指導老師 : 譚仕馨主任報告學生 : 戴維報告日期 :2015/3/23

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1 The effectiveness of the Pilates method: Reducing the degree of non-structural scoliosis, and improving flexibility and pain in female college students 指導老師 : 譚仕馨主任報告學生 : 戴維報告日期 :2015/3/23 1

2 Introduction Scoliosis prevalence in the general population approaching 4%. (Bassani et al.,2008) The literature describes various methods and therapeutic techniques that have been used to improve postural problems 2

3 Introduction Pilates method Improves body awareness Using gravity and springs to increase resistance and aid (Rodrigues et al., 2010) 3

4 Introduction Use of trunk muscles to stabilize the pelviclumbar region (Rydeard et al., 2006) Emphasizing strength, posture and coordination of movements with respiration (Segal et al., 2004) Improve flexibility and overall body health 4

5 Introduction This study was to assess the effectiveness of the Pilates method in the improvement Nonstructural scoliosis Flexibility The level of pain in the spine 5

6 Introduction Plates principles (1)Breathing (2)Concentraction (3)Control (4)Centering (core muscle) (5)Precision (6)Balanced muscle development (7)Rhythm/Flow (8)Whole body movement (9)Relaxtion 6

7 Materials and methods Study type Randomized controlled design (Thomas et al., 2007) Subjects 31 physiotherapy students Age between 18 and 25 years Non-structural dorsoelumbar scoliosis back with rightward convexity (SRC) or leftward convexity (SLC) 7

8 Materials and methods Subjects Two groups: Experimental group (EG, n =20) that participated in a therapy program using the Pilates method Control group (CG, n =11) that did not undergo any therapeutic intervention 8

9 Materials and methods Assessment procedures Adams test :non-structural Standing position Barefoot and without a shirt Forward flexion of the trunk (Costa et al., 2002). Degree of scoliosis: Cobb s angle (Goldberg et al., 1995) Flexibility: goniometer Pain: Borg CR 10 (VAS) 9

10 Introduction Plates movements principles (1)Breathing (2)Lower core activation (3)Neutral spine: finding the optimum starting position (4)Abdonminal strengthening (5)Lumbopelvic stability (6)Shoulder stability and mobility (7)Correct alignment (8)Release work (9)stretching 10

11 Intervention using the Pilates method Three steps: Preparation (warming up, followed by stretching skills) Specific exercises Returning to a relaxed position 60 min/time,2 session/week for 3 month 11

12 Intervention using the Pilates method Cadillac Ladder-Barrel Step chair Reformer 12

13 Preparation 8 min of walking Stretching on the floor for 5 min( 5 repetitions) 13

14 Stretch Spine forward stretching Stretch the posterior muscle chain and to mobilize the vertebral spine Upper rolling Stretch the posterior chain and to mobilize the spine as well as to strengthen the abdomen 14

15 Stretch Child Position Stretch the thoracic paravertebral, lumbar and gluteal regions and to mobilize the vertebral spine. Forward leg pull Stretch the concavity of the vertebral spine 15

16 Specific exercises 12 exercises 10 repetitions each 16

17 Specific exercises Hip movements with a large ball (65 cm diameter) To strengthen the gluteal regions and to develop equilibrium with pelvic raise Inverted abdominal skills with a ball (55 cm diameter) To strengthen the infraabdominal region and the ischiotibial muscles Lift the ball off the floor 17

18 Specific exercises Rising into a seated position To strengthen rectus abdominis 18

19 Specific exercises Lateral spine movement on a step chair To stretch lateral muscle chain according to the direction of the convexity of the scoliosis. Resistance set: 0.14KG Lateral spine movement To stretch the lateral muscle chain according to the direction of convexity of the scoliosis 19

20 Specific exercises Flexibility on the step chair To mobilize the spine and to stretch the paravertebral thorax and lumbar regions. Resistance set: 0.14KG 20

21 Specific exercises Series of supine leg stretches in the Cadillac To strengthen the gluteus maximus, ischiotibial muscles and ankle adductors 2 springs of 0.015KG Leg extension in the Cadillac To strengthen the gluteus maximus and quadriceps. 2 springs of 0.015KG 21

22 Specific exercises Arms moving up and down in the Reformer To strength dorsal muscle and major pectoral sections and posterior deltoid 2 springs of 0.024KG Arms(triceps) in the Reformer To strength brachial triceps and anconeus muscle 2 springs of 0.024KG 22

23 Specific exercises Spine roll in the Cadillac To improve mobility of the vertebral spine and to improve abdominal control Extension of the spine in the Cadillac To stretch the posterior chain 23

24 relaxed position Returning to a relaxed position (relaxation with a ball 75 cm in diameter) 3 movements, 3 repetitions per movement Lasted 5 min Metabolic recovery Relaxation of the stimulated muscles 24

25 relaxed position Three steps: 1. Patient lies down with her side on the ball, according to the direction of the convexity of the scoliosis. 2. Afterward, the patient lies down inclined on the ball, supported by the feet and hands. 3. Last, the patient lies down in an elevated position on the ball, keeping her feet resting on the floor and her superior limbs backward. 25

26 Statistical analysis 2 X 2 ANOVA t tests SPSS 18 The level of significance was set at

27 Results 27

28 Results 28

29 Results 29

30 Results 30

31 Discussion The main findings Decrease the degree of scoliosis Increase flexibility of the posterior muscular chain Reduce pain in the spine. This improvement occurred because stabilize Transverse abdominal muscles lumbar multifidus Diaphragm Pelvic floor 31

32 Discussion Pilates Rebalancing muscles. Rehabilitation therapy : muscle imbalances due to scoliosis. Significant difference Before and after intervention in the experimental group (p < 0.001). The control group values Before intervention and after intervention, however the p value was not significant. 32

33 Conclusion The Pilates method in female patients with non-structural scoliosis improved : Back pain Muscle shortening of the posterior chain. Finding Minimize the degree of non-structural scoliosis Improve flexibility of the posterior muscular chain Reduce pain 38% improvement of scoliosis 80% increased flexibility 60% reduction in pain 33

34 Thank you 34

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