Clinical Pilates in Practice: Prediction of Motor Learning (February 2022)

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.



  • 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...
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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...
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Research Review: Ankylosing Spondylitis Pathogenesis (October 2021)


The authors of this article reviewed data from animals and genetic studies highlighting the importance of Type 17 immune responses. The article comprehensively discusses the multifactorial pathogenesis of ankylosing spondylitis.


Aniruddha V. and Paul B. New developments in our understanding of ankylosing spondylitis pathogenesis. 2020. Immunology, 161, 94–102.



  • Ankylosing spondylitis (AS) is an autoimmune inflammatory arthritis that is part of a larger class of spondyloarthropathies.
  • Complications of AS include iritis, an increased risk of osteoporosis, cardiovascular disease, and a high risk of spinal compression fractures.
  • Physiotherapy is the mainstay of treatment for AS along with pain management with analgesia and nonsteroidal anti-inflammatory drugs.


  • The risk of siblings or first-degree relatives of AS patients having AS is higher than that of the general population, and there is a high...
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Clinical Pilates in Practice: Is T9-T12 the Thoracolumbar Transition Zone? (April 2021)


The authors of this retrospective review study hypothesised that the true thoracolumbar junction is T10-11.


Murphy, J. et al. “Is T9-11 the true thoracolumbar transition zone?” Journal of clinical orthopaedics and trauma 11 5 (2020): 891-895.



  • For clinical purposes, the thoracolumbar transition zone is considered to be T11-L2 for due to the variation in the location of the caudal end of the cord, as well as the biomechanical weakness of false ribs at T11.

The point of transition from floating to false ribs resulting in increased mobility at T10-11.

  • Articulation between thoracic vertebrae and ribs plays an active role in stability and load-bearing of the thoracic spine, along with the ligaments and facet joint capsules.
  • The lumbar spine is relatively more mobile. 
  • Mean age in the patient cohort was 25.3 years; 300 MRIs were reviewed.
  • Disc degeneration was most frequent and most severe at T8-9 and T9-10, followed by...
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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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Anatomy Review: Iliocapsularis & Other Muscles of the Hip Capsule (October 2020)


An informal poll of our colleagues has concluded that no-one knew that the iliocapsularis muscle existed until two days ago… This got us thinking about other muscles of the hip that insert into the joint capsule, and their role in hip function and movement dysfunction.



  • The iliocapsularis is a constant muscle. ie., found in all human specimens!
  • Origin = Inferior border of the anterior inferior iliac spine + antereomedial joint capsule.
  • Insertion = Distal to the lesser trochanter.
  • Runs anterolaterally to posteromedially.
  • Lies under rectus femoris and lateral to iliacus (sometimes blends with iliacus).
  • Contraction pulls the hip joint capsule zona orbicularis superomedially -> stabilizing the hip anteriorly.
  • Hypertrophy of the iliocapsularis is seen in patients with hip dysplasia, particularly helping to stabilize the femoral head when there is a deficient acetabulum.

Iliocapsularis limits synovial impingement...

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Clinical Pilates in Practice: Closed Kinetic Chains & Motor Control (December 2019)


In the author’s words:

"This commentary encourages the study of mobility both as a potential explanation for different motor control strategies and as a useful concept for comparing otherwise seemingly disparate musculoskeletal systems.” (p.7).


Olsen, Aaron M. "A mobility-based classification of closed kinematic chains in biomechanics and implications for motor control." The Journal of Experimental Biology 222, no. 21 (2019), jeb195735. doi:10.1242/jeb.195735.



  • Closed-kinetic-chains have fewer degrees of freedom than open-kinetic chains.
  • There is a trade-off between stability with a closed kinematic chain vs mobility with an open kinematic chain (increased degrees of freedom).
  • An isometric muscle contraction can conditionally decrease the mobility of a CKC; this is controlled neurally (vs the mechanical nature of a ligament becoming taut or slack).
  • Passive/accessory...
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Clinical Pilates in Practice: Footwear Alters Lower Extremity Coordination Variability (November 2019)


This was a small study gauging the influence of footwear on motor coordination, and thus results are not transferable across populations. However, the findings are interesting from a clinical perspective, as this adds to information re: training for functional tasks with appropriate footwear.


Romer, Braden H., Wendi Weimar, and John Fox. "Footwear Alters Lower Extremity Coordination Variability." Perceptual and Motor Skills 126, no. 5 (2019), 764-778. doi:10.1177/0031512519863183.



  • Footwear, footwear components, and tactile feedback are capable of producing significant changes in gait mechanics and lower extremity muscle activity.
  • The amplitude and time to peak amplitude for the tibialis anterior, peroneus longus, and medial gastrocnemius are significantly different between barefoot and shod gait.
  • Footwear has a mechanical effect on gait, due to the increased mass of the distal segment of the shoe...
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