This transcript includes highlights from the live, interactive session of our Clinical Conversation: Axial Elongation. 

If you missed the live webinar, you can read about how to use axial elongation in your clinical Pilates practice below. 

Please join our next live event, where you can participate in our Case Study discussion and Q&A session. 

Check out our upcoming Clinical Conversations here. 

WHAT IS AXIAL ELONGATION?

• Many Pilates courses extol the virtues of axial elongation, and teach this principle as an elongation of the spine: creating space between the vertebrae.
  • Axial elongation opens space between the joints, and thus creates space for movement.
  • This space between the joints helps to decompress joints and rebalance the soft tissues around those joints. 
• Axial elongation can also be used along the axes of the long bones, or between any other joints in the body.
  • Wherever there is an...

This transcript includes highlights from the live, interactive session of our Clinical Conversation: Ehlers Danlos Syndromes. 

If you missed the live webinar, you can read about Ehlers Danlos syndromes and clinical Pilates below. 

Please join our next live event, where you can participate in our Case Study discussion and Q&A session. 

Check out our upcoming Clinical Conversations here. 

EHLERS DANLOS SYNDROMES VS HYPERMOBILITY SPECTRUM DISORDERS 

• Ehlers Danlos syndromes are a group of genetic connective tissue disorders that affect many body systems, and which share several clinical features.
  • Soft, extensible skin.
  • Hypermobile joints.
  • Abnormal wound healing.
  • Easy bruising.
• Hypermobility spectrum disorders.
  • Symptoms of hypermobile joints +/- skin hyperextensibility.
  • Joint and muscle fatigue and pain may or may not be present.
  • No other diagnostic criteria for EDS.

...

This transcript includes highlights from the live, interactive session of our Clinical Conversation: What is a Neutral Head Position? 

If you missed the live webinar, you can read about neutral head position and how to integrate it into your clinical Pilates practice below. 

Please join our next live event, where you can participate in our Case Study discussion and Q&A session. 

Check out our upcoming Clinical Conversations here. 

WHAT DO WE MEAN BY NEUTRAL? 

• The optimal alignment of a joint.
  • A position of efficiency.
• The position of a joint where the bones that make up the joint are placed in the optimal position for maximal movement.
• The midrange of a joint, where there is the least amount of load on the ligaments and non-muscular tissues around the joint.
  • Stabilizing muscles are working...

This transcript includes highlights from the live, interactive session of our Clinical Conversation: Integrating Objective Assessment Tools. 

If you missed the live webinar, you can read about how to integrate objective assessment tools in your clinical Pilates practice below. 

Please join our next live event, where you can participate in our Case Study discussion and Q&A session. 

Check out our upcoming Clinical Conversations here. 

WHY USE OBJECTIVE ASSESSMENT TOOLS IN CLINICAL PILATES PRACTICE?

• In the same way that we use objective assessment tools in other facets of clinical practice, we want to integrate these into our clinical Pilates sessions to:
  • Collect baseline data.
  • Assess current status.
  • Determine treatment planning.
  • Monitor changes over time.
  • Track client progress.
  • Be able to communicate with other healthcare practitioners.

CLINICAL PILATES: OBJECTIVE ASSESSMENT TOOLS

• Goniometry: AROM...

This study examined the lasting effect of passive training on visuomotor adaptation within a 24-hour timeline.

G. Tays et al. Consolidation of use-dependent motor memories induced by passive movement training. Neuroscience Letters 732 (2020) 135080.

KEY POINTS: VISOMOTOR ADAPTATION & PASSIVE MOVEMENT

• Adapting to a sensorimotor environment requires complex and dynamic systems that can adjust to the environment within minutes, resulting in long-term performance changes.
• Adaptation is driven by two primary learning mechanisms:
  • Error-based, model-based, or algorithmic learning; and
  • Use-dependent, model-free, or instant-reliant training.
• Use-dependent learning occurs both during active and passive movements.
• Passive movement training has the capacity to facilitate subsequent visuomotor adaptation.
  • Results showed improvement after one-hour and 24-hour delay conditions.

Use-dependent learning alongside passive movement training enhances the...

This review focuses on the contributions made by exploratory behaviors to skilled perception and action. 

Hacques, Guillaume et al. “Exploring to learn and learning to explore.” Psychological research, 10.1007/s00426-020-01352-x. 10 May. 2020, doi:10.1007/s00426-020-01352-x

KEY POINTS: LEARNING TO EXPLORE

• Exploratory activities are those that generate information about the association between environmental factors and action capabilities.
• Exploration describes the active process by which individuals disclose information during control of action.
• In ecological psychology, information resides as patterns in ambient arrays (mechanical, acoustic, and optical).
  • These ambient arrays specify the relationship between the individual and his/her environment.
• When information is relevant to the relationship between an individual and their environment, they perceive opportunities for action.
• Through exploratory-perpetual motor...

For motor learning tasks, analogies are usually given as a single biomechanical metaphor. This study demonstrates how analogies can influence motor kinematics and task outcome.

Zacks O, Friedman J. Analogies can speed up the motor learning process. Sci Rep. 2020 Apr 24;10(1):6932. doi: 10.1038/s41598-020-63999-1. PMID: 32332826; PMCID: PMC7181737.

KEY POINTS: ANALOGIES & MOTOR LEARNING

• The type of instruction given is important for motor learning.
• Different aspects of movement are affected differently by different instructional styles.

"Analogies in the case of motor learning combine various task-relevant rules into a single biomechanical metaphor, usually given to the learner as a verbal instruction."

• Explicit instructions lead to smoother training for movement.
• Instructions given as a verbal analogy can support smoother movement training when movement tasks are slowed down.
• Analogies may help for motor skills that are otherwise hard...

Researchers used a musculoskeletal model to predict joint contact forces and investigate the variations of joint contact forces due to joint impairment in 18 juvenile idiopathic arthritis patients.

Erica Montefiori et al. Linking Joint Impairment and Gait Biomechanics in Patients with Juvenile Idiopathic Arthritis. Annals of Biomedical Engineering 2019; 47(11): 2155-2167

KEY POINTS: JOINT IMPAIRMENT & GAIT BIOMECHANICS IN JUVENILE IDIOPATHIC ARTHRITIS

• Juvenile idiopathic arthritis (JIA) is the commonest rheumatic condition in childhood, although the etiology remains unknown.
• JIA encompasses several subgroups but most generally presents as peripheral arthritis.
  • Clinical presentation includes fever, joint swelling and pain, hepatomegaly, lymphadenopathy, cardiac involvement, splenomegaly, and skin rashes.
• Medical imaging of JIA:
  • Ultrasound is used to assess joint synovial and tendon inflammation.
  • MRI helps with...

This small study of healthy volunteers explored differences in the coronal biomechanics of the trunk, pelvis, hip, and knee joints, as well as gluteus medius muscle activity during walking and step down tasks.

Komsak Sinsurin, Raul Valldecabres & Jim Richards (2020) An exploration of the differences in hip strength, gluteus medius activity, and trunk, pelvis, and lower-limb biomechanics during different functional tasks, International Biomechanics, 7:1, 35-43, DOI: 10.1080/23335432.2020.1728381

KEY POINTS: BIOMECHANICS OF FUNCTIONAL TASKS

• Functional impairment of glute med can lead to excessive lateral trunk bending, which is often observed in people with knee problems.
• During gait, the following was observed:
  • Increased contralateral pelvic drop and pelvic obliquity excursion, compared to step-down tasks.
  • Increased lateral bending versus step-down tasks.
  • Significantly greater knee adduction, compared to step-down tasks.
  • Peak hip...

Integrating neural mobility exercises into functional movements and clinical Pilates practice can have multiple benefits, regardless of whether a client is displaying neural mechanosensitivity: all tissues in the body need to move!

NEURODYNAMICS

• Mechanical and physiological events within the nervous system are dynamically interdependent. Functionally, that means that nerves have to be able to move in order to work optimally.
• Neurodynamics is essentially the dynamic movement of the peripheral nerves of the body, although clinically and in rehab, the term neurodynamics pertains to nervous system mobilization for neuropathic pain.
• In practice, when performing neurodynamic exercises, posture and multi-joint movements are combined to apply force to a nerve.

Mobilisation triggers a range of responses in nervous tissues, including tension and pressure changes, and positive impacts on nervous impulses, axonal transport, viscoelasticity, microcirculation, and abnormal...