This Masterclass / review article discusses current literature and clinical practice for physiotherapists working with patients with migraines.

Carvalho, Gabriela F., Annika Schwarz, Tibor M. Szikszay, Waclaw M. Adamczyk, Débora Bevilaqua-Grossi, and Kerstin Luedtke. "Physical therapy and migraine: musculoskeletal and balance dysfunctions and their relevance for clinical practice." Brazilian Journal of Physical Therapy 24, no. 4 (2020), 306-317. doi:10.1016/j.bjpt.2019.11.001.

KEY POINTS: MIGRAINES

• Migraines are under-diagnosed and under-treated.

•  Patients may present with episodic, highly frequent, or chronic migraines.

• Neck pain is common as part of the migraine cycle, and is related to worse clinical presentations.

• Most patients present with at least three of the following:

  • Increased prevalence of cervical trigger points.
  • Decreased cervical ROM.
  • Decreased cervical flexion and extension strength.
  • Decreased upper cervical...

This transcript includes highlights from the live, interactive session of our Clinical Conversation: Footwork Options for Pregnancy.

If you missed the live webinar, you can read about some of the biomechanical changes during pregnancy, as well as footwork options for 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. 

OUR FEET AS OUR FOUNDATION

•  Pilates sessions traditionally begin with footwork and other strength work to set a foundation for movement.
• By spending time building strength through the feet, you can help to support a stable and dynamic support for standing, and for upright movement.
• This is an incredibly functional place to begin, and it's no different when working with a pregnant body.

 CLINICAL PILATES EMBODIED ANATOMY: FOOTWORK...

 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.

...

The authors of this paper used an ethological approach to test the hypothesis that practice-related refinements of multiple behavioural features would be independently predictive of motor learning.

Perry, Christopher M., Tarkeshwar Singh, Kayla G. Springer, Adam T. Harrison, Alexander C. McLain, and Troy M. Herter. "Multiple processes independently predict motor learning." Journal of NeuroEngineering and Rehabilitation 17, no. 1 (2020). doi:10.1186/s12984-020-00766-3.

KEY POINTS: PREDICTION OF MOTOR LEARNING

• Motor learning results from neural adaptations that produce refinements of behavioural features of motor tasks.
• Motor learning can induce changes in visual processing that are associated with the refinements of skilled limb movement.
• The interactions between skilled limb movements and visual search lead to coordinated patterns of the eyes and limbs (ie., hand-eye coordination).
• Experts with different visuomotor...

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 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

KEY POINTS: HERNIA REPAIR OUTCOMES

• 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...

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...