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Conventional Kinesiotherapy Or Pilates Mat Exercises, What Is More Efficient for Abdominal Weakness? a Feasibility Study

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Conventional Kinesiotherapy Or Pilates Mat Exercises, What Is More Efficient for Abdominal Weakness? a Feasibility Study J. Biomedical Science and Engineering, 2013, 6, 1171-1177 JBiSE http://dx.doi.org/10.4236/jbise.2013.612146 Published Online December 2013 (http://www.scirp.org/journal/jbise/) Conventional kinesiotherapy or Pilates mat exercises, what is more efficient for abdominal weakness? A feasibility study Renan Lima Monteiro1, Laio Braga de Oliveira2, Luiz Armando Vidal Ramos1*, Mauricio Oliveira Magalhães1, Marília Maniglia de Resende2, Bianca Callegari3 1Department of Physical, Speech and Occupational Therapy, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil 2Educational Association of Amazonia—SEAMA, Amapá, Brazil 3Department of Physical Therapy and Occupational Therapy, Institute of Health Sciences, University Federal of Pará, Belém, Brazil Email: *[email protected] Received 29 October 2013; revised 28 November 2013; accepted 9 December 2013 Copyright © 2013 Renan Lima Monteiro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In accordance of the Creative Commons Attribution License all Copyrights © 2013 are reserved for SCIRP and the owner of the intellectual property Renan Lima Monteiro et al. All Copyright © 2013 are guarded by law and by SCIRP as a guardian. ABSTRACT It aims to improve flexibility, increase global muscular strength and endurance, by emphasizing spinal and pel- The aim of this feasibility study was to contrast rectus vic alignment, proper breathing, and the development of abdominis (RA) muscle strength and electrical activ- a strong core or center (tones abdominals while strength- ity after two abdominal training protocols, conven- ening the back). PME is considered to improve coordina- tional kinesiotherapy (CK) and Pilates mat exercises tion and balance and is claimed to increase activation of (PME). 13 participants were randomized to one of abdominal muscles during athletics or daily living activi- two groups: CK and PME, and were trained accord- ingly. The upper rectus abdominis (URA) and lower ties [1-3]. Joseph Pilates (1880-1967) developed this rectus abdominis (LRA) were independently exam- method seeking to match scientific principles of physical ined and inter and intra group comparisons were training with oriental philosophies and movement tech- done. Findings demonstrate a significant increase in niques [4,5]. RA strength after both protocols, relative to baseline. The rectus abdominis muscle (RA) is a superficial and Significantly increased electrical activation was seen important postural muscle, which also stabilizes pelvic in the URA after CK. Training with PME, although movements, assists in breathing and supports mainte- as efficient as CK in strength improvement, produced nance of proper intra-abdominal pressure. When ab- decreased activation level of muscles. CK training dominal strength is not adequate to counter the pull of induced an opposite result. The differences after the antagonist Erector Spine under load, these low back training suggest that CK and PME training pro- muscles are put at a mechanical disadvantage further grammers may strength RA, but the neuromuscular placing additional stresses on lower back [6,7]. activation strategies for that are not the same. PME Conventional kinesiotherapy (CK) is often used for can be incorporated into protocols to improve ab- strengthening the RA, since this seems to be associated dominals strength, and trunk stabilization. with decreased risk of lumbar spine lesions, or with im- proved rehabilitation after these lesions [8-11]. Keywords: Rectus Abdominis; Pilates Mat Exercise; Both CK and PME focus on several deep and superfi- Surface Electromyography cial muscles, including the RA. A better comprehension of how the different types of exercises recruit the RA is a necessary step for the development of specific abdominal 1. INTRODUCTION routines that better attend customized needs of patients Pilates mat exercise (PME) has become a fast-growing or trainees [2,11-13]. Several studies investigated the popular trend in rehabilitation and conditioning programs. effectiveness of CK in activating the RA for strength, pain relief, and rehabilitation after specific lesions [6-8, *Corresponding author. 10,14]. Few studies focused, however, on the effective- OPEN ACCESS 1172 R. L. Monteiro et al. / J. Biomedical Science and Engineering 6 (2013) 1171-1177 ness of PME in improving abdominis muscular activity. Baseline Assessement Preview findings suggested low back pain, muscular (13) strength and dynamic balance improved following Pi- lates, but rectus abdominis muscle activity was never measured, especially with sEMG [1-4,15-19]. Critchley Randomization (13) et al. proposed, in 2011, the first prospective study into the effects of PME on abdominal muscles. Using ultra- sound to measure Transverses abdominal (TrA) and PME group CK group Oblique internal abdominal thickness, they found that (7) (6) PME training appears to increase TrA activity during the exercises but not during functional postures. There was Figure 1. Study design flow chart. no mention, however, about the muscles’ electrical activ- ity patterns [20]. was conducted in accordance to the Health National The aim of this feasibility study was to compare the Council guidelines (Resolution 196/96). effects of PME and a conventional strength training pro- gram of CK on the RA electrical activity and force. Sci- 2.3. Procedures entific evidence to support the differences between these Firstly, all basic anthropometric measurements were col- methods is yet missing. The secondary objective of this lected and the subjects were familiarizes with the tasks study was to contrast muscular activity in the upper (URA) and lower portions (LRA) of the RA after each and methods. The same investigator performed all pro- intervention. cedures and tasks with each subject to ensure uniformity. All exercises were explained and demonstrated by an 2. METHODS instructor trained in Pilates method by Metacorupus Stu- dio Pilates®. 2.1. Experimental Approach to the Problem Maximal isometric voluntary contraction (MIVC) was This study attempted to identify differences in force de- used to measure the RA force and URA and LRA elec- velopment and also in muscle recruitment patterns trical activity at baseline. The test was performed 3 times among two abdominal exercise methods. The Pilates me- and the average of electrical activity and force parame- thod has been gaining recognition recently as a novel ters was used for further comparisons. choice for strength and/or endurance of abdominal and MIVC was conducted with participants in dorsal decu- lumbar muscles [2,3]. Few studies have investigated the bitus, with hip and knees straight and strapped with a belt. electromyographic activity and strength during PME, and The measurement position was resisted curl-up with none of them had this follow-up investigation [18,21]. maximal isometric resistance applied to the shoulders CK, however, includes several modes of exercises to [25]. Arms were crossed over the chest. RA maximal improve strength an has been well investigated [9,10,22, force contraction was measured during the test by digital 23]. By comparing both methods in a longitudinal study, dynamometer (Berman load cells, Primax Inc. São differences in the electrical activation associated to the Paulo-SP) with maximal capacity of 200 Kgf, attached force generated may be identified. The results of this bellow the bed. Surface electromyography (sEMG) was study are relevant to head coaches, strength coaches, used to measure muscle activity. coaches, athletic trainers and physical therapists in the fact that they may use different kinds of exercises con- 2.4. sEMG Measurements cerning their aims. See Figure 1. An 8-resolution channel data acquisition system (model EMG820C, Emgsystem Inc; São José dos Campos, Bra- 2.2. Participants zil), consisting of a signal conditioner with a band-pass This feasibility study included participants were ran- filter of 20 - 450 Hz, and amplifier gain of 2000, was domized to one of two groups: conventional kinesio- used to obtain the biological signals. All data were proc- therapy (CK) and Pilates mat exercises (PME). Abdomi- essed for analysis by specific software (Labview Emg- nal hypotonic was estimated using the Canadian Stan- system, Inc). sEMG activity was captured by differential dardized Test of Fitness [24]. Participants were asked to surface electrode (SDS500), and performed by an A/D conduct a series of abdominal flexions and were included board with 14-bit resolution input range, sampling fre- if incapable of doing at least 24 repetitions in one minute. quency of 2000 Hz, common rejection module greater This study was conducted in the Clinical Assessment than 100 dB, signal noise less than 0.3 μV RMS and im- Laboratory of “Faculdade Seama”, and participants agreed pedance of 109 Ω. to participate by signing informed consent. The study The electrodes (20 mm diameter and centre-to-centre Copyright © 2013 SciRes. OPEN ACCESS R. L. Monteiro et al. / J. Biomedical Science and Engineering 6 (2013) 1171-1177 1173 distance 20 mm) were placed bilaterally in the ventral in abdominal muscles, lifting straighten alternate legs to portion of the upper and lower parts muscle, and verti- full knee extension. Volunteers could progress to starting calized according to the guidance of the Surface EMG with both legs in 90˚. Three series of 30 repetitions
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