Definition of Pilates Exercise:

A systematic review

Ms Cherie Wells

Professor Gregory Kolt

A/Professor Andrea Bialocerkowski

Origins of Pilates Exercise

• Mental and physical conditioning program

founded by Joseph Pilates in the 1920s Friedman & Eisen, 2005

• Initially called “contrology” because of the

emphasis on control of the body by the mindLatey, 2001

• Traditional principles included centering,

concentration, control, precision, flow, breathingFriedman & Eisen, 2005, Latey 2002 http://www.lovastyle.me/wp-content/uploads/2012/03/JosephPilates2.jpg

Specialised Pilates Equipment

• Provide adjustable spring resistance that can increase or decrease

exercise challenge and enhance proprioceptive feedback Anderson & Spector, 2000

http://www.staffordphysio.com.au/images/StaffordPilates2.jpg http://www.isofit.com.hk/assets/images/Action/BrentTrapeze.jpg

Pilates Today...

• Pilates exercise has changed from being

primarily used by dancers to become popular in

fitness and rehabilitationAnderson & Spector, 2000

• Varies across different contexts

- Fitness versus rehabilitation

- Traditional versus evidence-based techniques

Owsley , 2005, Latey, 2002http://www.andersonpilates.co.uk/userimages/Move7.jpg

Relevance to Chronic Low Back Pain (CLBP)

• CLBP is common, disabling, and costly condition .

Hoy et al., 2010 , Woolf & Pfleger, 2003

• Pilates may activate and strengthen lumbopelvic muscles that

stabilise and support the back.La Touche et al, 2008

• These muscles are inhibited in people with CLBP, and may

contribute to ongoing disability. Ferreira et al, 2010, Wallwork et al., 2009

However...

• There is no evidence to suggest one type of exercise is more effective in

reducing pain and disability people with CLBP.

Hayden et al., 2005, van Middelkoop et al, 2010

• There is limited volume and quality of research available on the efficacy of

Pilates in people with CLBP. Lim et al, 2011

• Pilates is defined and applied differently in research studies of people with

CLBP. Posadzki et al, 2011, Wells et al, 2012

Definition of Pilates Exercise: A systematic review

Aims:

i. To identify and synthesise descriptions of Pilates exercise in peer-

reviewed literature

ii. To compare definitions used in papers with healthy participants and

those with low back pain

Methods:

• Adheres to PRISMA guidelines for systematic reviews

Methods (cont):

Results:

Frequency of Mention of Content Categories in All Papers

Content Categories

Frequency of Mention of Content Categories -

Papers with Healthy vs LBP participants

Content Categories

Results (cont):

• There was no significant difference in frequency of recommendations of

use of mat or specialised equipment in papers with healthy versus low

back pain participants (x2 = 0.015, p=0.904)

• Apart from breathing, traditional Pilates principles were not mentioned

in papers with low back pain participants.

Conclusions:

• Pilates is a mind-body exercise that focuses on strength, core stability,

flexibility, muscle control, posture and breathing. It can be mat-based,

or involve use of specialised Pilates equipment.

• Posture may be a particularly important for people with low back pain

undertaking Pilates exercise, while traditional principles may be less

relevant.

Implications:

• Further research required to:

i. Confirm validity of definition of Pilates exercise in clinical practice

ii. Explore interpretation of components in clinical practice

• A greater understanding of key components of Pilates exercise will

assist in valid research designs to assess efficacy in people with CLBP

Anderson, B. D., & Spector, A. (2000). Introduction to Pilates-based rehabilitation. Orthopaedic Physical Therapy Clinics of North America, 9 (3), 395-410.

Charlton, J.E. (Ed.) (2005). Core Curriculum for Professional Education in Pain, (3rd Ed.) Seattle: International Association of the Study of Pain (IASP) Press.

Ferreira, P.H., Ferreira, M.L., Maher, C.G., Refshauge, K., Herbert, R., Hodges, P.W. (2010). Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain. British Journal of Sports Medicine, 44, 1166-72.

Friedman, P. & Eisen, G. (2005). The pilates method of physical and mental conditioning. (10 th ed.). London: Penguin Books.

Hayden, J., Dunn, k., van der Windt, D., Shaw, W. (2010). What is the prognosis of back pain? Best Practice Research Clinical Rheumatology, 24 (2), 167-179.

Hoy, D., March, L., Brooks,P., Woolf, A., Blyth, F. Vos, T., Buchbinder, R. (2010). Measuring the global burden of low back pain. Best Practice Research in Clinical Rheumatology, 24 (2), 155-165.

Latey, P. (2001). The Pilates method: History and philosophy. Journal of Bodywork and Movement Therapies, 5 (4), 275-282.

Latey, P. (2002). Updating the principles of the Pilates method - Part 2. Journal of Bodywork and Movement Therapies, 6, 94-101.

References

La Touche, R., Escalante, K., & Linares, M.T. (2008). Treating non-specific chronic low back pain through the Pilates Method. Journal of Bodywork and Movement Therapies, 12(4), 364-370.

Lim, E.C.W., Poh, R.L.C., Low, A.Y., Wong, W.P. (2011). Effects of Pilates-based exercises on pain and disability in individuals with persistent non specific low back pain: A systematic review with meta-analysis. Journal of Orthopaedic and Sports Physical Therapy, 41(2), 70-80.

Owsley, A. (2005). An introduction to clinical Pilates. Athletic Therapy Today, 10 (4),19-25.

Posadzki, P., Lizis, P., & Hagner-Derengowska, M. (2011). Pilates for low back pain: A systematic review. Complementary Therapies in Clinical Practice, 17, 85-89.

Van Middelkoop, M., Rubinstein, S.M., Verhagen, A.P., Ostelo, R.W., Koes, B.W., van Tulder, M.W. (2010). Exercise therapy for chronic nonspecific low-back pain. Clinical Rheumatology, 24 (2), 193-204.

Wallwork, T., Stanton, W., Freke, M., & Hides, J. (2009). The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle. Manual therapy, 14(5), 496-500.

Wells, C., Kolt, G.S., Bialocerkowski, A. (2012). Defining Pilates exercise: A systematic review. Complementary Therapies in Medicine, 20 (4), 253-262.

Woolf, A.D., Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bulletin of World Health Organisation, 81 (9), 646-656.  

References (cont)