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Jessica Miller Objectives List the benefits of Pilates List the 6 principles of Pilates List 3 Pilates exercises that can be performed when rehabilitating a TKA List 3 Pilates exercises that can be performed when rehabilitating a THA ID: 499542 Download Presentation


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Jessica MillerSlide2



the benefits of Pilates

List the 6 principles of Pilates

List 3 Pilates exercises that can be performed when rehabilitating a TKA

List 3 Pilates exercises that can be performed when rehabilitating a THA

List 3 Pilates exercises that can be performed when rehabilitating LBPSlide3

What is Pilates?

Low-impact, complete body workout








stability and

support in

the body.Slide4


Joseph Pilates

Germany 1880

Sickly child


gymnast, skier, boxer and


WWI he taught Mind and Body = Contrology

U.S. in 1926, New York Ballet

Pilates (1967)

Became popular with HollywoodSlide5

6 Pilates Principles






Fluidity of MovementSlide6



Improve efficiency of lung function and blood oxygenation

Increase mental focus

Improve ability to relax

Increase overall ribcage mobility

Encourage efficient exhalation

Assist posture, musculoskeletal function and movement patternsSlide7


All moves should be done as conscious acts

Conducive environment

Calming mood

Soothing background music

Don’t let the mind wander, keep focused on the movementSlide8


Abdominals should contract before initiating any movement

Exercises centered on “Powerhouse”

Use proper alignment and formSlide9


Mind and body control

Slow and controlled movements

Constant speed

No jerky or meaningless movements

Several muscle groups engaged Slide10


Body Awareness

Appropriate placement of limbs

Correct alignment

Execute each exercise as best you can

“Honor every movement”Slide11

Fluidity of Movement

Continuous motion

Smooth and slow movement

No jarring repetitions

Energy flows through body evenly

No beginning or end

Body constantly in motion during each exercise/transitionSlide12

Pilates and Rehabilitation

Start integrating this principles into your interventions

Encourage patients to implement these with their HEP


principles of Pilates are awesome for rehabilitation, but if they aren't used in conjunction with proper therapy techniques it could aggravate the injury


Benefits of PilatesSlide13

Benefits of Pilates

Core strength and good posture

Balance and Coordination

Mobility and learning

to move


Joint flexibility and long



Create an evenly conditioned




challenging as well as adaptable

Refreshing mind and body


Pilates Rehab for TKA and THA

More THA and TKAs are being performed

Shorter hospital stay and quicker recovery

Less invasive surgical techniques allow rapid rehabilitation

Pre-op and rapid post-op rehab may improve patient’s balance and coordination as well as gait adaptations

Proposed advantages of utilizing Pilates:

Maximizing pre-op function

Develop a pathway for return to outpatient exercise

Promote whole body approach to post-op rehabSlide15

Pilates for Rehab Purpose

1. Introduce Pilates into orthopedic community as a safe way to restore function

2. Describe an improved program suited to all levels of skill that can be continued as a long term maintenance program

3. Review a series of patients having completed the rehab programs at 1 year follow-up

4. Pilates can be a viable option for rehabilitationSlide16

Pilates Field Observation Facts


Patients (30

Women, 8



22 Patients, average age 46 years

Pre-Operative Diagnoses:

16 Osteoarthritis

4 Osteonecrosis of femoral head

1 Hip Dysplasia

1 Lupus



17 Patients, average age 55 years

Preoperative Diagnoses

14 Osteoarthritis

3 Inflammatory ArthritisSlide17

Exercise Regimen

Pre-Operative Regimen

Adapted to meet pt needs

Pre-op exercise 3-4x/week for 1-2 hours

Exercises recommended: Week 2-6 in Tables

Post-Operative Regimen

Early post-op exercises should be

modified and begin 2 weeks after hospital D/C

3-4x/week for a minimum of 1 hour

Progression can occur according to pain levels, quality of movement and as

the MD


Pilates can be an enjoyable approach that can be molded into a maintenance programSlide18

Pilates Rehab Protocol for TKASlide19

Pilates Rehab Protocol for THASlide20

Pilates Field Observation Results

1 year follow-up by charts and phone calls

25 Extremely Satisfied w/ outcome

13 Satisfied w/ outcome

73% of women continued after rehab


Pre-op exercises to improve function

Implement exercises into HEP

Adaptability of exercises for joint precautions and restrictionsSlide21

Chronic Low Back Pain

70% of adults suffer from LBP at some point

90% of LBP cases seem to be non-specific

15% of people develop LBP and have persistent pain one year after initial episode

Exercise therapy is one of the most common recommended treatments for chronic LBPSlide22

Clinical Pilates

Theory based exercise regimen founded on rationale of improving segmental stability and functional movement

Adapted from traditional Pilates by physiotherapists

Described as an exercise based on the Pilates Method adapted for rehabilitation purposes

Treatment for chronic LBP using


linical Pilates have shown a reduction in pain and improvement in function compared to no tx, but no significant difference compared to other formsSlide23

Pilates and LBP Pilot Study

15 Participants

Skilled Clinical Pilates Exercise Program

Spring resistance used with Reformer

Strength, Endurance and Stability Exercises

1 hour 2x/week for 6 weeks

Home Exercise Program

Floor Exercises

30 minutes 3x/week for 6 weeks

New HEP for 26 weeks after skilled interventionSlide24

LBP Exercises

Pelvic Tilt

Bridge with Pelvic Tilt

Chest Lift

Swan Prep

Child’s Pose

Kneeling Arm and Leg Reach


Spine Stretch

The SawSlide25

LBP Pilot Study Outcome

Statistically significant improvement in all measures from the start of the intervention to the 6 weeks

No significant differences from 6 weeks to 26 week F/U, note pt adherence had gone down

Findings indicate improved function and decreased pain levels maintained for 26 weeks

Clinical Pilates can be equally effective as other stabilization exercisesSlide26


Levine B, Kaplanek B, Jaffe W. Pilates training for use in rehabilitation after total hip and knee arthroplasty: a preliminary report.

Clinical Orthopaedics & Related Research

[serial online]. June 2009;467(6):1468-1475. Available from: CINAHL with Full Text, Ipswich, MA. Accessed November 8, 2012



J. The power of Pilates.

Nursing & Residential Care

[serial online]. October 2009;11(10):520-523. Available from: CINAHL with Full Text, Ipswich, MA. Accessed November 8, 2012.

Taylor L, C., Dean S. Can clinical pilates decrease pain and improve function in people complaining of non-specific chronic low back pain? A pilot study.

New Zealand Journal Of Physiotherapy

[serial online]. March 2011;39(1):30-38. Available from: CINAHL with Full Text, Ipswich, MA. Accessed November 8, 2012


Bodylines Pilates, Orchard Hills Athletic Club. The Six Principles of Pilates.

Bodylines Pilates.

Available at


. Accessed 14 Nov 2012

Pilates Reformer Overview. Pilates Overview.

Pilates Reformer.

Oct 24 2012. Available at


. Accessed 15 Nov




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