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Pilates: Mat vs Reformer Pilates (Part 2 of 3)

Pilates: Mat vs Reformer Pilates (Part 2 of 3)

by | Jun 21, 2019 | Reformer Pilates

In part one, we unearthed that pilates has a role to play in reducing the severity of chronic lower back pain. In part two, we tackle a common question from our patients and delve further into the research to see if there is a difference between mat and reformer pilates.

SUMMARY:

  • A reformer is a large piece of pilates equipment that utilises a spring mechanism to apply load in various positions and degrees of loading from gravity.
  • Both forms of exercise are better than the ‘wait and see’ or pharmacological approach with respect to chronic lower back pain
  • The use of reformers may provide a larger stimuli to the sensory system which facilitates proper performance due to better stabilisation
  • Pilates promotes the restoration of the function of muscles involved in lumbopelvic stabilisation, that is, transversus abdominis, multifidus, diaphragm and pelvic floor muscles (the “core”)
  • Reformer pilates provides more options for strengthening, ideal for those recovering from injury, pregnancy or surgery

 

As a general rule, the aim of pilates is to restore or sustain the motor control of the lumbar spine and proper body posture. Joseph Pilates (the founder of pilates) believed beginning exercise in the horizontal plane was important to relieve the stress and strain on the joints, and to align the body before adding additional gravitational forces while standing, sitting or kneeling.

Both mat and reformer are popular types of pilates which both focus on strengthening. Mat pilates, as its names suggests is a floor based method that tends to use bodyweight as the chief form of resistance.

Reformer, is the most popular equipment of Pilates. The design of Reformer utilises a spring mechanism that the person works to control while moving in various planes (Bulguroglu et al 2017). Reformer pilates allows more exercises compared to a mat and it provides the option of performing exercises numerous body positions – from your back, side, stomach and being seated — and also on your feet or knees.

COMPARE THE PAIR

Not a great deal of research has been conducted on differentiating the two forms of pilates. What studies do exist tend poorly define what equipment was used or whether individual tailoring of the sessions occurred.

Luz et al compared the effectiveness of Pilates mat and equipment-based Pilates exercises (with the use of Reformer) in a group of 86 individuals with chronic lower back pain. The 6-week routine included individual, 1-hour sessions performed twice a week and supervised by a Pilates-experienced physical therapist. The outcome measures were: pain intensity, disability, global perceived effect, patient’s specific disability and fear of movement, known as kinesiophobia (Luz et al 2014). The assessment was recorded after 6-week intervention and 6 months. A significant difference was noted in both groups after a 6-week programme in all of the areas evaluated. After 6 months however, a significant difference was found in disability, specific disability and kinesiophobia in favour of equipment-based Pilates exercises (Luz et al 2014; Eilks et al 2019).

 

In the study by Cruz-Diaz et al, the influence of Pilates mat exercises and equipment-based Pilates exercises (with reformer) on pain, disability, kinesiophobia and activation of transversus abdominis (expressed as a change in muscle thickness and assessed by real-time ultrasound examination) was assessed. The trial involved 98 patients with chronic lower back pan (CLBP) allocated to three groups: Pilates mat exercises, Pilates apparatus or the control group. The programme was conducted in groups of four participants during 12 weeks with 50 min sessions (twice a week). The evaluation was carried out during intervention (6 weeks after baseline) and after 12 weeks. As with Luz et al, significant improvement were shown in both groups for all outcome measures after 6 and 12 weeks. However, in the comparison between groups, the superiority of equipment-based Pilates was noted (Cruz-Diaz et al 2017). In both studies, it was suggested that the finding may be an effect of the use of apparatus in exercises that provides larger stimuli to the sensory system, resulting in larger feedback, which facilitates proper performance due to better stabilisation (Eilks et al 2019). According to da Luz et al, this result may also be caused by a placebo effect inherent for the application of equipment. As noted earlier however, reformer pilates offers a larger scope of exercises to draw upon for those who are limited by pain, weakness or fear of movement. So there you have it. What little research there is suggests that any pilates is good for your rehabilitation or as a part of your ongoing strength program. However, it appears that reformer pilates is more effective, and allows a greater degree of variability of training. For more about what makes Praxis Pilates special, check out our website here. Join us for part 3 next week where we look at what the research suggests regarding the frequency of pilates. Is more actually better? Till next time – Praxis what you preach Prevent. Prepare. Perform

References:

  1. Eliks, M., Zgorzalewicz-Stachowiak, M., & Zeńczak-Praga, K. (2019). Application of Pilates-based exercises in the treatment of chronic non-specific low back pain: state of the art. Postgraduate medical journal, 95(1119), 41-45.
  2. da Luz Jr, M. A., Costa, L. O. P., Fuhro, F. F., Manzoni, A. C. T., Oliveira, N. T. B., & Cabral, C. M. N. (2014). Effectiveness of mat Pilates or equipment-based Pilates exercises in patients with chronic nonspecific low back pain: a randomized controlled trial. Physical therapy, 94(5), 623-631.
  3. Bulguroglu, I., Guclu-Gunduz, A., Yazici, G., Ozkul, C., Irkec, C., Nazliel, B., & Batur-Caglayan, H. Z. (2017). The effects of Mat Pilates and Reformer Pilates in patients with Multiple Sclerosis: A randomized controlled study. NeuroRehabilitation, 41(2), 413-422.
  4. Cruz-Díaz, D., Bergamin, M., Gobbo, S., Martínez-Amat, A., & Hita-Contreras, F. (2017). Comparative effects of 12 weeks of equipment based and mat Pilates in patients with Chronic Low Back Pain on pain, function and transversus abdominis activation. A randomized controlled trial. Complementary therapies in medicine, 33, 72-77.
Pilates: Reforming our back pain rehabilitation (Part 1 of 3)

Pilates: Reforming our back pain rehabilitation (Part 1 of 3)

by | Jun 3, 2019 | Lower Back, Pain, Reformer Pilates

With our 30 day pilates challenge starting today, we thought we would take a look at why we love pilates so much for our patients, and what some of the benefits are. Part 1 looks at how pilates affect those with chronic lower back pain. Part 2 looks at the difference between mat and reformer pilates and part 3 looks at how often is required to see the benefit of pilates.

SUMMARY:

  • Back pain is extremely common, multifactorial, and often reoccurs
  • Strengthening interventions appear better for long term suffers of lower back pain
  • Pilates has been shown to improve muscular strength and endurance of key pelvic and postural musculature associated with lower back pain
  • Specifically, pilates promotes the restoration of the function of muscles involved in lumbopelvic stabilisation, that is, transversus abdominis, multifidus, diaphragm and pelvic floor muscles
  • As little as 2 sessions per week for 6 weeks has been shown to see improvements in pain and function for those with longstanding lower back pain, even after stopping pilates

Chronic low back pain (CLBP) is one of the commonest musculoskeletal problems in modern society (Anderson 1999) and is a highly prevalent in both the sporting and general public. CLBP is experienced by 70%–80% of adults at some time in their lives (Crombez et al 1999) and as such, the costs associated with LBP and related disability are enormous, causing a major economic burden for patients, governments and health insurance companies (Dagenais 2008).

Lower back pain has been one of the most extensively studied musculoskeletal conditions as a result of the prevalence and debilitation nature. Its management comprises a range of different intervention strategies including surgery, drug therapy and non-medical intervention like rehabilitation (Paolucci et al 2018). Within Physiotherapy, exercise therapy is probably the most commonly used intervention for the treatment of patients with chronic non-specific LBP due to its plausible biological rationale and low cost.

Whilst general conditioning programs to train strength and endurance of the spine musculature have been shown to reduce pain intensity and disability (Rainville et al 2004), the popularity of pilates (both mat and reformer) has helped provide an accessible and supervised form of therapeutic exercise.

EVIDENCE FOR PILATES

The Pilates method, using functional exercises aims to improve muscular strength and endurance. Specifically, the pilates method have promotes the restoration of the function of muscles involved in lumbopelvic stabilisation, that is, transversus abdominis, multifidus, diaphragm and pelvic floor muscles. Using the principles of progressive overload, your body adapts to the incremental loading week after week and consequently results important postural control improvement. In 2009, Curnow and colleagues showed that the Pilates method improves load transfer through the pelvis, something that intuitively helps those with CLBP.

However, a systematic review (Patti et al 2015) reported evidence that Pilates method-based exercises are more effective than no treatment or minimal physical exercise interventions in the management of chronic nonspecific LBP. Further, they pointed out that the effects of the Pilates method are only proven for patients with chronic nonspecific LBP in the short term.

A recent study by Natour and colleagues (2015) showed that the group of participants that were practicing Pilates method resulted statistically better compared with the a non exercising group who only used inflammatory medication. Those who were in the pilates group used less pain medication at 45, 90 (conclusion of the Pilates method), and 180 days, 90 days after the conclusion of the exercise program.

In conclusion, Pilates as an exercise choice is more effective than minimal physical exercise or drug based interventions in reducing pain and disability in the short-term period. There is agreement that exercise “helps” in the treatment of chronic pain, but it is still not clear exactly which factors or particular kind of exercises may be responsible of such improvements (Natour et al 2015; Patti et al 2015). Praxis Physiotherapy has always been a strong proponent of movement and loading early in rehabilitation (more on this in later blogs!).

In the next instalment, we discuss the difference between mat and reformer pilates and perhaps find some more answers regarding which exercise regime reigns supreme!

Check out all our other reformer pilates services on our website

Until next time,

Prevent. Prepare. Perform.

References:

  1. Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999;354(91789178):581–585.
  2. Crombez G, Vlaeyen JW, Heuts PH, Lysens R, Crombez G. Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability. Pain. 1999;80(1-2):329–339.
  3. Dagenais DC, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. The Spine Journal 2008;8(1):8‐20.
  4. Paolucci, T., Attanasi, C., Cecchini, W., Marazzi, A., Capobianco, S. V., & Santilli, V. (2019). Chronic low back pain and postural rehabilitation exercise: a literature review. Journal of pain research, 12, 95.
  5. Rainville J, Hartigan C, Martinez E, Limke J, Jouve C, Finno M. Exercise as a treatment for chronic low back pain. Spine J. 2004;4:106-115
  6. Patti, A., Bianco, A., Paoli, A., Messina, G., Montalto, M. A., Bellafiore, M., … & Palma, A. (2015). Effects of Pilates exercise programs in people with chronic low back pain: a systematic review. Medicine, 94(4).
  7. Curnow, D., Cobbin, D., Wyndham, J., & Choy, S. B. (2009). Altered motor control, posture and the Pilates method of exercise prescription. Journal of bodywork and movement therapies, 13(1), 104-111.
  8. Natour, J., Cazotti, L. D. A., Ribeiro, L. H., Baptista, A. S., & Jones, A. (2015). Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial. Clinical rehabilitation, 29(1), 59-68.
Congratulations 30 Day Challengers

Congratulations 30 Day Challengers

by | Jul 20, 2018 | Uncategorized

Final measures have been taken. Numbers crunched and the results are in…

But first, a massive congratulations to all our 30 Day Challengers who recently completed a gruelling but rewarding 30 days of Reformer Pilates. Participants completed a suite of baseline strength measures (recording maximum repetitions) on the reformers and then underwent a structured program devised by our clinical Pilates guru’s Emma, Karen and Kylie. No two workouts were the same and challengers used their 20 classes over the 30 days to take giant strides in improving their pilates technique and strength.

We had an eager and wide range of participants from the sporting to the previously sedentary office worker. All participants have reported how strong they feel after only a month with further benefits felt in enhanced posture and energy levels.

During this challenge, our participant’s average improvement to their baseline testing was more than 80%! Special mentions to Dominique P, whose push ups went from 15 to 43 repetitions. Sandra L doubled her ab curl ups to record the highest measure of 120 reps and increased her scooter lunge a whopping 55 reps!

But there can only be one winner from each clinic. Our winners were *drumroll please* Michael B. from Club Coops Carseldine and Siobhan E. from the X-Centre in the Valley. Michael in particular blew the competition away with calf raises progressing from 38 to 105 reps, footwork (on all springs) from 40 to a mammoth 120 reps! Not to be outdone, Siobhan almost doubled her abdominal curls to 118 and added almost 40 reps to her Scooter lunge!

Michael and Siobhan each receive a FREE 5-Pack as a reward for effort and dedication during the colder months of the year! Great stuff!!

Congratulations again to all our participants and our winners Michael and Siobhan. Stay tuned for the next challenge date which we’ll have a few added surprises and bonuses included!

Yours in Health,

Praxis Pilates – Prevent. Prepare. Perform.

Private Health Preferred Provider Schemes

Private Health Preferred Provider Schemes

by | Jul 1, 2018 | Uncategorized

PRIVATE HEALTH

Firstly it is important to point out that when seeing a practitioner at Praxis Physiotherapy, you will be able to use your private health insurance (PHI) towards the fee if you have appropriate cover (usually called ‘Extras’). It must be said that we think PHI for physiotherapy is an excellent investment for those that have it as a part of their cover. It must also be stated that whilst we offer HICAPS transactions onsite at all our clinics, we at Praxis Physiotherapy are not currently a member of any preferred provider schemes.

We are often asked why we aren’t so we have done this blog to outline some important information which outlines some things for you to consider before automatically choosing a clinic with a preferred provider status.

What is a preferred provider scheme?

Some PHI companies have created their own list of health providers which they recommend to their members. Preferred provider schemes take several different forms but include the following examples:

  • Bupa / Medibank – Members First Extras / Provider
  • HCF – More for Muscles
  • NIB – Extra Cover Providers

These providers are generally marketed as being ‘preferred’ as though they have achieved this title through clinical excellence but in fact these are just practices who have agreed to sign a contract which allows the PHI to set the fee structure and reimbursements for the practice.

There are no minimum standards of practice, experience or quality of care required to qualify for these contracts. It is purely an agreement that the practice will charge those patients the amount the insurance company has set.

You might ask why a practice would do this? It is an easy way to gain exposure to many prospective new patients, so it can be an effective way to get your practice up and running or boost numbers.

What’s the problem here?

Although discounting services to get more patients to your business might be good to start with, and also good for the patients who will have a smaller gap to pay, problems occur relatively quickly when there are many patients coming to the clinic who are not paying a normal/typical fee. The cost of providing adequate length appointments with experienced staff generally is too great for the business to sustain.

Practices in these schemes may then be forced to make some difficult decisions about how they run their business, and generally these result in shorter appointment times or using less experienced staff who they can pay less (or both). The combination of these two things is a big concern to the allied health industry as it is likely to be detrimental to the quality of healthcare provided to the patient.

What can you do?

Remember that you have a choice!

If you are concerned about the small contribution your health fund makes for physiotherapy or other allied health, it is important you know that you can shop around for an insurer that better suits your needs. Some funds (usually the smaller not for profits) pay much better rebates for allied health. It is important to note also, that you can have hospital cover with one insurer, and your extras cover with another.

What does the Australian Physiotherapy Association (APA) say about preferred provider schemes?

This information is taken directly from their website:

“The Australian Physiotherapy Association remains concerned that health funds actively divert their members to network providers, regardless of existing therapeutic relationships.

The APA believes the term ‘preferred’ might make a patient think a practice is of a particular standard than those practices that are not preferred. This is not the case. By being a preferred provider, a physiotherapist simply elects to join the scheme and bring their fees in line with what the health funds mandate. We know this is a significant disadvantage to physiotherapists and that keeping fees close to market rates is essential to maintain the financial viability of a physiotherapy business.

We have raised this matter with the ACCC, which has not determined this is a matter for further investigation. We will continue to advocate for change when appropriate.”

In summary…

We at Praxis Physiotherapy believe that schemes such as these do not allow us to sustainably offer the expert services, longer appointment times (60mins for initials / 30mins subsequents), experienced staff and the physical environment that we do. We feel that compromising in any of these areas would not align with the values we set ourselves when we started our clinic. In short, we do not apologise for putting the needs of our patients above the bottom line and believe that in order to help you Prevent. Prepare. Perform, the requisite time, expertise and effort is required from your Praxis therapist.

Until next time…

Prevent. Prepare. Perform.

Team Praxis

Physiological

Changes in parasympathetic activity (as measured by heart rate, blood pressure and heart rate variability) and hormonal levels (as measured by cortisol levels) following massage result in a relaxation response.

Psychological

A reduction in anxiety and an improvement in mood state also cause relaxation, and has been shown prior to sports to help lower performance anxiety.

Ultimately, what the above proposed mechanisms translate into a series of studied benefits on specific conditions. According to the Massage and Myotherapy Australia website, massage has also been shown to help:

  • Back pain
  • Arthritis
  • Insomnia
  • Headaches
  • Depression and anxiety
  • Constipation
  • High blood pressure
  • Chronic pain​

All in all, massage provides good bang for buck when used in the appropriate setting. Our mantra at Praxis is Prevent Prepare Perform and as physiotherapists, we work in tandem with our qualified massage therapists to deliver the best results for a wide variety of conditions. Whilst, physiotherapy is focussed on the diagnosis and treatment of acute or chronic injuries, remedial massage enables a little more hands on time to truly address issues that our physiotherapists may have identified in their sessions. Further, massages offers a great medium for regular ‘tune-ups’ when the rigours of training and working take their toll.

We ensure that your massage experience is not only blissful, but productive for your rehabilitation as well. So if you have been swayed by the evidence, or just looking for that little reward, we are here to help!

BOOK YOUR MASSAGE HERE

Until next time – Prevent. Prepare. Perform

References:

  1. Hopper D, Deacon S, Das S, et al. Dynamic soft tissue mobilization increases hamstring flexibility in healthy male subjects. Br J Sports Med. 2004;39:594–598
  2. Weerapong, P., Hume, P.A. & Kolt, G.S. The mechanisms of massage and effects on performance, muscle recovery and injury prevention. Sports Med 2005; 35: 235
  3. Morelli M, Seaborne DE, Sullivan SJ. Changes in h-reflex amplitude during massage of triceps surae in healthy subjects.J Orthop Sports Phys Ther. 1990;12(2):55-9.
  4. Arroyo-Morales M1, Fernández-Lao C, Ariza-García A, Toro-Velasco C, Winters M, Díaz-Rodríguez L, Cantarero-Villanueva I, Huijbregts P, Fernández-De-las-Peñas C. Psychophysiological effects of preperformance massage before isokinetic exercise. J Strength Cond Res. 2011 Feb;25(2):481-8.

https://www.massagemyotherapy.com.au/Home

Pilates Launch Day! Northside Clinic

Pilates Launch Day! Northside Clinic

by | Mar 7, 2018 | Uncategorized

OPENING DAY || Exciting times at Praxis! We are stoked to be launching our reformer pilates classes @clubcoops on Saturday March 17. We have FREE 30min classes starting at 8am with Emma and Tara! Opening day specials available! Email admin@praxisphysio.com.au or call (07) 3102 3337 or chat to the Club Coops front desk to secure your FREE class today! www.praxisphysio.com.au