Pilates and Neurology
Pilates and Neurology. By Susan Czyzo (Bachelor of Physical Education and Health, Master of Science in Physical Therapy)
A physiotherapist’s role when working with people with multiple sclerosis (MS) or Parkinson’s disease (PD) will revolve around assisting the individual with maintaining their physical independence for as long as possible. Recent literature has found that exercise therapy is a valid method for fulfilling this role as it can result in increased strength, improved mobility and enhanced balance. Research into the effect of Pilates in people with MS or PD although limited at this stage, is producing similar results. With a key focus of Pilates being improvement of trunk control, it need not come as a surprising choice of therapeutic activity for people with MS or PD. Poor trunk control, after all, is not uncommon in these populations. The main Pilates principles, such as breath, flow and centering, can be applied and be of benefit to all participants regardless of their level of physical impairment. Providing clients with successful movement experiences using Pilates is often augmented by the variety of specialised equipment available and the resistance and/or feedback they offer to the client. This can be especially useful in neurological populations where impairments in proprioception and motor control are common. Nevertheless, there are a few special considerations to be aware of when teaching these populations.
Challenging beliefs. It is not uncommon for people with MS to be fearful of exercise and to be concerned that it may bring about a relapse or exacerbation of symptoms. Research highlights the numerous benefits of exercise in the MS population and even demonstrates a decreased risk of relapse. As physiotherapists we need to be aware of the current evidence and educate our clients accordingly.
Variability. When designing an exercise program, Pilates or otherwise, for an individual with MS or PD, it is imperative to recognize that every client experiences different symptoms, at different times and to varying degrees. Effective Pilates teaching, therefore, requires a very adaptable and attentive approach. Not taking the time to analyze how a client presents at the beginning and throughout each session will compromise their safety and fail to yield the benefits that this form of exercise provides.
Focus on breathing. Chronic health conditions are often accompanied by anxiety. This, in turn, can result in disordered breathing and wasted energy. With fatigue being a common symptom experienced by clients with MS, building awareness of their breathing pattern and correcting disordered breathing is an important step in maintaining their independence. The breathing principles of Pilates are a great place to start to assess and correct breathing patterns. Once an adequate breathing pattern is established, it can be trained throughout their Pilates program.
References:
Motl, R. W., & Pilutti, L. A. (2012). The benefits of exercise training in multiple sclerosis. Nat Rev Neurol, 8(9), 487- 497.
Guclu-Gunduz, A. Citaker, S. Irkec, C. Nazliel, B. Batur-Caqlayan, H.Z. (2014). The effects of pilates on balance, mobility and strength in patients with multiple sclerosis. NeuroRehabilitation, 34(2), 337-42.