The Feldenkrais Method (FM) is based on the learning of alternative movement patterns, carried out in an active and conscious way, which may have therapeutic effects. The objective of this systematic ...review is to identify the populations and conditions for which the FM can be used in physiotherapy and to determine the intervention modalities. Research in PubMed, Cochrane and PEDro databases was performed. The PEDro scale was employed to assess the methodological quality. Meta-analyses (MA) were performed whenever populations and outcome measures were comparable in at least two studies. Sixteen studies were included. In elderly people, in three of the four selected trials, the FM group significantly improved gait, balance, mobility and quality of life. The MA showed significant differences between interventions in the Timed-Up-and-Go test Cohen's d = -1.14, 95% CI (-1.78, -0.49),
= 0.0006. FM significantly improved pain, functional balance, and perceived exertion in three trials performed on subjects with cervical, dorsal, or shoulder pain. FM demonstrated improvements in pain, disability, quality of life and interoceptive awareness in the three trials performed in subjects with chronic low back pain. In multiple sclerosis, an improvement in functional capacity was observed in the two selected studies. The MA showed no significant differences between groups in the Function (
= 0.97) and Control (
= 0.82) dimensions of the Multiple Sclerosis Self-Efficacy Scale. In Parkinson's disease, two studies showed significant effects on quality of life and functional tests. In conclusion, evidence shows that FM has therapeutic effects comparable to other physiotherapy techniques in patients with spine pain. In addition, improvements in mobility and balance were seen in the elderly and people with neurodegenerative diseases.
To tackle non-specific low back pain (NSLBP) among patients and find the most effective solution and to quantitatively synthesize the overall effect of motor control training (MCT) compared with ...Pilates, McKenzie method, and physical therapy (PT) in pain and physical function.
Randomized controlled trials (RCTs) of four types of intervention (MCT, Pilates, McKenzie method, and PT) for LBP were collected by searching PubMed, Web of Science, EBSCOhost (Cochrane Central Register of Controlled Trials), and Scopus databases from the establishment of the database to September 30, 2023. The risk of bias was evaluated for included studies using the Revised Cochrane Risk of Bias tool for randomized trials (RoB 2.0). Taking pain and physical function in the experimental and control groups as outcome indicators, subgroup analysis was performed according to the intervention method to calculate the standardized mean difference (SMD) and 95% confidence interval (CI).
A total of 25 RCTs, including 1253 patients, were included. Meta-analysis showed that MCT effectively relieved pain SMD = -0.65, 95% CI (- 1.00, - 0.29), p < 0.01 and improved physical function SMD = -0.76, 95% CI (- 1.22, - 0.31), p < 0.01 comparing with other 3 types of intervention. Subgroup analysis suggested that MCT could alleviate pain SMD = -0.92, 95% CI (- 1.34, - 0.50), p < 0.01 and improve physical function SMD = -1.15, 95% CI (- 1.72, - 0.57), p < 0.01 compared with PT, but it had no statistical significance compared with Pilates pain: SMD = 0.13, 95% CI (- 0.56, 0.83), p = 0.71; physical function: SMD = 0.10, 95% CI (- 0.72, 0.91), p = 0.81 and the McKenzie method pain: SMD = -0.03, 95% CI (- 0.75, 0.68), p = 0.93; physical function: SMD = -0.03, 95% CI (- 1.00, 0.94), p = 0.95.
MCT can effectively relieve pain and improve physical function in patients with NSLBP. It is more effective compared with PT for LBP, while no differences were detected between MCT and Pilates, as well as McKenzie method. Therefore, MCT, Pilates, and the McKenzie method should be encouraged as exercise interventions for NSLBP rehabilitation.
Objective:
To evaluate the feasibility of Pilates exercise in older people to decrease falls risk and inform a larger trial.
Design:
Pilot Randomized controlled trial.
Setting:
Community ...physiotherapy clinic.
Participants:
A total of 53 community-dwelling people aged ⩾60 years (mean age, 69.3 years; age range, 61–84).
Interventions:
A 60-minute Pilates class incorporating best practice guidelines for exercise to prevent falls, performed twice weekly for 12 weeks. All participants received a letter to their general practitioner with falls risk information, fall and fracture prevention education and home exercises.
Main outcome measure(s):
Indicators of feasibility included: acceptability (recruitment, retention, intervention adherence and participant experience survey); safety (adverse events); and potential effectiveness (fall, fall injury and injurious fall rates; standing balance; lower limb strength; and flexibility) measured at 12 and 24 weeks.
Results:
Recruitment was achievable but control group drop-outs were high (23%). Of the 20 participants who completed the intervention, 19 (95%) attended ⩾75% of the classes and reported classes were enjoyable and would recommend them to others. The rate of fall injuries at 24 weeks was 42% lower and injurious fall rates 64% lower in the Pilates group, however, was not statistically significant (P = 0.347 and P = 0.136). Standing balance, lower-limb strength and flexibility improved in the Pilates group relative to the control group (P < 0.05). Estimates suggest a future definitive study would require 804 participants to detect a difference in fall injury rates.
Conclusion:
A definitive randomized controlled trial analysing the effect of Pilates in older people would be feasible and is warranted given the acceptability and potential positive effects of Pilates on fall injuries and fall risk factors.
Trial Registration:
The protocol for this study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN1262000224820).
Introduction
The aim of the present study was to explore the experiences and perceptions of adult patients with chronic musculoskeletal conditions following a Pilates exercise programme. A ...qualitative approach was taken to both data collection and analysis, with alignment to the philosophy of interpretive phenomenology. Participants included 15 women and seven men with a range of chronic musculoskeletal conditions, including nonspecific low back pain, peripheral joint osteoarthritis and a range of postsurgical conditions. The age range was from 36 years to 83 years, and the mean age was 57 years (standard deviation 14.1 years).
Methods
Data were collected via digital recordings of four focus groups in three North‐West of England physiotherapy clinics. The data were transcribed verbatim and then analysed using a thematic framework. Data were verified by a researcher and randomly selected participants, and agreement was achieved between all parties.
Results
The results were organized into five main themes: physical improvements; Pilates promotes an active lifestyle: improved performance at work and hobbies; psychosocial benefits and improved confidence; increased autonomy in managing their own condition; and motivation to continue with exercise.
Conclusion
The study was the first to investigate individual perceptions of the impact of Pilates on the daily lives of people with chronic conditions. The Pilates‐based exercise programme enabled the participants to function better and manage their condition more effectively and independently. Further to previous work, the study revealed psychological and social benefits which increase motivation to adhere to the programme and promote a healthier lifestyle.
Chronic low back pain (CLBP) is a leading cause of disability globally. Exercise therapies are one of the commonly prescribed treatment options for CLBP. The specific exercise therapies for CLBP most ...commonly target movement dysfunction, but seldom brain-based pain modulation. Exercise therapies with specific breathing techniques (SBTs) have been shown to influence and enhance brain-based structural and functional pain modulation.
To assess the feasibility of the SBTs protocol, eligibility criteria, randomization, and dropout rates. To quantify the changes in patient outcome measures and choose the most relevant measure for larger-scale study. To quantify self-adherence levels to home exercise and monitor and record possible pain medication and other treatment modality usage, and adverse events during exercise.
A parallel randomised analyst-blinded feasibility trial with two-month follow-up.
Feasibility related to aims and objectives. Multiple pain- and health-related patient-reported outcome measures of pain intensity, disability, central sensitization, anxiety, kinesiophobia, catastrophising, self-efficacy, sleep quality, quality of life, and health and well-being status. Exercise adherence, pain medication and other treatment modality usage, and possible adverse events related to exercises will be monitored and recorded.
Thirty participants will be randomized to movement control exercise with SBTs (15 subjects in experimental group) or movement control exercise without SBTs (15 subjects in control group) in private chiropractic practice setting with two-month follow-up. Trial registration number; NCT05268822.
The clinical difference in effectiveness between practically identical exercise programs in uniform study settings with or without SBTs has not been studied before. This study aims to inform feasibility and help determine whether progression to a full-scale trial is worthwhile.
The purpose of this pilot case study is to investigate the effects of Pi-lates training on hamstring/quadriceps ratio, trunk strength, shoulder strength, and body composition in adolescent baseball ...players. Eight adolescent baseball players, 15 years of age, participated in Pilates program (supervised training, 50 min per session for three times a week for 8 weeks) using reformer and Cadillac. The intensity of the program was progressively increased by applying beginner level for 1–2 weeks, intermediate level for 3–6 weeks, and advance level for 7–8 weeks. To verify the effect of the Pilates program on hamstring/quadriceps ratio, trunk strength, shoulder strength and body composition, participants performed bioelectrical impedance analysis and isokinetic testing at pre- and posttraining. After the Pilates training, there were significant increases in body weight (P<0.01), left arm muscle mass (P<0.01), and trunk muscle mass (P<0.01). In addition, there were significant increas-es in left and right knee flexion peak torque (P<0.01 and P<0.05, re-spectively), right knee extension peak torque (P<0.05), left and right hamstring/quadriceps ratio (both P<0.01), trunk flexion peak torque (P<0.05) and shoulder flexion peak torque (P<0.05) after 8 weeks of training. Therefore, Pilates training increased muscle mass, hamstring/quadriceps ratio, trunk and shoulder strength, suggesting that it may help baseball players do better performance and prevent future injuries in adolescent players.
To evaluate the effects of 12-week Pilates training program on cardiac autonomic modulation.
A randomized controlled trial of a 12-week Pilates training program was conducted. A total of 54 men were ...randomly allocated to either a control or a Pilates group. Initially, the RR intervals were captured for 20 min for later analysis of heart rate variability (HRV). The training protocol was then initiated, in which the Pilates group performed 36 sessions of the Pilates method for approximately 60 min each session, three-times a week, totaling 12 weeks. The control group was instructed to maintain their normal activities during this period. One week after the end of the training, the final evaluations were performed with the capture of RR intervals in both the groups. Linear indices in the time (SDNN and rMSSD) and frequency (low frequency LF and high frequency HF) domains, and the Poincaré plot (SD1 and SD2) were used. Nonlinear indices were also analyzed (approximate entropy and detrended fluctuation analysis). Descriptive statistics and generalized mixed models were performed.
There was a group effect for LF (ms
) and a time effect for SD2. There was a training effect observed by the time*group interactions in which an increase in global HRV indices was found for the Pilates group after 12 weeks (SDNN: mean difference MD = 9.82; standard deviation SD = 18.52; ES = -0.514; LF ms
: MD = 334.23; SD = 669.43; ES = -0.547; SD2: MD = 14.58; SD = 24.28; ES = -0.693).
A 12-week Pilates training program promotes significant improvement in global modulation of HRV in the Pilates group considering the significant increase in SDNN, LF (ms
) and SD2 indices.
.
Fibromyalgia is characterized by chronic generalized pain, fatigue, sleep disorders and other symptoms. Physical exercise is recommended as the first choice of non-pharmacological therapy. Thus, the ...aim of this study is to evaluate the effectiveness and cost-effectiveness of modified Pilates exercises compared to aerobic exercises in the treatment of patients with fibromyalgia.
In this randomized controlled trial with blinded assessor, 98 patients who meet the fibromyalgia classification criteria of the American College of Rheumatology 2010, aged between 20 and 75 years, and with pain intensity greater than or equal to 3 points in the Pain Numerical Rating Scale, will be randomly divided into Aerobic Group (aerobic exercises on treadmills or stationary bikes) and Pilates Group (modified Pilates exercises), and treated twice a week for eight weeks on the Center for Excellence in Clinical Research in Physical Therapy at Universidade Cidade de São Paulo, Brazil. The following outcomes will be evaluated by a blinded assessor at baseline, eight weeks, six months, and 12 months after randomization: impact of fibromyalgia assessed by the Fibromyalgia Impact Questionnaire, pain intensity by the Pain Numerical Rating Scale, kinesiophobia by the Tampa Scale of Kinesiophobia, specific disability by the Patient-Specific Functional Scale, functional capacity by the 6-min Walk Test, quality of sleep by the Pittsburgh Sleep Quality Index, and health-related quality of life by EQ-5D-3L and SF-6D questionnaires.
It is expected that the Pilates exercises will be more effective than aerobic exercises in improving clinical outcomes and that this improvement will be maintained over the medium to long term. This study aims to clarify whether the Pilates method can be incorporated into the clinical practice of physical therapists treating patients with fibromyalgia. The study will also provide information on which exercise will be most cost-effective, information that can be used by insurers and public health systems.
This study was prospectively registered at the Clinical Trials Registry (NCT03050606) in February 2017.
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