pills 1-2 hours before attempting defecation. Diary data on cathartic use, straining, incomplete bowel movements, Bristol stool scores, and compliance with homework were reviewed biweekly.
Before treatment, the groups did not differ on demographic (average age 50, 85 percent females), physiologic or psychologic characteristics, severity of constipation, or expectation of benefit. Biofeedback was superior to diazepam by intention to treat analysis (70 percent vs. 23 percent reported adequate relief of constipation 3 months after treatment, χ2 = 13.1, p < 0.001), and also superior to placebo (38 percent successful, χ2 = 5.7, p = 0.017). Biofeedback patients had significantly more unassisted bowel movements at follow-up compared to Placebo (p = .005), with a trend favoring biofeedback over diazepam (p = .067). Biofeedback patients reduced pelvic floor electromyography during straining significantly more than diazepam patients (p < 0.001).
This investigation provides definitive support for the efficacy of biofeedback for pelvic floor dyssynergia and shows that instrumented biofeedback is essential to successful treatment.
biofeedback; constipation; dyssynergia; dyssynergic defecation; electromyography
Recently, a strong emphasis has been placed on establishing rehabilitation protocols after primary total hip and knee arthroplasty in an attempt to shorten, improve, and standardize the postoperative period of recovery. Less invasive surgical techniques, patient demands, and the pressure of insurance regulations have forced postoperative rehabilitation to be placed on an expedited scale. With these concerns in mind, we introduce a pre- and postarthroplasty program involving the Pilates method. Modified exercises have been developed to account for the postoperative precautions and needs of total hip and knee arthroplasty patients. A patient-driven interest in the use of Pilates for postoperative rehabilitation has led to the development of our programs following total hip or knee arthroplasty. In reviewing our early observations of a small series of patients, it appears this technique can be utilized without early complications; however, further studies are necessary to confirm its utility and safety.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Rowing injuries have been attributed to poor technique, suggesting a need to understand the mechanics of rowing and the influence on technique of different training regimes and ergometers. The aims of this study were to investigate the repeatability of the kinematics of the lumbopelvic region during rowing and to compare these kinematics between rowing on two different ergometers. An electromagnetic motion measuring device in conjunction with a load cell was used to determine the ergometer rowing kinematics of 12 rowers. Subjects were tested on three occasions at two different stroke rates, with an interval of one week between testing. Two datasets were obtained for the Concept II, to establish the repeatability of the kinematics, and one for the WaterRower. Bland and Altman’s mean difference technique was used to test for consistency of technique, and the difference between ergometers was assessed using Students’ paired T-tests. The kinematic measures of the lumbo pelvic region during rowing demonstrated high repeatability. The two ergometers showed a similarity in force profiles but some significant differences in rowing kinematics. There was greater rotation of the thigh segment in the sagittal plane throughout the stroke on the WaterRower (p < 0.01). There were also trends indicating that rotation of the pelvis in the sagittal plane was different between the two ergometers, for example on the Concept the mean angle of the pelvis at the catch was 5.4° and on the WaterRower it was 2.4° (p < 0.05). Measurement of lumbopelvic kinematics during rowing on a Concept II ergometer is repeatable. However, rowing kinematics varies between ergometers. Because a full analysis comparing rowing kinematics on water with rowing ergometers has not been made in this study, no conclusions regarding which ergometer simulates rowing on water can be made. The implications of the effect of these differences in technique requires further investigation.
Key PointsMeasurement of lumbopelvic kinematics during rowing on a Concept II ergometer is repeatable.Rowing kinematics varies between the WaterRower and Concept II
Lumbo-pelvic rhythm; spinal biomechanics
This study examined whether mindfulness increased through participation in movement based courses and whether changes in self-regulatory self-efficacy, mood, and perceived stress mediated the relationship between increased mindfulness and better sleep.
166 college students enrolled in the 2007-2008 academic year in 15 week classes in Pilates, Taiji quan, or GYROKINESIS®.
At beginning, middle, and end of the semester, participants completed measures of mindfulness, self-regulatory self-efficacy, mood, perceived stress and sleep quality.
Total mindfulness scores and mindfulness subscales increased overall. Greater changes in mindfulness were directly related to better sleep quality at the end of the semester after adjusting for sleep disturbance at the beginning. Tired Mood, Negative Arousal, Relaxed Mood, and Perceived Stress mediated the effect of increased mindfulness on improved sleep.
Movement based courses can increase mindfulness. Increased mindfulness accounts for changes in mood and perceived stress that explain, in part, improved sleep quality.
mindfulness; mood; Pilates; sleep; stress; Taiji quan; GYROKINESIS®