teneriffe Archives - Praxis Physiotherapy

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

by Stephen Timms | 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

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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).

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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:

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.
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.
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.
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.

Congratulations Nancy!

by Stephen Timms | May 19, 2019 | Uncategorized

GRADUATION

A massive congratulations to our resident remedial massage guru Nancy! She recently “doffed the cap” during her graduation ceremony. Nancy successfully completed a Bachelor of Health Science (Myotherapy) at the Endeavour College of Natural Health.

Myotherapy involves an extensive physical evaluation and an integrated therapeutic approach in the treatment of affected muscles, joints and nerves. Nancy gains an in depth understanding of human biology, musculoskeletal anatomy and function. Through extensive practical classes and clinical experience, graduates such as Nancy learn to conduct testing and physical assessments and apply a variety of practical skills such as myofascial release, dry needling, joint mobilisation and trigger point therapy.

Nancy continues to service her loyal massage followers on Tuesdays and Fridays at our Teneriffe location (91 Commercial Rd). You can book online here.

Well deserved Nancy – we are all proud of you!

– Team Praxis

Prevent. Prepare. Perform

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Private Health Preferred Provider Schemes

by Stephen Timms | 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

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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