Efficacy Of Pilates Exercises As Therapeutic Intervention In Treating Patients With Low Back Pain

"The purpose of this research was to investigate the efficacy of Pilates exercises as a therapeutic intervention in treatment of low back pain (LBP). Pilates exercises have been integrated into many rehabilitation programs for those with LBP; however, no clinical research was found that supports its efficacy. Twelve subjects who presented for physical therapy with LBP, were randomly assigned to either the traditional lumbar stabilization exercise group (A, n=6) or the Pilates exercise group (B, n=6) and completed participation in the study. The mean age for group A was 30.33 (SD 12.40) for group B was 36.00 (SD 11.43) P=0.430, and the percent with LBP over 3 months (chronic) was 83.3% in group A and 66.7% in group B. Outcome measures used were the Visual Analogue Scale (VAS), the Revised Oswestry Disability Index (ODI), lumbar spine active range of motion (AROM), and measures of core stability on the Stability Platform (LaFayette Instrument Co), taken at pre-treatment, every fourth visit and at discharge from physical therapy. Repeated measures ANOVAs were performed for measures of VAS, ODI and AROM for (pre, 4th and post treatments) and measures of core stability (pre and post treatments). All subjects progressed significantly in measures of pain (P=0.004), function (P=0.004), and stability measures of center balance time (P=0.013) and deviations to the right (P=0.004). The measures of AROM and left deviations on the Stability Platform did not change significantly over time. There were no significant differences in any of the outcome measures between the groups over time. Subjects participating in Pilates exercises as provided as part of physical therapy treatment for LBP under the guidance of a physical therapist and Stott trained clinicians improved in measures of pain, function, and core stability equal to that of those performing traditional lumbar stabilization exercises as typically provided in rehabilitation for LBP. Given that there have been no clinical studies performed assessing the benefits suggested from performing Pilates exercises, this study provides a legitimate and safe basis for inclusion of Pilates exercises, taught and progressed by appropriately trained clinicians, as therapeutic exercise intervention with patients who have LBP." -- Abstract.

As CAM becomes widely accepted, rehabilitation professionals are incorporating CAM concepts and techniques into their own practice. This book will help them to gain an understanding of the field, and to acquire specific knowledge and skills which they can apply to the treatment of movement related disorders.

Accessible to all health care professionals, this text provides a guide to understanding and managing back pain and is one of the premier examples of a biopsychosocial approach to medicine. The content challenges unsubstantiated beliefs regarding the best way to treat and manage back pain and presents an interdisciplinary debate on the subject. In a society where patients are demanding more effective approaches to their problems, this resource offers a radical rethink, a necessary step to achieving a more effective method of treatment. The unorthodox spirit of this material places this book at the center of the revolution taking place in the back pain area. Gordon Waddell is the world authority on the topic of the back pain revolution. The content addresses huge problems of concern to many disciplines and governments. The unbiased, open-minded view looks at the issues and the evidence and invites the readers to consider, debate, and agree on the best course of action. Comprehensive coverage of all aspects of the problem offers both interventionist and conservative approaches to treatment, psychosocial issues, economic factors, patient education, and prevention. A new chapter on Occupational Health Guidelines keeps the reader up-to-date. New information allows the book to expand on the insights of the previous edition, which was considered a classic text. More social and work-related research and material provides information on these important issues. Updated guidelines and references make this resource one of the best for current practice. The new illustrations, graphs, tables, and education handouts present Waddell's theory in a fresh, new way that aids in the reader's understanding.

The Pilates® method may be today's hottest exercise, but it has been endorsed by physicians for almost a century. Originally developed by Joseph H. Pilates to help strengthen and condition muscles, Pilates is the ultimate mind-body exercise for anyone who wants to tone, streamline, and realign their body without the bulked-up results of more conventional workout methods. Now, in The Pilates® Body, author Brooke Siler--one of the most sought-after personal trainers in the country and owner of New York's top studio for Pilates training, re:AB--provides a complete, easy-to follow program of Pilates exercises that can be done anywhere, anytime, and without machines. With step-by-step instructions, Siler guides the reader through the complete circuit of mat exercises, each of which is clearly illustrated by photographs, line drawings, and unique visualization exercises. With Pilates you will not only streamline your figure--you will dramatically improve your posture, flexibility, and balance, and enhance your physical and emotional well-being. The Pilates Body shows you how.

This book presents the latest information and research on the prevention and management of musculoskeletal pain and dysfunction. It introduces the reader to an approach to clinical management and prevention based on that research. This text's impressively thorough coverage makes it an indispensable text for both researchers and clinicians in the field of musculoskeletal pain and dysfunction.

Acute low back pain is treated by a variety of health care providers utilizing an array or treatment approaches. In 1995, acute low back pain was the 5th most common reason for all physician visits in the United States over 13 billion dollars of medical expenses per year are attributed to low back pain affecting from 5 to 10% of the adult population annually with a prevelance from 60 to 90% over a ltfetime. Acute low back pain occurs in people with a wide variety of professions including those involving heavy labor, repetitive work activities and extended sedentary postures. Half of the population will have experienced a significant incidence of low back pain by age thirty. There is much controversy in the literature in regards to how to best manage patients with acute low back pain. Much of this controvery stems from two distinctly different philosophies: medical management and physical therapy management. Standard medical management most often emphasizes the need for the patient to remain as active as possible while prescribing nonsteroidal anti-inflammatory drugs (NSAIDs) and/or muscle relaxants to assist in symptom control/relief. Some advocates of medical management believe that physical therapy, especially exercise-based interventions, are contraindicated for patients with acute low back pain. Others feel that the "limited" benefits attained with exercise-based or manual therapy interventions are not worth the increased cost of care. Many proponents of medical management believe that 80 to 90% of all patients with acute low back pain will "spontaneously" improve within three months. However, recent reports in the literature demonstrate that 75% of the patients medically managed for acute low back pain will have recurrent episodes of low back pain within one year after intial onset of symptoms. Clearly, there must be a more efficient method of managing this patient population. Physical therapists attempt to manage patients with acute low back pain by utilizing a wide variety of interventions including exercise and manual therapy. One of the key exercise approaches that can counter the potentially long-term effects of acute low back pain is strength training. Deyol stated that failure to strength train could cause increased severity and frequency of low back pain. According to Twomey and Taylor properly implemented resistance-exercise regimes play a vital role in the treatment of acute low back pain and are crucial for a patient's successful return to function. The Mayo Foundation for Medical Education and Research advocated the use of a comprehensive, dynamic strengthening program to stabilize the trunk and spine. Unfortunately, the literature is incomplete on issues involving how to best strength train patients with acute low back pain and which specific populations will have the best outcomes with this intervention. Another common treatment for acute low back pain is the use of manual therapy. Manual therapy is a broad term that encompasses numerous techniques with many subcategories. Two of the more popular sub-categories of manual therapy are manipulation and mobilization. DiFabio defined spinal manipulation as a "high velocity thrust momentarily exceeding the available ROM". While under the broad umbrella of "manual therapy", muscle energy technique (MET) does not fall into either the manipulation or mobilization sub-categories. Muscle energy technique is an active technique in that the patient supplies the corrective force instead of the care provider. Greenman defined muscle energy technique as a "manual medicine treatment procedure that involves the voluntary contraction of patient muscle in a precisely controlled direction, at varying levels of intensity, against a distictly executed counterforce applied by the operator." It has been hypothesized that muscle energy technique can be used to lengthen and strengthen muscle(s), increase fluid mechanics and decrease local edema, and to mobilize a restricted articulation. Muscle energy technique has become more popular over the past several years. While originally considered an osteopathic treatement, muscle energy technique has found increased favor with physiatrists, physical therapists, and chiropractors in the treatment of acute and chronic spinal disorders. One of the reasons for this is that it requires active participation on the part of the patient, both in performing and maintaining the effects of the treatment - thus decreasing the risk of patient dependency. DeRosa and Porterfield advocated the use of muscle energy technique as one of the preferred methods to apply "nondestructive forces" in order to facilitate movement at the site of impairment. If the patient is able to tolerate forces into the impaired joint area and more normal motion is restored, the patient should be able to improve spinal mobility with greater ease. Enhanced spinal mobility should lead to improved activity levels, which is imperative for the successful long-term management of low back pain. While muscle energy technique has found an increased audience with clinicians, very little has been published in the peer-reviewed literature on this intervention. Its wide-spread use in the clinic makes it imperative that we determine if this technique is viable procedure for the treatment of acute low back pain. The purpose of this randomized, double-blind, sequential clinical trial was to determine whether patients with acute low back pain would demonstrate a more rapid return to function, as assessed by the Oswestry Disability Index, after being treated with muscle energy technique treatment coupled with supervised strengthening exercises as compared to patients treated with supervised strengthening exercises alone. The following research hypothesis was investigated: There will be a statistically significant difference (p

This second edition of 'Low Back Disorders' provides research information on low back problems and shows readers how to interpret the data for clinical applications.