Scientific Evidence for Pilates in Rehabilitation

If you haven't heard about Pilates, you're not alone. But for the millions of people who have discovered and now use of this specialized exercise for core stabilization, you will find the results of this study of interest. And if you are looking for some help with exercise, fitness, or rehabilitation from an injury, Pilates may be something to consider.

Pilates is actually the name of the German born man (Joseph Pilates) who first developed this technique back in the mid-1900s. It was almost a lost art until about 10 years ago. And then the momentum behind the Pilates movement seemed to snowball. The word spread and now it is a technique that is offered in classes at the local YMCA, health club, fitness center and even physiotherapy clinics.

For physiotherapists, two questions arise: 1) is there any scientific basis for the Pilates technique and 2) is there any evidence to support its use in a rehabilitation program? According to this review of 90 articles published since 1995, there is a scientific foundation but limited evidence for Pilates.

Actually, only nine of the 90 published studies were high enough quality to be considered in the review. But those studies did show that some of the Pilates techniques designed to align, lengthen, and protect the spine are effective in developing strength of the abdominal and trunk muscles.

As it turns out, the combined use of focus, breathing, rhythmical movement, and precision results in total body strengthening (not just the core or central muscles of the abdomen and trunk).

Weaker muscles start to contract and participate in the movement when stronger muscles are engaged. With improved muscle control comes better alignment and protection of the spine. The end result is the ability to perform even more advanced skilled movements with perfect balance and coordination.

You can see why this approach appeals to dancers, martial artists, and athletes of all kinds who need strength, balance, coordination, and endurance all at the same time. And physiotherapists quickly saw the advantage of these techniques for patients suffering from chronic back pain or recovering from injuries.

Research to better understand the effects of Pilates has fostered the growth of Pilates technique in rehab. It has been shown to help reduce stress and chronic back pain, improve flexibility, and promote better posture and relaxation. Although it is believed that anyone of any age in any condition can benefit from Pilates exercises, research to support this with evidence is still lacking.

Future studies are also needed to investigate the effects of using the traditional classical approach as taught by Joseph Pilates versus the modified forms of Pilates currently in use.

For example, his program has been varied and changed for the more physically challenged individual who cannot perform the advanced or technical Pilates techniques. Are these altered movements just as effective? Perhaps even more effective? Is there any benefit at all in doing Pilates when there are any physical limitations? These are all questions that must be addressed before physiotherapists incorporate Pilates as a mainstream rehabilitation technique.

Reference: Christine E. DiLorenzo, PT, DPT, CPI. Pilates: What Is It? Should It Be Used in Rehabilitation? In Sports Health. June/July 2011. Vol. 3. No. 6. Pp. 352-361.