Clinical Pilates in Practice: Hip-Spine Syndrome (January 2022)


This narrative review explains the mechanism by which abnormal hip pathologies contribute to low back pain in patients without hip osteoarthritis.


Anthony N Khoury, Munif Hatem, Joshua Bowler, Hal David Martin, Hip–spine syndrome: rationale for ischiofemoral impingement, femoroacetabular impingement and abnormal femoral torsion leading to low back pain, Journal of Hip Preservation Surgery, hnaa054.



  • Hip abnormalities limiting hip flexion and/or extension require compensation from the pelvis and lumbar spine for the lack of sagittal movement at the hip.
  • Between 13.1% and 37.5% of the total hip flexion is provided by the pelvis through sagittal movement at the lumbopelvic area.
  • Abnormalities at the hip joint contributing to low back pain include flexion deformities, osteoarthritis, developmental dysplasia, and limited hip range of movement.
  • The bony overgrowth of a cam impingement produces shear forces resulting in...
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Clinical Pilates in Practice: Visuomotor Adaptation & Passive Movement (December 2021)

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.



  • 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...

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Clinical Pilates in Practice: Hernia Repair Outcomes (November 2021)

This article is a comprehensive retrospective review of ventral hernia repair outcomes performed at one facility in the USA. The study was limited by a small sample size, facility treatment bias, retrospective review, and loss of information due to data extraction from paper charts; these are all acknowledged by the authors of the paper.


Kadakia N, Mudgway R, Vo J, et al. (August 02, 2020) Long-Term Outcomes of Ventral Hernia Repair: An 11-Year Follow-Up. Cureus 12(8): e9523. DOI 10.7759/cureus.9523



  • Ventral hernia repairs (VHR) may be performed through open or laparoscopic techniques, and with or without mesh.
  • Complication rates may be affected by various factors such as mesh placement and mesh position technique.
  • Mesh use is associated with a lower risk for recurrence and a higher risk of infections.
  • Laparoscopic repairs are associated with decreased quality of life, length of stay, and infection rates.
  • VHRs with...
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Clinical Pilates in Practice: Learning to Explore (September 2021)

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



  • 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 activity,...
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Clinical Pilates in Practice: Biomechanics & The Formation of Nervous Tissue (August 2021)

This review is a critical assessment of recent advances in the utilization of mechanical stimuli towards exploiting nervous tissue growth and formation. The authors discuss current in vitro systems designed to restate the mechanical environment of developing neural tissues, and the advancements made in integrating these systems into the clinical setting.


Pfister, Bryan J., Jonathan M. Grasman, and Joseph R. Loverde. "Exploiting biomechanics to direct the formation of nervous tissue." Current Opinion in Biomedical Engineering 14 (2020), 59-66. doi:10.1016/j.cobme.2020.05.009.



  • Mechanics can be used to guide and accelerate neuronal expansion.
  • The central nervous system plays a key role in initiating the autonomic functions and coordinated actions of every being.
  • The peripheral nervous system coordinates signal transmission between the central nervous systems and the...
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Clinical Pilates in Practice: Shoulder Kinematics & Subacromial Impingement (June 2021)

This literature review examines the relationship between shoulder kinematics and the aetiology of rotator cuff pathology.


Lawrence, Rebekah L., Jonathan P. Braman, and Paula M. Ludewig. "Shoulder kinematics impact subacromial proximities: a review of the literature." Brazilian Journal of Physical Therapy 24, no. 3 (2020), 219-230. doi:10.1016/j.bjpt.2019.07.009.



  • Subacromial compression is unlikely a contributing factor to rotator cuff pathologies.
  • There are limitations to 2D measurements when trying to quantify 3D relationships.
  • 3D techniques are not as broadly available.
  • There are extreme variations in metrics for quantifying the subacromial space.
    • The most common metric is the minimum distance; it quantifies the smallest distance between two structures.
  • A ‘‘painful arc’’ of motion between 700 and 1200 humerothoracic elevation is...
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Research Review: Neuroplasticity & Motor Learning in Sport (May 2021)

This is a brief summary of neuronal plasticity and motor learning, particularly as it pertains to physical activity.


Minino, Roberta, Patrizia Belfiore, Marianna Liparoti (2020): Neuroplasticity and motor learning in sport activity, Journal of Physical Education and Sport; DOI: 10.7752/jpes.2020.s4318.



  • Motor learning is defined as the ability to acquire new motor actions or new movement patterns.
  • Cortical reorganization can be used for motor learning; the process follows a path consisting of two phases: unmasking and strengthening preexisting conditions, and creating new connections.
  • In motor learning, the transition from coarse movement to a precise execution has three phases:
    • Cognitive phase: Understanding the purpose of the action to be acquired and how to perform it.
    • Associative phase: Structuring movements and finalizing the motor sequence.
    • Automation phase: Automation of motor...
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Clinical Pilates in Practice: Sleep & Motor Memory Consolidation (March 2021)

This meta-analysis compared the effect of sleep gain on motor memory consolidation between sleep and wake groups. The mechanisms by which sleep helps to consolidate motor memory are not fully understood, and further research is still needed in this field.


Daniel Schmid, Daniel Erlacher, André Klostermann, Ralf Kredel, Ernst-Joachim Hossner. Sleep-dependent motor memory consolidation in healthy adults: A meta-analysis. Neuroscience & Biobehavioral Reviews, Volume 118, 2020. Pages 270-281. ISSN 0149-7634.



  • Several studies show that whole-night and short diurnal sleep yield positive effects on motor tasks.
  • Longer periods of sleep only show slightly improved effects over shorter "naps".

 While positive, there is only a small effect of sleep on motor memory consolidation.

  • Physiologically, there are five stages of sleep (sleep stages 1-4 and rapid eye movement - REM...
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Clinical Pilates in Practice: Biokinetic Analysis of the Foot & Ankle (February 2021)

This literature review argues that clinically we need to observe functional - rather than conventional - biomechanics at the ankle and foot. Functional biomechanics observes that all segments in a joint can be simultaneously mobile. The authors suggest that:

 "The reader should be able to understand how the 3-dimensional biokinetic analysis of the ankle and foot can contribute along with imaging examinations to the clinical setting, thus allowing the construction of a more complete profile of the patient."


Metsavaht L, Leporace G. Current trends for the biokinetic analysis of the foot and ankle. J Foot Ankle. 2020;14(2):191-6.



  • The central nervous system works as the generator of complex movement patterns based on muscular synergies; the control of active joint stability is coordinated by the neuromuscular system and not by isolated muscle strength or range of motion.
  • Functional ankle...
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Clinical Pilates in Practice: Choice & Skill Learning (January 2021)

This small study observed the motor learning effects of allowing small choices by individuals.


An, Jongseong, Rebecca Lewthwaite, Seungmin Lee, and Gabriele Wulf. "Choice of practice-task order enhances golf skill learning." Psychology of Sport and Exercise 50 (2020), 101737. doi:10.1016/j.psychsport.2020.101737.



  • Autonomy is a key motivational factor in the OPTIMAL theory of motor learning.1
    • Enhances expectancies for performance.
    • Increases task focus.
    • Enhanced processing of task errors.
    • Greater neuro-cognitive engagement.
  • Lack of autonomy can be stressful and therefore negatively impact performance.
    • Stress also takes focus away from task performance.
  • In the "choice group", participants selected the order of their practice, which were seemingly small choices.
  • Having a choice enhanced learning, compared to the group that did not choose the order of their practice.
  • Positive affect...
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