modified pilates rehabilitation

Research has shown that specific retraining of the Multifidus muscle reduces the recurrence rate of LBP. Hides et al (1994) reported evidence of lumbar Multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute LBP. Further studies found that Multifidus muscle recovery is not automatic after the resolution of acute, first-episode LBP (Hides et al., 1996). In their study with LBP patients, Hides et al (1996), demonstrated that this deficit in Multifidus can be reversed with exercises that focus on activating the Multifidus muscle. Two to three year follow up studies found that the recurrence rate of LBP was reduced by 50% in patients who had performed specific exercises for activating Multifidus. An integral part of therapeutic rehabilitation following LBP is retraining correct activation of the Multifidus muscles which can be done using Modified Pilates.

The Transversus Abdominis (TrA) is the other principle muscle affected in LBP. Studies have found delayed onset of activation and poor activation of the TrA in LBP patients compared to healthy controls (Hodges & Richardson 1997). In healthy individuals the TrA activates prior to limb movements to provide postural support to the lumbar spine (Hodges & Richardson 1997). In LBP patients TrA activation occurs after the limb movement and therefore renders the lumbar spine unsupported during functional activities. A model for retraining motor control of the TrA is provided as a part of Modified Pilates.

Modified Pilates provides Physiotherapists and equivalent degeree therapists with a clinical and user friendly tool for retraining correct activation of the Multifidus, TrA muscles and pelvic floor muscles. It consists of a progressive repertoire of mat based exercises designed specifically for Physiotherapists and equivalent degree therapsits to teach to the clinical population. The key elements of Modified Pilates include retraining:

* Neutral lumbo-pelvic alignment and activation of the key lumbo-pelvic stabilising muscles
* Correct ribcage/thoracic alignment
* Scapulo-thoracic stabilisation
* Deep neck flexor retraining to stabilise the cervical spine

The repertoire of Modified Pilates exercises also include exercises to improve spinal mobility, flexibility of the key trunk and lower limb muscles groups, body awareness and postural awareness.