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REVIEW




             Maximizing the bene®ts of
            Pilates-inspired exercise for
        learning functional motor skills
                                                     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

                                                     Claudia Lange, Viswanath Unnithan,
                                                     Elizabeth Larkam, Paula M. Latta



                                                     Abstract Joseph Pilates (1880±1967) created a system of ®tness exercises that are still
                                                     practiced in a more or less modi®ed form. Within the last two decades, there has been
                                                     a signi®cant increase in the popularity of such Pilates-inspired (PI) exercises. This
                                                     paper describes current claims for the e€ectiveness of PI exercises and comments on
                                                     their validity. Motor learning principles and ®ndings are applied to make
                                                     recommendations for using PI exercises to enhance the execution of functional
                                                     movement tasks. The learning-performance distinction, augmented information
Claudia Lange PhD                                    feedback, contextual interference, skill transfer and augmented verbal cues are
Viswanath B. Unnithan PhD                            discussed. Finally, suggestions are made for aspiring PI practitioners seeking training
Department of Exercise and Sport Science,            and certi®cation. # 2000 Harcourt Publishers Ltd
University of San Francisco
Elizabeth Larkam MA
Center for Sports Medicine, Saint Francis Memorial   Joseph Pilates and                                        and soon opened an exercise studio
Hospital, San Francisco
Paula M. Latta BS
                                                     Contrology                                                with his wife Clara. Pilates wrote a
Peninsula RSI, Redwood City, CA
                                                                                                               slender volume (1934) outlining his
                                                     Joseph Pilates was born in Germany                        system of Contrology, which he
                                                     in 1880. A sickly child, he used                          described as a set of healthful
Correspondence to: C. Lange
Department of Exercise and Sport
                                                     physical exercise to turn himself into                    lifestyle changes and corrective
Science, University of San Francisco,                a ®t adult. In 1912, Pilates moved to                     exercises. A later booklet (Pilates
2130 Fulton St, San Francisco,                       the UK and held a variety of                              & Miller 1945) features a number of
CA 94117-1080, USA.                                  occupations, including boxer and                          the exercises. His methods and
Tel.: +1 415 422 6874; Fax: +1 415 422 6040;
                                                     self-defense trainer. During World                        specialized ®tness equipment
E-mail: langec@usfca.edu
                                                     War I, while interned in a prison                         achieved popularity with dance
This research was conducted in the Department of     camp for German nationals, he                             professionals such as George
Exercise and Sport Science, University of San        taught his ®tness exercises to                            Balanchine and Martha Graham,
Francisco, 2130 Fulton St, San Francisco,            inmates. Upon returning to                                but were largely unknown to the
CA 94117-1080, USA
                                                     Germany after the war, he gave                            general public. Pilates died in 1967.
                                                     exercise classes to police and                            A handful of students have carried
Received October 1999
                                                     military personnel and interacted                         on his teachings and in¯uenced
Revised November 1999
                                                     with members of the avant-garde                           numerous other individuals to learn
Accepted December 1999
...........................................          dance community, such as Rudolf                           and teach his exercises. As a result,
Journal of Bodywork and Movement Therapies (2000)    von Laban and Hanya Holm. In                              the name Pilates has become
4(2), 99^108
# 2000 Harcourt Publishers Ltd                       1926, he moved to New York City                           associated with a form of movement

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that is increasingly popular in          Considering the widespread                         Fundamentals), and Chinese
clinical and ®tness settings.            application and adaptation of these                medicine. Today, these (more or less
   Pilates (1934; Pilates & Miller       exercises, there is a growing need to              modi®ed) exercises are known
1945) made bold claims for the           objectively assess their outcomes                  collectively as Pilates, Pilates-based
bene®ts of Contrology. For               and bene®ts.                                       or Pilates-evolved. It is not the goal
example, he stated that it would            The purpose of this paper is to                 of this paper to distinguish among
prevent coronary heart disease,          evaluate current claims on the                     di€erent exercise styles that are
increase muscular power, and reduce      learning bene®ts of exercises derived              based on Pilates' teachings. Rather,
the risk of respiratory ailments. He     from the system developed by                       all exercises emanating from those
also stated that it would result in      Pilates. Motor learning principles                 established by Pilates will be de®ned
complete voluntary control of the        and ®ndings will be used as a model                as Pilates-inspired (PI). There is an
body. He described Contrology as a       to make recommendations for                        ongoing discourse between Pilates'
`balance' or `complete coordination      administering Pilates-type exercises               central ideas and movement
of body, mind, and spirit' achieved      to enhance functional movement                     routines, and other systems of
by relinquishing strenuous exercises     skills. Finally, suggestions will be               movement and rehabilitation. The
and deliberately performing              made for aspiring practitioners of                 de®ning characteristics of PI
functional activities in a posturally    these exercises seeking training and               exercises are listed in Box 1.
appropriate manner. Despite Pilates'     certi®cation.                                      Examples of equipment and
assurances (1934, Pilates & Miller                                                          exercises based on Pilates' designs
1945) that he had `scienti®cally'                                                           are shown in Figures 1±5.
proven the e€ectiveness of his           Claims on the learning
approach, he did not subject his         e¡ectiveness of
                                                                                            Current claims for
claims to experimental testing and       Pilates-inspired
                                                                                            Pilates-inspired exercises
maintained that such testing was         exercises
unnecessary.                                                                                A sampling of relevant sources
                                         The legacy of Pilates
   Within the last two decades, there                                                       reveals three categories of claims on
has been a signi®cant increase in the    Pilates was in¯uenced by hatha                     the bene®ts of PI exercises:
popularity of exercises based on         yoga, gymnastics, modern dance                     enhanced physiological functioning,
Pilates' teachings. In the USA alone,    and other movement systems. He                     enhanced psychological functioning
more than 700 studio and                 designed about 40 mat exercises and                and learning or re-learning of
rehabilitation sites use his methods     hundreds of exercises for his                      functionally e€ective postural sets
(Larkam & Brownstein 1998). A            specialized equipment (Larkam &                    and motor patterns (e.g. Robinson
directory of UK practitioners (Body      Nichols 1999). His exercises have                  & Thomson 1997, Balanced Body1
Control Pilates 1999) lists roughly      been further in¯uenced by ®elds as                 1999, Gallagher & Kryzanowska
100 studios. Practitioners can also      diverse as physical therapy, somatics              1999, Physicalmind Institute 1999,
be found in Africa, Asia, Australia      (e.g. Feldenkrais MethodTM, Body/                  Stott Conditioning 1999, The
and New Zealand, Europe and              Mind Centering1, Bartenie€                         Balanced Body Studio 1999, Pilates
South America. In order to
understand the signi®cance of
                                           Box 1 De¢ning characteristics of Pilates-inspired exercises
Pilates for functional skill
improvement, it is necessary to be
                                           . Progressively enhance breath, core (body center), shoulder girdle, and limb control.
aware of claims made by current            . Movements are slow and deliberate, with few repetitions (usually 5±10).
practitioners regarding the learning       . Programs are highly individualized. One-on-one, dyad, and small group sessions are
bene®ts of their exercise sessions.          conducted.
This can serve as a basis for              . Exercises are done on ¯oor mats and equipment.
                                           . Exercises are done from lying, sitting, kneeling, standing and other postures.
practical recommendations about
                                           . Some equipment uses springs to provide variable resistance.
improving the quality of sessions.         . Main piece of equipment is the Universal Reformer, a frame with a padded carriage
Such recommendations can                     that slides back and forth within the frame. Adjustable springs attach from the carriage
generically be derived from the              to the frame. The carriage may be moved by pushing it, or by pulling on straps placed
®ndings of existing experiments on           around arms or legs.
                                           . Other large pieces of equipment include the TrapezeTable (Cadillac), Combo (Wunda)
motor skill learning. However, more
                                             Chair, Ladder and Step Barrels, and Ped-a-Pul.
Pilates-speci®c recommendations            . Small pieces of equipment include exercise balls, foam rollers, rotating disks, balance
can only emerge with scienti®c study         boards, resistance rings, small arcs, and boxes.
of Pilates-type exercises themselves.

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                                                                                                        Box 2 Claims made on the e¡ectiveness
                                                                                                        of Pilates-inspired exercises

                                                                                                        Enhanced physiological functioning
                                                                                                        . ¯exibility and range of motion
                                                                                                        . muscular strength
                                                                                                        . muscular endurance
                                                                                                        . muscular power
                                                                                                        . cardiorespiratory ®tness

                                                                                                        Enhanced psychological functioning
                                                                                                        . mood
                                                                                                        . motivational state
                                                                                                        . attentional focus
                                                                                                        . enjoyment of life
                                                                                                        . energy and zest

                                                                                                        Enhanced motor learning
                                                                                                        . core control
                                                                                                        . static and dynamic posture
                                                                                                        . intralimb and interlimb coordination
                                                                                                        . aesthetically pleasing movement form
                                                                                                        . body awareness
                                                                                                        . static and dynamic balance




                                                                                                       1994, Krasnow et al. 1997,
                                                                                                       McMillan et al. 1998). Roughly an
                                                                                                       equal number of studies also report
                                                                                                       the failure of PI exercises to elicit
Fig. 1 A golfer has been diagnosed with spinal facette lock. During rehabilitation, the therapist is
                                                                                                       improvements (Fitt et al. 1994,
giving verbal and tactile information to guide her to the appropriate position of spine extension      Krasnow et al. 1997, McLain et al.
and rotation. The patient is lying on the Trapeze Table and is using the spring-loaded pedals of       1997). Despite the lack of
the Combo (Wunda) Chair to assist her action. Desired functional activity might be a golf swing.       supportive, research-based data on
Reproduced by kind permission of Balanced Body1, Inc. (1999) and Polestar1 EducationLLC                PI exercises, anecdotal reports by
(1999).
                                                                                                       practitioners and clients indicate
                                                                                                       that signi®cant bene®ts do indeed
                                                                                                       exist. It is therefore worthwhile to
Institute 1999). To give an idea of                 disrupt normal coordination, such                  make preliminary recommendations
the extent of these claims, examples                as orthopedic surgery, stroke, and                 for maximizing the bene®ts of PI
are listed in Box 2.                                head trauma. They also see PI                      exercises to enhance coordination,
   Of speci®c interest to this paper                exercises as a possible tool for                   sensory awareness, and performance
are claims related to motor learning.               management or improvement of                       on functional tasks. These
A main aspect of PI sessions                        physical ailments including multiple               recommendations are derived from
marketed to the ®tness consumer is                  sclerosis, ®bromyalgia and chronic                 the ®eld of motor learning, which
the aesthetic bene®t of a longer,                   pain.                                              deals with the experimental study of
leaner appearance that comes from                      The claims made by current PI                   skill acquisition and performance.
improved posture. Dancers are told                  practitioners regarding the motor
they can develop more graceful                      learning bene®ts of their exercises
movement patterns. Athletes are                     are overwhelmingly                                 Recommendations
assured they will maximize their                    unsubstantiated. Only a small                      to practitioners
biomechanical eciency through                      number of published experimental                   of Pilates-inspired
more appropriate muscle synergies.                  studies document measured                          movement
A growing number of rehabilitation                  improvements in posture or
                                                                                                       Practitioner goals
professionals are attracted to PI                   functional tasks that are
exercises due to the promise of                     unequivocally attributable to PI                   PI practitioners have three
regained function after events that                 exercises (Parrott 1993, Fitt et al.               important learning goals, which are

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                                                                                                      environment. Such tasks include
                                                                                                      walking, reaching, lifting and other
                                                                                                      activities of daily living and work.
                                                                                                      They also include complex
                                                                                                      movement sequences executed by
                                                                                                      athletes and performing artists.
                                                                                                      Third, practitioners want to
                                                                                                      structure practice to facilitate
                                                                                                      retention and transfer.
                                                                                                         Though practice by itself is often
                                                                                                      considered the most important
                                                                                                      variable for successful retention and
                                                                                                      transfer-hence the adage that
                                                                                                      practice makes perfect-it is certainly
                                                                                                      not the only one. The conditions
                                                                                                      under which practice takes place
                                                                                                      have a great in¯uence on the
                                                                                                      amount of skill learning. Some
                                                                                                      practice conditions appear to have a
                                                                                                      positive e€ect on learning, whereas
                                                                                                      others seem to result in less
                                                                                                      successful learning. It is beyond the
                                                                                                      scope of this paper to provide a
Fig. 2 In a health club, clients are kneeling on the spring-loaded carriages of portable Reformers    thorough discussion of all practice
and using their pectoral, biceps brachii, and anterior deltoid muscles to pull against the arm        conditions. For more in-depth
straps. This action results in a backward movement of the spring-loaded carriage. Equal attention     information, the reader is referred to
is paid to concentric and eccentric contractions. The group exercise instructor is providing verbal   several appropriate sources (Feltz &
cues and imagery. Desired functional activities include any actions requiring dynamic trunk and
                                                                                                      Landers 1983, Landin 1994, Magill
scapular stabilization. Reproduced by kind permission of Balanced Body1, Inc. (1999) and
Polestar1 EducationLLC (1999).                                                                        1998, McCullagh 1993, Rose 1997,
                                                                                                      Schmidt & Lee 1999, Shea et al.
                                                                                                      1993). The structure of practice
outlined in Box 3. First, they want                 Second, practitioners want clients to             becomes all the more relevant for PI
clients to retain the exercises they are            be able to transfer the coordination              routines, because the latter rely on
teaching. In other words, they want                 patterns and sensory awareness                    low numbers of repetitions. Pilates
clients to develop independent                      learned during sessions to functional             (1934, Pilates & Miller 1945)
control of new movement patterns.                   tasks outside of the practice                     stressed the importance of few
                                                                                                      repetitions (usually less than 10 per
                                                                                                      exercise). Instead, he emphasized
 Box 3 Learning goals of Pilates-inspired practitioners                                               deliberate practice during which
                                                                                                      conscious attention is focused on
 . Clients retain PI exercises taught by practitioner and can perform PI exercises without            relevant task-related stimuli and
   practitioner's corrections.                                                                        processes. Current PI practitioners
 . Breathing, core control, body awareness, and coordination patterns learned from PI
                                                                                                      follow his lead and recommend 5±10
   exercises transfer to functional tasks.
 . Practice is structured to facilitate retention and transfer.                                       repetitions for most exercises (e.g.
                                                                                                      Robinson & Thomson 1997; Evans
                                                                                                      & Stott Merrithew 1998a, 1998b;
                                                                                                      Gallagher & Kryzanowska 1999).
 Box 4 How to increase the e¡ectiveness of Pilates-inspired exercises
                                                                                                      Hence, the amount of practice may
                                                                                                      be less critical for learning than the
 .   Observe the learning-performance distinction.                                                    conditions of practice, and PI
 .   Use augmented verbal cues, self-talk and imagery.
 .   Use augmented information feedback judiciously.
                                                                                                      practitioners play an essential role in
 .   Vary the context of practice trials.                                                             structuring these conditions. Five
 .   Use the right practice tasks to maximize transfer to functional tasks.                           important recommendations for
                                                                                                      how practice conditions may be

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                                                                                                         structured, in order to accomplish
                                                                                                         the goals of retention and transfer,
                                                                                                         will be described in the following
                                                                                                         paragraphs. Recommendations are
                                                                                                         summarized in Box 4.


                                                                                                         Recommendations for
                                                                                                         practitioners
                                                                                                         Recommendation1: observe the
                                                                                                         learning-performance distinction
                                                                                                         Motor learning has been de®ned as
                                                                                                         `a set of processes associated with
                                                                                                         practice or experience leading to
                                                                                                         relatively permanent changes in the
                                                                                                         capability for movement' (Schmidt
                                                                                                         & Lee 1999). One important aspect
                                                                                                         of this de®nition is the so-called
                                                                                                         learning-performance distinction.
                                                                                                         Learning is not a merely a change in
                                                                                                         behaviour, because changes can be
Fig. 3 In a studio setting, a client is straddling the Ladder Barrel. She is lifting the pelvis o€ the
                                                                                                         transient. For instance, augmented
barrel by activating her adductors, hamstrings, pelvic ¯oor muscles, and external rotators. This         information feedback (AIF) can be
complex posture can also be done with feet parallel. The instructor may provide cues or feedback.        provided to learners about the
Examples of applications include ballet and horseback riding. Reproduced by kind permission of           success of their movements in the
Elizabeth Larkam and Balanced Body1, Inc. (1999).                                                        environment, or about the quality of
                                                                                                         their movement patterns. An




                                                                                                         Fig. 4 In a studio or rehabilitation setting, a
                                                                                                         ballet dancer is using the Trapeze Table
                                                                                                         (Cadillac) to increase awareness of proper
                                                                                                         hamstring and hip extensor activation, in
                                                                                                         conjunction with core control and spine
                                                                                                         articulation. She is pressing with her left foot
                                                                                                         against a spring-loaded bar. A therapist may
                                                                                                         spot for safety by placing a hand over the
                                                                                                         dancer's left foot to prevent it from slipping
                                                                                                         o€ the bar. This exercise can be done in many
                                                                                                         variations to facilitate intratask transfer.
                                                                                                         Reproduced by kind permission of Elizabeth
                                                                                                         Larkam and Balanced Body1, Inc. (1999).

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                                                                                                      instructors to direct the learner's
                                                                                                      attention to task-relevant stimuli
                                                                                                      and to prompt correct task
                                                                                                      execution (Landin 1994).
                                                                                                      Furthermore, cue words can be used
                                                                                                      by learners themselves prior to
                                                                                                      carrying out a task, in which case
                                                                                                      they are referred to as self-talk
                                                                                                      regimens (STR). Short-term memory
                                                                                                      is considered to be limited to ®ve to
                                                                                                      nine separate pieces of information
                                                                                                      (Miller 1956; Rose 1997). The
                                                                                                      number may be lower for some
                                                                                                      populations, such as stroke patients.
                                                                                                      Therefore, too many instructions
                                                                                                      may overload a learner trying to
                                                                                                      attend to task-relevant stimuli and
                                                                                                      organize a new response. AVC are
                                                                                                      somewhat like instructions, but
                                                                                                      because they consist of fewer words
Fig. 5 During an advanced mat class, a ®tness client is executing a front leg pull. This action       and only address a few important
requires activation of deep abdominal and spinal musculature, as well as posterior shoulder girdle    aspects of the task, they are thought
stabilizers. It can also be done prone (facing down) as well as sidelying. Switching among di€erent   to place less load on short-term
postures assists the client in maintaining axial elongation and core control during a variety of
                                                                                                      memory and increase chances that
upright functional activities and is a precursor to sport-speci®c conditioning. Reproduced by kind
permission of Elizabeth Larkam and Balanced Body1, Inc. (1999).                                       the learner will retain the correct
                                                                                                      motor pattern. For example, in the
                                                                                                      Reformer group exercise depicted in
                                                                                                      Figure 2, the practitioner might use
example of AIF might be a                           sessions. Rather, the temporary and               the cue `funnel your ribs into your
practitioner's verbal or tactile                    relatively permanent in¯uences of                 pelvic bowl.' Such a cue might be
information about the degree of                     instructional methods must be taken               more e€ective than giving a detailed
spine extension and rotation                        into account. The learning-                       explanation on how to use the deep
achieved during the prone Chair                     performance distinction is a crucial              abdominal, spinal and pelvic ¯oor
exercise depicted in Figure 1. Until                aspect of evaluating the success of               muscles for dynamic trunk
recently, it was thought that                       any rehabilitation or conditioning                stabilization. Similarly, in the
providing a lot of AIF was better for               system. Practitioners should strive               Ladder Barrel exercise in
learning. Indeed, laboratory                        to be aware of this distinction and               Figure 3, the phrase `sit tall in the
experiments show that when                          understand that clients may be                    saddle' may be more e€ective in
learners receive AIF after each                     performing PI exercises or                        constraining the body's degrees of
practice trial, their performance is                functional tasks very di€erently                  freedom than telling the client to
usually better when compared to                     when not in the rehabilitation center             activate a variety of separate
that of learners who receive                        or studio. One way to assess learning             muscle groups.
feedback after fewer trials.                        is to ask the client at the beginning                Although AVC and STR have not
However, once AIF is removed and                    of the session to demonstrate an                  been as extensively studied as some
learners must rely on their own                     exercise or functional activity that              other instructional methods,
recollection of the movement, those                 was practiced last session. This type             research evidence (Landin 1994)
who received less in practice are                   of approach can give an estimate of               suggests they are quite useful.
typically more successful (Salmoni et               how much was learned.                             Landin makes several
al. 1984, Schmidt 1991a, Schmidt &                                                                    recommendations for using verbal
Lee 1999).                                          Recommendation 2: use augmented                   cues: First, he suggests using two
   It is evident from the example of                verbal cues, self-talk, and imagery               words or less for STR, and up to
AIF that one cannot always predict                  Augmented verbal cues (AVC) are                   four words for AVC. Second, if cues
learning from the quality of                        concise phrases, often consisting of              address di€erent parts of a task, it is
performance during practice                         one or two words, which are used by               important to consider how those

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parts are interrelated. Cues should       physical practice. It can also be used     action (Winstein & Schmidt 1990).
not disrupt the normal rhythm of          by itself, in which case it is called      A third guideline for AIF is that the
the movement pattern by drawing           mental practice. Although not              learner must know how to interpret
too much attention to one part of         always e€ective, telling learners to       it (Schmidt 1991b). A person with
the task and creating arti®cial           mentally imagine or mentally               little knowledge of anatomy will not
breaks between parts. For example,        practice the correct movement              be able to understand a statement
breathing relies on a smooth              pattern frequently appears to have         such as `you aren't using your
transition between in-breath and          positive e€ects on retention               intercostals.' Finally, giving AIF
out-breath. Too much emphasis on          Feltz & Landers 1983, Schmidt &            during, or right after, a movement
the in-breath can create breath           Lee 1999). Therefore, cues                 may not always be a good idea. A
holding and destroy the movement's        such as `funnel your ribs' or              learner who is trying to master an
¯ow. Landin's third                       `sit tall' may act like mnemonic           exercise involving all four limbs
recommendation is to consider the         prompts that help evoke task-              while maintaining core control, such
variability of the environment and        relevant muscular activity during          as the Trapeze Table exercise in
whether it is important for the           exercises or related functional            Figure 4, may be overly distracted if
learner to focus on internal body         activities.                                the practitioner interrupts with
stimuli, or external environmental                                                   helpful advice. For extended PI
stimuli, or both. Many tasks in sport                                                routines that last 30 s or more, it
and everyday life require switching       Recommendation 3: use augmented            may be best to give AIF
attention between internal and            information feedback judiciously           periodically. For discrete PI
external stimuli (Nide€er 1993). PI       As already stated, AIF is task-            movements like doing a head and
exercises typically focus the learner     related information that helps the         spine roll-up to a sitting position, it
entirely on internal body sensations,     learner correct errors in the              may be best to wait a few seconds
which may be necessary during             movement's outcome and pattern.            after a trial before giving AIF. This
initial phases of recovery or             Research suggests that it should be        may give the learner an opportunity
conditioning, or when an exercise is      used judiciously. First and most           to focus on the ¯eeting sensory
®rst introduced. However, if              importantly, too much information          impression of what the movement
switching between an internal and         about errors may overload the              felt like, before receiving
external focus is part of the             learner's short-term memory, direct        information about its correctness
functional activities the client must     attention away from important              (Swinnen et al. 1990).
perform, practitioners should create      sensory stimuli, and prevent the
situations that require switching.        development of proper coordination         Recommendation 4: vary the context
Fourth, Landin states that STR can        patterns. Therefore, PI practitioners      of practice trials
be used in some cases to supplant         should resist the temptation to point      Whereas practice conditions such as
AIF by priming the correct action         out all the errors a learner is making     frequent AIF temporarily enhance
before it takes place. This is            and suggest corrections. It is more        performance but degrade learning,
particularly useful in group exercise     useful to select one or two errors         others have the opposite e€ect. One
classes, outside of class when the        appropriate to skill level. For            example for this occurs when
instructor is not present, or if there    example, beginners might need              contextual interference is
is only one chance to `do it right', a    corrections related to breathing and       manipulated during practice. Low
situation that exists in many             maintaining a neutral spine while          contextual interference occurs when
competitive sports. Finally, skill        doing supine leg circles on the mat.       all repetitions of Task A are
level must be considered when             More advanced clients might need           followed by all repetitions of Task
designing cues. Beginners need cues       pointers on how to maintain                B, all repetitions of Task C, and so
that re¯ect their less re®ned             dynamic trunk alignment and                on. For example, a client might do 8
understanding of the task and allow       scapulo-humeral rhythm when                supine leg presses on the Reformer,
them to get the general idea of the       doing any exercises involving trunk        followed by eight toe raises and
correct action, whereas more              lateral ¯exion and arm reaching. A         eight jumps. By contrast, high
advanced learners may need to focus       second recommendation for using            contextual interference is present
on speci®c errors. Rose (1997)            AIF is to taper o€ the amount of           when one repetition of Task A is
makes the additional                      feedback as the learner becomes            followed by one repetition of Task
recommendation that cues should           more pro®cient and can increasingly        B, one repetition of Task C, and so
help evoke task-relevant imagery.         rely on internal representations and       on. In other words, a leg press is
Mental imagery can be used during         sensory awareness of the correct           followed by a toe raise, a jump,

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another leg press, another toe raise,    has been de®ned as a gain or loss in          However, even when movement
another jump, and so on. High            the capability for performing a            patterns appear similar, positive
contextual interference is thought to    criterion task as a result of prior        transfer can be negligible. For
represent a number of `real-life'        experience with a practice task (Ellis     example, supine jumps on the
movement conditions with                 1965, Schmidt & Young 1987). One           Reformer are practiced to prepare
constantly alternating tasks.            goal of practice is to develop the         dancers and athletes for standing
   Compared to low contextual            capability to adapt a previously           vertical jumps. Yet research
interference, high contextual            learned action to new settings, or to      indicates that supine jumping
interference tends to depress            perform variations of the action.          practice does not necessarily result
performance during practice.             This is called near transfer or            in positive transfer to upright
Beginners sometimes report feeling       intratask transfer (Sage 1984, Magill      jumping (McLain et al. 1997). The
frustrated or confused by high           1998, Schmidt 1991b). For example,         authors of the latter study remarked
contextual interference. It is           during the hip extensor and                that a during a jump on the
therefore tempting to conclude that      hamstring exercise performed on the        Reformer, the legs may be placed up
it also causes less skill learning.      Trapeze Table in Figure 1, positive        to 30 degrees above the plane of the
However, numerous experiments            intratask transfer means successfully      body, creating signi®cant di€erences
have shown that even for beginners,      doing the movement with internal or        in jump strategies between the
high contextual interference is often    external hip rotation, with the entire     supine and standing conditions and
more bene®cial to skill learning than    spine resting on the Table, with both      possibly reducing successful
low contextual interference (Magill      legs at once, and other                    transfer. In a biomechanical study,
1998, Schmidt & Lee 1999).               modi®cations. On the whole,                Self et al. (1994) found a di€erent
Therefore, practice under high-          intratask transfer as described above      relationship between force and knee
interference conditions may actually     tends to be positive, though not                                      Â
                                                                                    angle during a supine plie on the
be preferable in the long run.           always very large (Schmidt & Young         Reformer and a standing plie,  Â
Practitioners should be aware that       1987).                                     suggesting that the two tasks are
learners will be often be performing        A second goal of practice is to use     di€erent.
functional tasks under conditions of     prior experience with one action to           PI practitioners should bear in
high contextual interference and         successfully execute a di€erent            mind that two overtly similar tasks
should create routines that              action. This is called far transfer or     may in fact require di€erent muscle
progressively approximate these          intertask transfer (Sage 1984, Magill      synergies and be accompanied by
conditions. Using the example of the     1998, Schmidt 1991b). The overall          di€erent sensory input. Experience
mat exercise in Figure 5, a client       similarity of coordination patterns        with one task may not give the
might do 1±2 repetitions of a            seems to be one of several factors         learner the necessary capability to
posture that requires supine trunk       determining the degree of positive         do the other task. Conversely, two
and shoulder girdle stabilization,       intertask transfer. Very di€erent          tasks that appear dissimilar may
followed by 1±2 repetitions of the       patterns, such as swimming and             actually involve similar underlying
same posture in a prone position,        volleyball, do not transfer positively     muscle synergies, sensory stimuli, or
and 1±2 sidelying. The client is         to one another (Nelson 1957,               cognitive strategies. This principle is
challenged to exert sensory              Schmidt & Lee 1999). The same              referred to as transfer-appropriate
awareness, and proper control of         principle probably applies to              processing (Lee 1988, Rose 1997).
core and shoulder girdle muscles,        two PI exercises that use both             Practitioners should ask themselves
while switching tasks.                   di€erent pieces of equipment and           whether the exercises they assign
                                         di€erent body parts, such                  provide learners with an
                                         as lateral trunk ¯exion on the             opportunity to practice the internal
Recommendation 5: use the right          Reformer and seated leg                    processing they will need for
practice tasks to maximize skill         extension on the Chair. When               functional activities in sport, dance,
transfer                                 movement patterns are reasonably           or everyday life. Care should be
Learning is typically evaluated          similar, intertask transfer is             taken to ensure a transition from
through retention and transfer tests.    frequently small-to-moderate and           supine, non-weight bearing activities
Retention involves executing a given     positive (Schmidt & Lee 1999). For         to bipedal weightbearing activities
movement at a later time, whereas        example, doing a pelvic bridge on          (Loosli & Herold 1992). Practice
transfer is the application of a         the mat may transfer positively to         with supine exercises alone may not
previously acquired movement skill       doing the same exercise on the             translate into improved alignment
to new situations. Formally, transfer    Reformer.                                  or stability when standing up.

                                                           106
                       J O U R NAL O F B O DY W O R K AN D MOV E M E N T TH E R APIE S APRIL 20 0 0
Pilates-inspired exercise


                                                                                                Evans B, Stott Merrithew M 1998b Essential
 Box 5 Checklist for aspiring practitioners                                                          Reformer Manual. Toronto: Stott
                                                                                                Feltz DL, Landers DM 1983 The e€ects of
 .   Investigate a number of programs.                                                               mental practice on motor skill learning
 .   Consider program availability, cost, and duration.                                              and performance: a meta-analysis.
 .   Trainers and certi®ers must have sucient experience with the desired client population.        Journal of Sport Psychology 5: 25±57
 .   Instructional modules dealing with anatomy, physiology, and clinical populations should    Fitt S, Sturman J, McClain-Smith S 1994
     be overseen by individuals with proper training.                                                E€ects of Pilates-based conditioning on
 .   Certi®cation examinations should include oral, written, and case study portions.                strength, alignment, and range of motion
 .   To avoid con¯ict of interest, trainers should not have dual roles as certi®ers.                 in university ballet and modern dancers.
 .   Trainers should have up-to-date knowledge of motor learning principles and ®ndings.             Kinesiology and Medicine for Dance
                                                                                                     16: 36±51
                                                                                                Gallagher S, Kryzanowska R 1999 The
                                                                                                     Pilates Method of Body Conditioning.
                                                                                                     BanBridge Books, Philadelphia
Summary and                                      1999, Polestar1 Education 1999,                Krasnow DH, Chat®eld SJ, Barr S, Jensen
recommendations for                              Stott Conditioning 1999). Some                      JL, Dufek JS 1997 Imagery and
the future                                       training centers also mention                       conditioning practices for dancers. Dance
                                                 practice conditions and teaching                    Research Journal 29: 43±64
                                                 strategies in their informational              Larkam E 1999 Personal communication
In the preceding paragraphs, several
                                                                                                Larkam E, Brownstein B 1998 Balanced
recommendations for maximizing                   literature (e.g. Physicalmind                       body: application of Pilates-evolved
the learning bene®ts of PI sessions              Institute 1999, Polestar1 Education                 exercises in ®tness, training and
were introduced. However, these                  1999, Stott Conditioning 1999, The                  rehabilitation. Unpublished manuscript
recommendations are only                         Pilates Center 1999), which suggests           Larkam E, Nichols J 1999 The history and
preliminary. To date, no published               that the trainers have some formal                  evolution of techniques in¯uenced by
                                                                                                     those of Joseph H. Pilates, 1920±1999.
studies have been conducted in                   knowledge of motor learning                         Presentation at the American College of
which an attempt was made to                     principles. However, it is best for                 Sportsmedicine, New Orleans
discover causal links between                    prospective students to inquire                Landin D 1994 The role of verbal cues in skill
practice conditions, such as the ones            before beginning any program.                       learning. Quest 46: 299±313
                                                    This paper was intended to                  Lee TD 1988 Transfer-appropriate
described in this paper, and
                                                                                                     processing: a framework for
improvements on PI exercises or                  provide an overview of current                      conceptualizing practice e€ects in motor
functional skills. This oversight                claims on the e€ectiveness of PI                    learning. In: Meijer OG, Roth K. eds.
should certainly be remedied.                    exercises. Readers were introduced                  Complex Movement Behaviour: `The'
   A second critical issue is the                to several practice conditions and                  Motor-Action Controversy. Elsevier,
training and certi®cation that PI                principles of motor learning that                   Amsterdam
                                                                                                Loosli AR, Herold D 1992 Knee
practitioners receive. Assumptions               may enhance the usefulness of PI                    rehabilitation for dancers using a Pilates-
about learning, and the instructional            exercises for improving functional                  based technique. Kinesiology and
techniques that practitioners                    movement. Suggestions were made                     Medicine for Dance 14: 1±12
themselves are taught, may be the                for aspiring practitioners seeking             Magill RA 1998 Motor Learning: Concepts
most important sources of in¯uence               training and certi®cation. Finally, it              and Applications (5th ed). Columbus,
                                                                                                     Ohio, McGraw-Hill
on their own teaching methods and                must again be stated that controlled           McCullagh P 1993 Modeling: learning,
behaviours (Larkam 1999).                        experimental studies are urgently                   developmental, and social psychological
Therefore, the selection of a suitable           needed to verify the e€ectiveness of                considerations. In: Singer RN, Murphy
training and certi®cation program is             PI exercises for enhancing                          M, Tennant LK, eds. Handbook of
                                                 functional skills in a diversity of                 Research on Sport Psychology.
critical for the aspiring practitioner.
                                                                                                     Macmillan, New York
A checklist of important                         populations.                                   McLain S, Carter CL, Abel J 1997 The e€ect
considerations is provided in Box 5.                                                                 of a conditioning and alignment program
Training courses typically introduce                                                                 on the measurement of supine jump
the practitioner to functional                                                                       height and pelvic alignment when using
anatomy, a wide range of mat and                 REFERENCES                                          the Current Concepts Reformer. Journal
                                                                                                     of Dance Medicine and Science 1:
equipment exercises, and supervised              Balanced Body1 1999                                 149±154
hands-on teaching experiences.                        www.balancedbody.com                                                    Á
                                                                                                McMillan A, Proteau L, Lebe R-M 1998 The
Written and/or oral certi®cation                 Body Control Pilates 1999                           e€ect of Pilates-based training on
examinations are also provided                        www.bodycontrol.co.uk                          dancers' dynamic posture. Journal of
                                                 Ellis HC 1965 The Transfer of Learning. New         Dance Medicine and Science 2: 101±107
(e.g. Body Control Pilates 1999,                      York: Macmillan                           Miller GA 1956 The magical number seven,
Physicalmind Institute 1999, Pilates             Evans B, Stott Merrithew M 1998a Mat                plus minus two: some limits on our
Institute 1999, Pilates1 Method                       Manual. Toronto: Stott

                                                                     107
                             J O U R NAL O F B O DY W O R K AN D MOV E M E N T TH E R APIE S APRIL 20 0 0
Lange et al.


     capacity for processing information.       Rose DJ 1997 A Mulitlevel Approach to the      Self BP, Bagley AM, Triplett TL, Paulos LE
     Psychological Review 63: 81±97                 Study of Motor Control and Learning.            1996 Functional biomechanical analysis
Nelson DO 1957 E€ects of swimming on the            Allyn & Bacon, Massachusetts: Needham           of the Pilates-based reformer during
     learning of selected gross motor skills.       Heights                                                   Â
                                                                                                    demi-plie movements. Journal of Applied
     Research Quarterly 28: 374±378             Sage GH 1984 Motor Learning and Control:            Biomechanics 12: 326±337
Nide€er RN 1993 Attention control training.         A Neuropsychological Approach. Wm.         Shea CH, Shebilske WL, Worchel S 1993
     In: Singer RN, Murphy M, Tennant LK            C. Brown, Dubuque, Iowa                         Motor Learning and Control. Prentice-
     (eds) Handbook of Research on Sport        Salmoni AW, Schmidt RA, Walter CB 1984              Hall: Englewood Cli€s, New Jersey
     Psychology. Macmillan, New York                Knowledge of results and motor learning:   Stott Conditioning 1999
Parrott AA 1993 The e€ects of Pilates               a review and critical reappraisal.              www.stottconditioning.com
     technique and aerobic conditioning on          Psychological Bulletin 95: 355±386         Swinnen SP, Schmidt RA, Nicholson DE,
     dancers' technique and aesthetic.          Schmidt RA 1991a Frequent augmented                 Shapiro DC 1990 Information feedback
     Kinesiology and Medicine for Dance             feedback can degrade learning: Evidence         for skill acquisition: instantaneous
     15: 45±64                                      and interpretations. In: Requin J,              knowledge of results degrades learning.
Physicalmind Institute 1999                         Stelmach GE, eds. Tutorials in motor            Journal of Experimental Psychology:
     www.themethod.com                              neuroscience. Kluwer, Dordrecht,                Learning, Memory and Cognition
Pilates JH 1934 Your Health. Presentation           Netherlands                                     16: 706±716
     Dynamics, Incline Village, Nevada          Schmidt RA 1991b Motor learning and            The Balanced Body Studio 1999
Pilates JH, Miller WJ 1945 Return to Life           performance. Human Kinetics,                    www.pilates.uk.com
     through Contrology. Presentation               Champaign, Illinois                        The Pilates Center 1999
     Dynamics, Incline Village, Nevada          Schmidt RA, Lee TD 1999 Motor control and           www.thepilatescenter.com
Pilates Institute 1999 www.pilates.net              learning, 3rd ed. Champaign, Illinois:     Winstein CJ, Schmidt RA 1990 Reduced
Pilates1 Method 1999                                Human Kinetics                                  frequency of knowledge of results
     www.pilates-studio.com                     Schmidt RA, Young DE 1987 Transfer of               enhances motor skill learning.
Polestar1 Education 1999                            movement control in motor learning. In:         Journal of Experimental Psychology:
     www.polestareducation.com                      Cormier SM, Hagman JD, eds. Transfer            Learning, Memory and Cognition 16:
Robinson L, Thomson G 1997 Body Control:            of Learning. Academic Press, Orlando,           677±691
     Using Techniques Developed by Joseph H.        Florida
     Pilates. BanBridge Books, Philadelphia




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                            J O U R NAL O F B O DY W O R K AN D MOV E M E N T TH E R APIE S APRIL 20 0 0

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Jbmt 00 maximizing the benets of

  • 1. REVIEW Maximizing the bene®ts of Pilates-inspired exercise for learning functional motor skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Claudia Lange, Viswanath Unnithan, Elizabeth Larkam, Paula M. Latta Abstract Joseph Pilates (1880±1967) created a system of ®tness exercises that are still practiced in a more or less modi®ed form. Within the last two decades, there has been a signi®cant increase in the popularity of such Pilates-inspired (PI) exercises. This paper describes current claims for the e€ectiveness of PI exercises and comments on their validity. Motor learning principles and ®ndings are applied to make recommendations for using PI exercises to enhance the execution of functional movement tasks. The learning-performance distinction, augmented information Claudia Lange PhD feedback, contextual interference, skill transfer and augmented verbal cues are Viswanath B. Unnithan PhD discussed. Finally, suggestions are made for aspiring PI practitioners seeking training Department of Exercise and Sport Science, and certi®cation. # 2000 Harcourt Publishers Ltd University of San Francisco Elizabeth Larkam MA Center for Sports Medicine, Saint Francis Memorial Joseph Pilates and and soon opened an exercise studio Hospital, San Francisco Paula M. Latta BS Contrology with his wife Clara. Pilates wrote a Peninsula RSI, Redwood City, CA slender volume (1934) outlining his Joseph Pilates was born in Germany system of Contrology, which he in 1880. A sickly child, he used described as a set of healthful Correspondence to: C. Lange Department of Exercise and Sport physical exercise to turn himself into lifestyle changes and corrective Science, University of San Francisco, a ®t adult. In 1912, Pilates moved to exercises. A later booklet (Pilates 2130 Fulton St, San Francisco, the UK and held a variety of & Miller 1945) features a number of CA 94117-1080, USA. occupations, including boxer and the exercises. His methods and Tel.: +1 415 422 6874; Fax: +1 415 422 6040; self-defense trainer. During World specialized ®tness equipment E-mail: langec@usfca.edu War I, while interned in a prison achieved popularity with dance This research was conducted in the Department of camp for German nationals, he professionals such as George Exercise and Sport Science, University of San taught his ®tness exercises to Balanchine and Martha Graham, Francisco, 2130 Fulton St, San Francisco, inmates. Upon returning to but were largely unknown to the CA 94117-1080, USA Germany after the war, he gave general public. Pilates died in 1967. exercise classes to police and A handful of students have carried Received October 1999 military personnel and interacted on his teachings and in¯uenced Revised November 1999 with members of the avant-garde numerous other individuals to learn Accepted December 1999 ........................................... dance community, such as Rudolf and teach his exercises. As a result, Journal of Bodywork and Movement Therapies (2000) von Laban and Hanya Holm. In the name Pilates has become 4(2), 99^108 # 2000 Harcourt Publishers Ltd 1926, he moved to New York City associated with a form of movement 99 J O U R NAL O F B O DY W O R K AN D MOV E M E N T TH E R APIE S APRIL 20 0 0
  • 2. Lange et al. that is increasingly popular in Considering the widespread Fundamentals), and Chinese clinical and ®tness settings. application and adaptation of these medicine. Today, these (more or less Pilates (1934; Pilates & Miller exercises, there is a growing need to modi®ed) exercises are known 1945) made bold claims for the objectively assess their outcomes collectively as Pilates, Pilates-based bene®ts of Contrology. For and bene®ts. or Pilates-evolved. It is not the goal example, he stated that it would The purpose of this paper is to of this paper to distinguish among prevent coronary heart disease, evaluate current claims on the di€erent exercise styles that are increase muscular power, and reduce learning bene®ts of exercises derived based on Pilates' teachings. Rather, the risk of respiratory ailments. He from the system developed by all exercises emanating from those also stated that it would result in Pilates. Motor learning principles established by Pilates will be de®ned complete voluntary control of the and ®ndings will be used as a model as Pilates-inspired (PI). There is an body. He described Contrology as a to make recommendations for ongoing discourse between Pilates' `balance' or `complete coordination administering Pilates-type exercises central ideas and movement of body, mind, and spirit' achieved to enhance functional movement routines, and other systems of by relinquishing strenuous exercises skills. Finally, suggestions will be movement and rehabilitation. The and deliberately performing made for aspiring practitioners of de®ning characteristics of PI functional activities in a posturally these exercises seeking training and exercises are listed in Box 1. appropriate manner. Despite Pilates' certi®cation. Examples of equipment and assurances (1934, Pilates & Miller exercises based on Pilates' designs 1945) that he had `scienti®cally' are shown in Figures 1±5. proven the e€ectiveness of his Claims on the learning approach, he did not subject his e¡ectiveness of Current claims for claims to experimental testing and Pilates-inspired Pilates-inspired exercises maintained that such testing was exercises unnecessary. A sampling of relevant sources The legacy of Pilates Within the last two decades, there reveals three categories of claims on has been a signi®cant increase in the Pilates was in¯uenced by hatha the bene®ts of PI exercises: popularity of exercises based on yoga, gymnastics, modern dance enhanced physiological functioning, Pilates' teachings. In the USA alone, and other movement systems. He enhanced psychological functioning more than 700 studio and designed about 40 mat exercises and and learning or re-learning of rehabilitation sites use his methods hundreds of exercises for his functionally e€ective postural sets (Larkam & Brownstein 1998). A specialized equipment (Larkam & and motor patterns (e.g. Robinson directory of UK practitioners (Body Nichols 1999). His exercises have & Thomson 1997, Balanced Body1 Control Pilates 1999) lists roughly been further in¯uenced by ®elds as 1999, Gallagher & Kryzanowska 100 studios. Practitioners can also diverse as physical therapy, somatics 1999, Physicalmind Institute 1999, be found in Africa, Asia, Australia (e.g. Feldenkrais MethodTM, Body/ Stott Conditioning 1999, The and New Zealand, Europe and Mind Centering1, Bartenie€ Balanced Body Studio 1999, Pilates South America. In order to understand the signi®cance of Box 1 De¢ning characteristics of Pilates-inspired exercises Pilates for functional skill improvement, it is necessary to be . Progressively enhance breath, core (body center), shoulder girdle, and limb control. aware of claims made by current . Movements are slow and deliberate, with few repetitions (usually 5±10). practitioners regarding the learning . Programs are highly individualized. One-on-one, dyad, and small group sessions are bene®ts of their exercise sessions. conducted. This can serve as a basis for . Exercises are done on ¯oor mats and equipment. . Exercises are done from lying, sitting, kneeling, standing and other postures. practical recommendations about . Some equipment uses springs to provide variable resistance. improving the quality of sessions. . Main piece of equipment is the Universal Reformer, a frame with a padded carriage Such recommendations can that slides back and forth within the frame. Adjustable springs attach from the carriage generically be derived from the to the frame. The carriage may be moved by pushing it, or by pulling on straps placed ®ndings of existing experiments on around arms or legs. . Other large pieces of equipment include the TrapezeTable (Cadillac), Combo (Wunda) motor skill learning. However, more Chair, Ladder and Step Barrels, and Ped-a-Pul. Pilates-speci®c recommendations . Small pieces of equipment include exercise balls, foam rollers, rotating disks, balance can only emerge with scienti®c study boards, resistance rings, small arcs, and boxes. of Pilates-type exercises themselves. 100 J O U R NAL O F B O DY W O R K AN D MOV E M E N T TH E R APIE S APRIL 20 0 0
  • 3. Pilates-inspired exercise Box 2 Claims made on the e¡ectiveness of Pilates-inspired exercises Enhanced physiological functioning . ¯exibility and range of motion . muscular strength . muscular endurance . muscular power . cardiorespiratory ®tness Enhanced psychological functioning . mood . motivational state . attentional focus . enjoyment of life . energy and zest Enhanced motor learning . core control . static and dynamic posture . intralimb and interlimb coordination . aesthetically pleasing movement form . body awareness . static and dynamic balance 1994, Krasnow et al. 1997, McMillan et al. 1998). Roughly an equal number of studies also report the failure of PI exercises to elicit Fig. 1 A golfer has been diagnosed with spinal facette lock. During rehabilitation, the therapist is improvements (Fitt et al. 1994, giving verbal and tactile information to guide her to the appropriate position of spine extension Krasnow et al. 1997, McLain et al. and rotation. The patient is lying on the Trapeze Table and is using the spring-loaded pedals of 1997). Despite the lack of the Combo (Wunda) Chair to assist her action. Desired functional activity might be a golf swing. supportive, research-based data on Reproduced by kind permission of Balanced Body1, Inc. (1999) and Polestar1 EducationLLC PI exercises, anecdotal reports by (1999). practitioners and clients indicate that signi®cant bene®ts do indeed exist. It is therefore worthwhile to Institute 1999). To give an idea of disrupt normal coordination, such make preliminary recommendations the extent of these claims, examples as orthopedic surgery, stroke, and for maximizing the bene®ts of PI are listed in Box 2. head trauma. They also see PI exercises to enhance coordination, Of speci®c interest to this paper exercises as a possible tool for sensory awareness, and performance are claims related to motor learning. management or improvement of on functional tasks. These A main aspect of PI sessions physical ailments including multiple recommendations are derived from marketed to the ®tness consumer is sclerosis, ®bromyalgia and chronic the ®eld of motor learning, which the aesthetic bene®t of a longer, pain. deals with the experimental study of leaner appearance that comes from The claims made by current PI skill acquisition and performance. improved posture. Dancers are told practitioners regarding the motor they can develop more graceful learning bene®ts of their exercises movement patterns. Athletes are are overwhelmingly Recommendations assured they will maximize their unsubstantiated. Only a small to practitioners biomechanical eciency through number of published experimental of Pilates-inspired more appropriate muscle synergies. studies document measured movement A growing number of rehabilitation improvements in posture or Practitioner goals professionals are attracted to PI functional tasks that are exercises due to the promise of unequivocally attributable to PI PI practitioners have three regained function after events that exercises (Parrott 1993, Fitt et al. important learning goals, which are 101 J O U R NAL O F B O DY W O R K AN D MOV E M E N T TH E R APIE S APRIL 20 0 0
  • 4. Lange et al. environment. Such tasks include walking, reaching, lifting and other activities of daily living and work. They also include complex movement sequences executed by athletes and performing artists. Third, practitioners want to structure practice to facilitate retention and transfer. Though practice by itself is often considered the most important variable for successful retention and transfer-hence the adage that practice makes perfect-it is certainly not the only one. The conditions under which practice takes place have a great in¯uence on the amount of skill learning. Some practice conditions appear to have a positive e€ect on learning, whereas others seem to result in less successful learning. It is beyond the scope of this paper to provide a Fig. 2 In a health club, clients are kneeling on the spring-loaded carriages of portable Reformers thorough discussion of all practice and using their pectoral, biceps brachii, and anterior deltoid muscles to pull against the arm conditions. For more in-depth straps. This action results in a backward movement of the spring-loaded carriage. Equal attention information, the reader is referred to is paid to concentric and eccentric contractions. The group exercise instructor is providing verbal several appropriate sources (Feltz & cues and imagery. Desired functional activities include any actions requiring dynamic trunk and Landers 1983, Landin 1994, Magill scapular stabilization. Reproduced by kind permission of Balanced Body1, Inc. (1999) and Polestar1 EducationLLC (1999). 1998, McCullagh 1993, Rose 1997, Schmidt & Lee 1999, Shea et al. 1993). The structure of practice outlined in Box 3. First, they want Second, practitioners want clients to becomes all the more relevant for PI clients to retain the exercises they are be able to transfer the coordination routines, because the latter rely on teaching. In other words, they want patterns and sensory awareness low numbers of repetitions. Pilates clients to develop independent learned during sessions to functional (1934, Pilates & Miller 1945) control of new movement patterns. tasks outside of the practice stressed the importance of few repetitions (usually less than 10 per exercise). Instead, he emphasized Box 3 Learning goals of Pilates-inspired practitioners deliberate practice during which conscious attention is focused on . Clients retain PI exercises taught by practitioner and can perform PI exercises without relevant task-related stimuli and practitioner's corrections. processes. Current PI practitioners . Breathing, core control, body awareness, and coordination patterns learned from PI follow his lead and recommend 5±10 exercises transfer to functional tasks. . Practice is structured to facilitate retention and transfer. repetitions for most exercises (e.g. Robinson & Thomson 1997; Evans & Stott Merrithew 1998a, 1998b; Gallagher & Kryzanowska 1999). Box 4 How to increase the e¡ectiveness of Pilates-inspired exercises Hence, the amount of practice may be less critical for learning than the . Observe the learning-performance distinction. conditions of practice, and PI . Use augmented verbal cues, self-talk and imagery. . Use augmented information feedback judiciously. practitioners play an essential role in . Vary the context of practice trials. structuring these conditions. Five . Use the right practice tasks to maximize transfer to functional tasks. important recommendations for how practice conditions may be 102 J O U R NAL O F B O DY W O R K AN D MOV E M E N T TH E R APIE S APRIL 20 0 0
  • 5. Pilates-inspired exercise structured, in order to accomplish the goals of retention and transfer, will be described in the following paragraphs. Recommendations are summarized in Box 4. Recommendations for practitioners Recommendation1: observe the learning-performance distinction Motor learning has been de®ned as `a set of processes associated with practice or experience leading to relatively permanent changes in the capability for movement' (Schmidt & Lee 1999). One important aspect of this de®nition is the so-called learning-performance distinction. Learning is not a merely a change in behaviour, because changes can be Fig. 3 In a studio setting, a client is straddling the Ladder Barrel. She is lifting the pelvis o€ the transient. For instance, augmented barrel by activating her adductors, hamstrings, pelvic ¯oor muscles, and external rotators. This information feedback (AIF) can be complex posture can also be done with feet parallel. The instructor may provide cues or feedback. provided to learners about the Examples of applications include ballet and horseback riding. Reproduced by kind permission of success of their movements in the Elizabeth Larkam and Balanced Body1, Inc. (1999). environment, or about the quality of their movement patterns. An Fig. 4 In a studio or rehabilitation setting, a ballet dancer is using the Trapeze Table (Cadillac) to increase awareness of proper hamstring and hip extensor activation, in conjunction with core control and spine articulation. She is pressing with her left foot against a spring-loaded bar. A therapist may spot for safety by placing a hand over the dancer's left foot to prevent it from slipping o€ the bar. This exercise can be done in many variations to facilitate intratask transfer. Reproduced by kind permission of Elizabeth Larkam and Balanced Body1, Inc. (1999). 103 J O U R NAL O F B O DY W O R K AN D MOV E M E N T TH E R APIE S APRIL 20 0 0
  • 6. Lange et al. instructors to direct the learner's attention to task-relevant stimuli and to prompt correct task execution (Landin 1994). Furthermore, cue words can be used by learners themselves prior to carrying out a task, in which case they are referred to as self-talk regimens (STR). Short-term memory is considered to be limited to ®ve to nine separate pieces of information (Miller 1956; Rose 1997). The number may be lower for some populations, such as stroke patients. Therefore, too many instructions may overload a learner trying to attend to task-relevant stimuli and organize a new response. AVC are somewhat like instructions, but because they consist of fewer words Fig. 5 During an advanced mat class, a ®tness client is executing a front leg pull. This action and only address a few important requires activation of deep abdominal and spinal musculature, as well as posterior shoulder girdle aspects of the task, they are thought stabilizers. It can also be done prone (facing down) as well as sidelying. Switching among di€erent to place less load on short-term postures assists the client in maintaining axial elongation and core control during a variety of memory and increase chances that upright functional activities and is a precursor to sport-speci®c conditioning. Reproduced by kind permission of Elizabeth Larkam and Balanced Body1, Inc. (1999). the learner will retain the correct motor pattern. For example, in the Reformer group exercise depicted in Figure 2, the practitioner might use example of AIF might be a sessions. Rather, the temporary and the cue `funnel your ribs into your practitioner's verbal or tactile relatively permanent in¯uences of pelvic bowl.' Such a cue might be information about the degree of instructional methods must be taken more e€ective than giving a detailed spine extension and rotation into account. The learning- explanation on how to use the deep achieved during the prone Chair performance distinction is a crucial abdominal, spinal and pelvic ¯oor exercise depicted in Figure 1. Until aspect of evaluating the success of muscles for dynamic trunk recently, it was thought that any rehabilitation or conditioning stabilization. Similarly, in the providing a lot of AIF was better for system. Practitioners should strive Ladder Barrel exercise in learning. Indeed, laboratory to be aware of this distinction and Figure 3, the phrase `sit tall in the experiments show that when understand that clients may be saddle' may be more e€ective in learners receive AIF after each performing PI exercises or constraining the body's degrees of practice trial, their performance is functional tasks very di€erently freedom than telling the client to usually better when compared to when not in the rehabilitation center activate a variety of separate that of learners who receive or studio. One way to assess learning muscle groups. feedback after fewer trials. is to ask the client at the beginning Although AVC and STR have not However, once AIF is removed and of the session to demonstrate an been as extensively studied as some learners must rely on their own exercise or functional activity that other instructional methods, recollection of the movement, those was practiced last session. This type research evidence (Landin 1994) who received less in practice are of approach can give an estimate of suggests they are quite useful. typically more successful (Salmoni et how much was learned. Landin makes several al. 1984, Schmidt 1991a, Schmidt & recommendations for using verbal Lee 1999). Recommendation 2: use augmented cues: First, he suggests using two It is evident from the example of verbal cues, self-talk, and imagery words or less for STR, and up to AIF that one cannot always predict Augmented verbal cues (AVC) are four words for AVC. Second, if cues learning from the quality of concise phrases, often consisting of address di€erent parts of a task, it is performance during practice one or two words, which are used by important to consider how those 104 J O U R NAL O F B O DY W O R K AN D MOV E M E N T TH E R APIE S APRIL 20 0 0
  • 7. Pilates-inspired exercise parts are interrelated. Cues should physical practice. It can also be used action (Winstein & Schmidt 1990). not disrupt the normal rhythm of by itself, in which case it is called A third guideline for AIF is that the the movement pattern by drawing mental practice. Although not learner must know how to interpret too much attention to one part of always e€ective, telling learners to it (Schmidt 1991b). A person with the task and creating arti®cial mentally imagine or mentally little knowledge of anatomy will not breaks between parts. For example, practice the correct movement be able to understand a statement breathing relies on a smooth pattern frequently appears to have such as `you aren't using your transition between in-breath and positive e€ects on retention intercostals.' Finally, giving AIF out-breath. Too much emphasis on Feltz & Landers 1983, Schmidt & during, or right after, a movement the in-breath can create breath Lee 1999). Therefore, cues may not always be a good idea. A holding and destroy the movement's such as `funnel your ribs' or learner who is trying to master an ¯ow. Landin's third `sit tall' may act like mnemonic exercise involving all four limbs recommendation is to consider the prompts that help evoke task- while maintaining core control, such variability of the environment and relevant muscular activity during as the Trapeze Table exercise in whether it is important for the exercises or related functional Figure 4, may be overly distracted if learner to focus on internal body activities. the practitioner interrupts with stimuli, or external environmental helpful advice. For extended PI stimuli, or both. Many tasks in sport routines that last 30 s or more, it and everyday life require switching Recommendation 3: use augmented may be best to give AIF attention between internal and information feedback judiciously periodically. For discrete PI external stimuli (Nide€er 1993). PI As already stated, AIF is task- movements like doing a head and exercises typically focus the learner related information that helps the spine roll-up to a sitting position, it entirely on internal body sensations, learner correct errors in the may be best to wait a few seconds which may be necessary during movement's outcome and pattern. after a trial before giving AIF. This initial phases of recovery or Research suggests that it should be may give the learner an opportunity conditioning, or when an exercise is used judiciously. First and most to focus on the ¯eeting sensory ®rst introduced. However, if importantly, too much information impression of what the movement switching between an internal and about errors may overload the felt like, before receiving external focus is part of the learner's short-term memory, direct information about its correctness functional activities the client must attention away from important (Swinnen et al. 1990). perform, practitioners should create sensory stimuli, and prevent the situations that require switching. development of proper coordination Recommendation 4: vary the context Fourth, Landin states that STR can patterns. Therefore, PI practitioners of practice trials be used in some cases to supplant should resist the temptation to point Whereas practice conditions such as AIF by priming the correct action out all the errors a learner is making frequent AIF temporarily enhance before it takes place. This is and suggest corrections. It is more performance but degrade learning, particularly useful in group exercise useful to select one or two errors others have the opposite e€ect. One classes, outside of class when the appropriate to skill level. For example for this occurs when instructor is not present, or if there example, beginners might need contextual interference is is only one chance to `do it right', a corrections related to breathing and manipulated during practice. Low situation that exists in many maintaining a neutral spine while contextual interference occurs when competitive sports. Finally, skill doing supine leg circles on the mat. all repetitions of Task A are level must be considered when More advanced clients might need followed by all repetitions of Task designing cues. Beginners need cues pointers on how to maintain B, all repetitions of Task C, and so that re¯ect their less re®ned dynamic trunk alignment and on. For example, a client might do 8 understanding of the task and allow scapulo-humeral rhythm when supine leg presses on the Reformer, them to get the general idea of the doing any exercises involving trunk followed by eight toe raises and correct action, whereas more lateral ¯exion and arm reaching. A eight jumps. By contrast, high advanced learners may need to focus second recommendation for using contextual interference is present on speci®c errors. Rose (1997) AIF is to taper o€ the amount of when one repetition of Task A is makes the additional feedback as the learner becomes followed by one repetition of Task recommendation that cues should more pro®cient and can increasingly B, one repetition of Task C, and so help evoke task-relevant imagery. rely on internal representations and on. In other words, a leg press is Mental imagery can be used during sensory awareness of the correct followed by a toe raise, a jump, 105 J O U R NAL O F B O DY W O R K AN D MOV E M E N T TH E R APIE S APRIL 20 0 0
  • 8. Lange et al. another leg press, another toe raise, has been de®ned as a gain or loss in However, even when movement another jump, and so on. High the capability for performing a patterns appear similar, positive contextual interference is thought to criterion task as a result of prior transfer can be negligible. For represent a number of `real-life' experience with a practice task (Ellis example, supine jumps on the movement conditions with 1965, Schmidt & Young 1987). One Reformer are practiced to prepare constantly alternating tasks. goal of practice is to develop the dancers and athletes for standing Compared to low contextual capability to adapt a previously vertical jumps. Yet research interference, high contextual learned action to new settings, or to indicates that supine jumping interference tends to depress perform variations of the action. practice does not necessarily result performance during practice. This is called near transfer or in positive transfer to upright Beginners sometimes report feeling intratask transfer (Sage 1984, Magill jumping (McLain et al. 1997). The frustrated or confused by high 1998, Schmidt 1991b). For example, authors of the latter study remarked contextual interference. It is during the hip extensor and that a during a jump on the therefore tempting to conclude that hamstring exercise performed on the Reformer, the legs may be placed up it also causes less skill learning. Trapeze Table in Figure 1, positive to 30 degrees above the plane of the However, numerous experiments intratask transfer means successfully body, creating signi®cant di€erences have shown that even for beginners, doing the movement with internal or in jump strategies between the high contextual interference is often external hip rotation, with the entire supine and standing conditions and more bene®cial to skill learning than spine resting on the Table, with both possibly reducing successful low contextual interference (Magill legs at once, and other transfer. In a biomechanical study, 1998, Schmidt & Lee 1999). modi®cations. On the whole, Self et al. (1994) found a di€erent Therefore, practice under high- intratask transfer as described above relationship between force and knee interference conditions may actually tends to be positive, though not  angle during a supine plie on the be preferable in the long run. always very large (Schmidt & Young Reformer and a standing plie,  Practitioners should be aware that 1987). suggesting that the two tasks are learners will be often be performing A second goal of practice is to use di€erent. functional tasks under conditions of prior experience with one action to PI practitioners should bear in high contextual interference and successfully execute a di€erent mind that two overtly similar tasks should create routines that action. This is called far transfer or may in fact require di€erent muscle progressively approximate these intertask transfer (Sage 1984, Magill synergies and be accompanied by conditions. Using the example of the 1998, Schmidt 1991b). The overall di€erent sensory input. Experience mat exercise in Figure 5, a client similarity of coordination patterns with one task may not give the might do 1±2 repetitions of a seems to be one of several factors learner the necessary capability to posture that requires supine trunk determining the degree of positive do the other task. Conversely, two and shoulder girdle stabilization, intertask transfer. Very di€erent tasks that appear dissimilar may followed by 1±2 repetitions of the patterns, such as swimming and actually involve similar underlying same posture in a prone position, volleyball, do not transfer positively muscle synergies, sensory stimuli, or and 1±2 sidelying. The client is to one another (Nelson 1957, cognitive strategies. This principle is challenged to exert sensory Schmidt & Lee 1999). The same referred to as transfer-appropriate awareness, and proper control of principle probably applies to processing (Lee 1988, Rose 1997). core and shoulder girdle muscles, two PI exercises that use both Practitioners should ask themselves while switching tasks. di€erent pieces of equipment and whether the exercises they assign di€erent body parts, such provide learners with an as lateral trunk ¯exion on the opportunity to practice the internal Recommendation 5: use the right Reformer and seated leg processing they will need for practice tasks to maximize skill extension on the Chair. When functional activities in sport, dance, transfer movement patterns are reasonably or everyday life. Care should be Learning is typically evaluated similar, intertask transfer is taken to ensure a transition from through retention and transfer tests. frequently small-to-moderate and supine, non-weight bearing activities Retention involves executing a given positive (Schmidt & Lee 1999). For to bipedal weightbearing activities movement at a later time, whereas example, doing a pelvic bridge on (Loosli & Herold 1992). Practice transfer is the application of a the mat may transfer positively to with supine exercises alone may not previously acquired movement skill doing the same exercise on the translate into improved alignment to new situations. Formally, transfer Reformer. or stability when standing up. 106 J O U R NAL O F B O DY W O R K AN D MOV E M E N T TH E R APIE S APRIL 20 0 0
  • 9. Pilates-inspired exercise Evans B, Stott Merrithew M 1998b Essential Box 5 Checklist for aspiring practitioners Reformer Manual. Toronto: Stott Feltz DL, Landers DM 1983 The e€ects of . Investigate a number of programs. mental practice on motor skill learning . Consider program availability, cost, and duration. and performance: a meta-analysis. . Trainers and certi®ers must have sucient experience with the desired client population. Journal of Sport Psychology 5: 25±57 . Instructional modules dealing with anatomy, physiology, and clinical populations should Fitt S, Sturman J, McClain-Smith S 1994 be overseen by individuals with proper training. E€ects of Pilates-based conditioning on . Certi®cation examinations should include oral, written, and case study portions. strength, alignment, and range of motion . To avoid con¯ict of interest, trainers should not have dual roles as certi®ers. in university ballet and modern dancers. . Trainers should have up-to-date knowledge of motor learning principles and ®ndings. Kinesiology and Medicine for Dance 16: 36±51 Gallagher S, Kryzanowska R 1999 The Pilates Method of Body Conditioning. BanBridge Books, Philadelphia Summary and 1999, Polestar1 Education 1999, Krasnow DH, Chat®eld SJ, Barr S, Jensen recommendations for Stott Conditioning 1999). Some JL, Dufek JS 1997 Imagery and the future training centers also mention conditioning practices for dancers. Dance practice conditions and teaching Research Journal 29: 43±64 strategies in their informational Larkam E 1999 Personal communication In the preceding paragraphs, several Larkam E, Brownstein B 1998 Balanced recommendations for maximizing literature (e.g. Physicalmind body: application of Pilates-evolved the learning bene®ts of PI sessions Institute 1999, Polestar1 Education exercises in ®tness, training and were introduced. However, these 1999, Stott Conditioning 1999, The rehabilitation. Unpublished manuscript recommendations are only Pilates Center 1999), which suggests Larkam E, Nichols J 1999 The history and preliminary. To date, no published that the trainers have some formal evolution of techniques in¯uenced by those of Joseph H. Pilates, 1920±1999. studies have been conducted in knowledge of motor learning Presentation at the American College of which an attempt was made to principles. However, it is best for Sportsmedicine, New Orleans discover causal links between prospective students to inquire Landin D 1994 The role of verbal cues in skill practice conditions, such as the ones before beginning any program. learning. Quest 46: 299±313 This paper was intended to Lee TD 1988 Transfer-appropriate described in this paper, and processing: a framework for improvements on PI exercises or provide an overview of current conceptualizing practice e€ects in motor functional skills. This oversight claims on the e€ectiveness of PI learning. In: Meijer OG, Roth K. eds. should certainly be remedied. exercises. Readers were introduced Complex Movement Behaviour: `The' A second critical issue is the to several practice conditions and Motor-Action Controversy. Elsevier, training and certi®cation that PI principles of motor learning that Amsterdam Loosli AR, Herold D 1992 Knee practitioners receive. Assumptions may enhance the usefulness of PI rehabilitation for dancers using a Pilates- about learning, and the instructional exercises for improving functional based technique. Kinesiology and techniques that practitioners movement. Suggestions were made Medicine for Dance 14: 1±12 themselves are taught, may be the for aspiring practitioners seeking Magill RA 1998 Motor Learning: Concepts most important sources of in¯uence training and certi®cation. Finally, it and Applications (5th ed). Columbus, Ohio, McGraw-Hill on their own teaching methods and must again be stated that controlled McCullagh P 1993 Modeling: learning, behaviours (Larkam 1999). experimental studies are urgently developmental, and social psychological Therefore, the selection of a suitable needed to verify the e€ectiveness of considerations. In: Singer RN, Murphy training and certi®cation program is PI exercises for enhancing M, Tennant LK, eds. Handbook of functional skills in a diversity of Research on Sport Psychology. critical for the aspiring practitioner. Macmillan, New York A checklist of important populations. McLain S, Carter CL, Abel J 1997 The e€ect considerations is provided in Box 5. of a conditioning and alignment program Training courses typically introduce on the measurement of supine jump the practitioner to functional height and pelvic alignment when using anatomy, a wide range of mat and REFERENCES the Current Concepts Reformer. 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