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Updates from EIM

Pilates in the Clinical Space

March 22, 2021 by Dominique Flores, BS, RN

Pilates, named after the creator Joseph Pilates, has earned recognition as a global fitness discipline. The growing popular exercise methodology was brought to New York City in 1926 after the German “nurse-physiotherapist” (Di Lorenzo, 2011) emigrated to the United States and began teaching his method to ballerinas and Hollywood celebrities. It has become popular among those in the dance industry, due to its ability to improve core stabilization, strength and muscular endurance without adding mass (Kloubec, 2004). These exercises can be adapted for gentle rehabilitation or used as a vigorous workout for athletes (Kloubec, 2011) to supplement their training routines. The exercise practice has become widely adopted within recent years and has now made its way into the healthcare space to potentially become part of treatment plans and physical therapy for various conditions.

From 2008-2010, the American College of Sports Medicine (ACSM) ranked Pilates in the top ten fitness trends. Over the past decade, Pilates has made its way to cities and towns in the form of boutique fitness gyms & in homes, with the production of affordable Pilates equipment and at-home streaming services. With the rise of health consciousness and the emergence of global health initiatives such as Exercise as Medicine ®, there has been an increase in research conducted on how exercise can provide physical and psychological benefits not only for health maintenance but also for those with injuries and non-communicable diseases, such as cancer. Within the past five years, there have been several studies on the effects of Pilates on patients diagnosed with breast cancer with the majority concluding that Pilates improved mobility and reduced cancer-related adverse symptoms due to treatment. In 2015, a randomized clinical trial was conducted that showed the impact of Pilates exercises on patients with lymphedema after breast cancer treatment (Sener, 2017). The results showed that Pilates reduced the severity of lymphedema and improved quality of life in addition to upper extremity function. Other cases in which Pilates has proven to be therapeutic are for “patients with chronic non-specific low back pain” (Valenza, 2017), “postmenopausal women experiencing anxiety, depression, fatigue and decreased sleep quality” (Aibar-Almazan, 2019), and patients with multiple sclerosis (Duff, 2018).

The number of successful patient outcomes from Pilates utilized in treatment plans has caught the attention of many providers but has yet to be adopted widely in healthcare. The first systematic review stated that pilates had “larger effects on diabetes, followed by chronic respiratory and cardiovascular diseases, and cancer” (Miranda, 2018) among interventions that lasted 8 to 16 weeks. Further longitudinal research is needed in order to evaluate the effectiveness of Pilates as an intervention & lifestyle-practice for those with non-communicable diseases that are of worldwide concern due to the social, health and economic burden. The results are promising but with additional research and successful implementation trials, Pilates may be seen as a future therapeutic modality.

Dominique Flores is a registered nurse at New York Presbyterian / Cornell Weill Medical Center in General Pediatrics, a member of the EIM Pediatric Committee and an aspiring Pilates and yoga practitioner.

References:

Aibar-Almazán, A., Hita-Contreras, F., Cruz-Díaz, D., de la Torre-Cruz, M., Jiménez-García, J. D., & Martínez-Amat, A. (2019). Effects of Pilates training on sleep quality, anxiety, depression and fatigue in postmenopausal women: A randomized controlled trial. Maturitas124, 62–67. https://doi.org/10.1016/j.maturitas.2019.03.019

Di Lorenzo C. E. (2011). Pilates: what is it? Should it be used in rehabilitation?. Sports health3(4), 352–361. https://doi.org/10.1177/1941738111410285

Duff, W., Andrushko, J. W., Renshaw, D. W., Chilibeck, P. D., Farthing, J. P., Danielson, J., & Evans, C. D. (2018). Impact of Pilates Exercise in Multiple Sclerosis: A Randomized Controlled Trial. International journal of MS care20(2), 92–100. https://doi.org/10.7224/1537-2073.2017-066

Kloubec, J. & Banks A. (2004) Pilates and Physical Education: A Natural Fit, Journal of Physical Education, Recreation & Dance, 75:4, 34-37, DOI: 10.1080/07303084.2004.10609265

Kloubec J. (2011). Pilates: how does it work and who needs it?. Muscles, ligaments and tendons journal1(2), 61–66.

Lausen, A., Marsland, L., Head, S., Jackson, J., & Lausen, B. (2018). Modified Pilates as an adjunct to standard physiotherapy care for urinary incontinence: a mixed methods pilot for a randomized controlled trial. BMC women's health18(1), 16. https://doi.org/10.1186/s12905-017-0503-y

Miranda, S., & Marques, A. (2018). Pilates in noncommunicable diseases: A systematic review of its effects. Complementary therapies in medicine39, 114–130. https://doi.org/10.1016/j.ctim.2018.05.018

Şener, H. Ö., Malkoç, M., Ergin, G., Karadibak, D., & Yavuzşen, T. (2017). Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial. The journal of breast health13(1), 16–22. https://doi.org/10.5152/tjbh.2016.3136

Valenza, M. C., Rodríguez-Torres, J., Cabrera-Martos, I., Díaz-Pelegrina, A., Aguilar-Ferrándiz, M. E., & Castellote-Caballero, Y. (2017). Results of a Pilates exercise program in patients with chronic non-specific low back pain: a randomized controlled trial. Clinical rehabilitation31(6), 753–760. https://doi.org/10.1177/0269215516651978

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