a basic form of exercise which is a combination of yoga and conventional exercise with main focus on breath

1. 
Pilates
RADHIKA CHINTAMANI

2. 
 Introduction
 History
 Principles
 Theory
 Effects
 Benefits
 Equipment
 Prescription
Contents

3. 
 Progression
 MAT work
 Indications
 Contraindications
 Evidences
 References
Contents

4. 
 Pilates is an anaerobic method of exercise, popular
all around the world. It combines the modern
knowledge about the human body with well known
ancient activity like yoga and tai chi.
 It was founded by Joseph H. Pilates.
Introduction

5.  According to APPI(Australian Physiotherapy and Pilates
Institute), Pilates is, “a form of dynamic stabilization
retraining that reconditions the body from central core to
prevent reoccurrence of and treat a range of postural,
musculoskeletal and neurological conditions.” - Withers &
Stanko, 2001
 A more recent definition, according to a systematic review
by Wells, C. et al in 2012, indicates that “Pilates is a mind-
body exercise approach requiring core stability, strength
and flexibility and attention to muscle control, posture and
breathing”.

6. 
 As a child Joseph was very sick and suffered from a
number of ailments like asthma, rheumatic fever and even
suspected of having tuberculosis and rickets. Hence, he
worked hard with the help of his father who was a trainer,
to improve his fitness.
 As he grew, he began to enjoy various sports like diving,
skiing and gymnastics.
 He became a professional boxer and taught self-defense
and in 1912 moved to England.
History

7.  Joseph began to work in refugee camps where he helped in
the rehabilitation of the injured by teaching them exercises
which were a combination of Yoga, Karate, ancient Greek and
Roman exercise programs and Zen meditation.
 In 1918, Joseph was credited when no internees at his camp
took ill during the influenza epidemic in England.
 He also experimented with bed springs for the recovery of
muscle tone which led to the creation of the Cadillac(or
Trapeze) and the Universal Reformer.
 He moved to the USA and gave the name “Contrology” to his
approach in the year 1926.

8.  He taught his method to 6 instructors and opened
two studios in New York city.
 He authored two books: Your Health (1934) and
Return to Life Through Contrology (1945)
 Joseph died at the age of 87 in 1967 and Romana
Kryzanowska became Joseph’s successor.

9. 
 Traditional Principles:
 Flat / Neutral Spine: Pilates believed that correct
breathing was very important and that if a child had a
flat spine, an adult should also have a flat spine.
 Contrology: is a complete coordination of the body,
mind and spirit. Pilates believed in performing vigorous
exercises to improve the blood circulation and correct
breathing that helps remove the germs out of the body
and also helps to develop the lung and heart control.
Principles

10.  Pilates Principles:
 Alignment:
 Correct postural alignment of the skeletal structure.
 Helps to prevent risk of injury.
 Hence, position the pelvis, ribcage, shoulder girdle and
head in neutral with each other and maintain this posture
while performing the exercises to maintain it.
 Breathing:
 Full and thorough inhalation and exhalation leads to a
body charged with oxygen and purged of waste gases.
 Oxygen circulating in the blood allows proper
functionality of each cell in the body and carries away
the waste related to fatigue.
 When performing Pilates, one must take deep breathes
that engages all the sides of the ribcage including the
postero-lateral wall.

11.  Centering:
 Pilates called a very large group of muscles surrounding the
abdomen, lower back and buttocks as ‘the POWERHOUSE’.
 Physical energy exerted from the center coordinates movement
with the extremities.
 Hence , it is important to build a very strong powerhouse in
order to rely on it for day-to-day activities.
 Modern instructors call it ‘the CORE’.
 Concentration:
 Pilates demands intense focus on the fundamental movements
and on the controlled breathing while paying careful attention to
the instructors.

12.  Control:
 All physical motion must be controlled by the mind.
 Control over the POWERHOUSE, where all the motions
originates, gives control over the movement of the extremities.
 A strong POWERHOUSE stabilizes the torso and allows flexibility
of the body.
 Fluidity of Movement:
 Movement is expected to be continuous, smooth and even
throughout the session through appropriate use of transitions.
 No jerky, rushed movements are allowed.
 Once precise movement has been achieved, the exercises
should become familiar or flow from within without the
instructions.

13. 
 The core is made of:
 The lumbopelvic/hip complex – impact from movement
meets compression of weight from upper trunk and arm
movement.
 The inner unit- the diaphragm, transversus abdominis,
multifidus, internal and external obliques, rectus abdominis,
erector spinae and the pelvic floor muscles.
 The outer unit- muscles of the neck like trapezius, muscles
that stabilize the shoulders, allowing the arm movements
like biceps, triceps and the muscles of the hips.
Theory

15.  Neutral Pelvis: in an anteriorly tilted pelvis, strengthening of
the abdominals and the gluteals is done with stretching of
the lower back to achieve a neutral pelvis.
Effects of Pilates on
Powerhouse

16.  Lengthening of the spine: Pilates looks to achieve a
lengthened POWERHOUSE as it decompresses the spine.
Hence, the core is first concentrically and then isometrically
engaged.
 Abdominopelvic Cavity Tone: this cavity is referred to as
the cylinder that connects the thigh to the ribcage. more rigid
the cylinder, the more stable is the core.

17. 
 Improves Strength & Muscle Endurance.
 Improves Flexibility
 Improves Posture and Alignment
 Helps in Relaxation
 Improves Coordination/Precision/Control
 Improves Natural Balance
 Reduces Stress and Fatigue
 Reduces Pain
 Improves Emotional and Mental Status
 Improves the Praxis
Benefits

18.  An observational study was done in the year 2004 by Segal N. A.
et al in order to assess the effects of the Pilates method on the
flexibility and body composition and health status. A sample of 47
adults were considered of which 32 met the criteria of missing no
more than 1 weekly 1 hour session of Pilates mat class during
each of the 2 month period.
 The raw data was collected at the time intervals of 2, 4 and 6
months. The investigator was blinded to the study and the results
showed no improvements of truncal lean body mass, height,
weight or any other body composition parameter.
 Conclusions showed that Pilates may have helped to increase the
flexibility of the muscles of the body.
Evidence

19. 
 A randomized controlled trial with pretest posttest
design was done by Rydeard R et al in 2006 aimed to
investigate the efficiency of therapeutic exercise
approach in a population with Chronic LBP.
 Thirty nine subjects aged between 22 and 50 years
were randomly allocated to 1 of 2 groups. The
experimental group participants underwent a 4 week
program of Pilates exercises while the control group
subjects were given no exercises but only routine
advice.
Evidence

20. 
 The outcome measures were Roland Morris Disability
Questionnaire and Numerical Pain Rating Scale.
 There was improvement in the functional disability and
the pain intensity which was maintained over a period
of 12 months after randomization.
Evidence

21. 
 People with chronic pain and joint stress
 People with low back pain
 People who need to prevent osteoporosis
 Overweight and obese people
 During and after pregnancy
 Senior Citizens
 Athletes
 Business Professionals
 Artists and Performers.
Who is benefited?

22. 
 The few equipment that were invented by Joseph
Pilates but have been modernized are :
 Mat
 Tower
 Cadillac/Trapeze
 Ring
 Barrels
 Chair
 Universal reformer
 Hand weights
Equipment

23.  Physio-ball
 Bosu ball
 Medicine ball
 Thera-bands/Thera-tubes

27. 
 A study was published with the title, “ effectiveness of Mat
Pilates or Equipment –based Pilates exercises in patients with
Chronic nonspecific Low Back Pain: A Randomized Controlled
Trial” authored by da Luz Jr. M. A. et al.
 It was a blinded study which was conducted at a private clinic.
 86 patients with chronic LBP participated and randomly
allocated into 1 of the 2 groups.
Evidence

28. 
 Scoop
 Pilates Box
 Softening
 Pilates Imagery
 Neutral Zone
 Pilates Stance
Terminology

29. 
 According to the FITTS principle:
 Frequency: 4 times a week
 Intensity: vigorous
 Time: 15-30 minutes per session
 Type: Both.
Prescription

30. 
 Body Awareness / Fundamental Exercises
 Beginner
 Intermediate
 Advanced
Progression

31. 
 Breathing/imprinting:
Fundamental Pilates

32. 
 Pelvic placement / bowl:
Fundamental Pilates

33. 
 Scooping:
Fundamental Pilates

34. 
 Head & Cervical
Placement
Fundamental Pilates

35. 
 Foot work / Toe raises:
Fundamental Pilates

36. 
MAT Work

37. 
 Weight loss
 Fitness during Pregnancy for mother and baby
 Dysmenorrhea
 Mobility enhancement
 Chronic LBP
 Chronic pain and joint stress
 General fitness
Indications

38.  A study on the effect of Pilates exercises on the post-partum
maternal fatigue was published by Ashrafini F et al in 2015 in
Singapore Medical Journal. 80 women participated in the
clinical trial and were randomly allocated into 1 of the 2 groups.
 The control group did not receive any treatment. The
experimental group was give Pilates exercises 5 times a week
for 30 minutes per session for a length of 8 weeks.
 Fatigue levels were measured using Multidimensional Fatigue
Inventory.
 The study’s findings showed a reduction of postpartum
maternal fatigue
Evidence

39. 
 Acute episodes of RA
 Suspected whiplash injuries
 Acute episodes of LBP
 Early stages of CV surgeries
 Third trimester of pregnancy
 Recent surgeries
 Acute infections and swellings
Contraindications

40. Thank You