Pilates and String Musicians: An Exploration of the Issues Addressed by the Pilates Method, an Illustrated Guide to Adapted Exercises, and a Pilates Course for University String Players

abstract: String players have been identified as the most affected group of instrumentalists suffering from musculoskeletal disorders, and most of the problems are related to posture. The high prevalence of injuries among string players suggests that there is room in the music curriculum for a program tailored to this population and that can provide both immediate and long-term solutions. Pilates is a mind-body conditioning method of exercises and a philosophy that shares many similarities with string playing technique and performance, which suggests that its practice can be beneficial to improve not only the posture of string players but also various other areas. Studies about Pilates as a treatment show the varied areas in which Pilates can help, which are all of interest to instrumentalists. However, the application of Pilates into the music curriculum as a way to help string players improve awareness and reduce injuries has not yet been fully explored. This document addresses the similarities between Pilates and string playing, identifies postural tendencies of string players, and demonstrates how specific Pilates exercises can help counteract asymmetries, restore balance, and reduce the number of musculoskeletal injuries of string players. All anatomical drawings included in this document were adapted from other sources, as cited, or originally drawn by the author.Dissertation/ThesisDoctoral Dissertation Music 201

The Effects of Postural Education or Corrective Exercise on the Craniovertebral Angle in Young Adults with Forward Head Posture: A Randomized Controlled Trial

International Journal of Exercise Science 16(1): 954-973, 2023. The purpose of this study was to compare the effects of three different intervention strategies, postural education (PE) and two corrective exercise programs (CEPs), on the craniovertebral angle (CVA) in young adults with forward head posture (FHP). A prospective four-arm parallel randomized controlled trial with repeated measures was performed. Seventy-nine healthy young adults (55 women, 24 men; mean age: 20.08 ± 2.19 years) with FHP were randomized into four groups: PE group, self-myofascial release + stretching group (SMRS), self-myofascial release + stretching + strengthening group (SMRSS), and a control group (CG). Participant CVA (°) was assessed before and after a 4-week intervention. Seventy-two participants completed the trial. Mean difference comparisons of within-group change in mean CVA revealed an increase in the PE (MD = 3.1, p \u3c .01), SMRS (MD = 3.8, p \u3c .01), and SMRSS (MD = 4.4, p \u3c .01) groups. Mean difference comparison of between-group change in mean CVA supported greater CVA change in the SMRS and SMRSS groups compared to the CG (F(3, 68) = 5.26, p \u3c .01, ƞ2 = .188). All three interventions appear to be effective techniques for improving FHP in young adults, however CEPs may provide superior outcomes than PE alone. A 4-week CEP consisting of self-myofascial release + stretching may yield similar CVA enhancements as a CEP consisting of self-myofascial release + stretching + strengthening. Study findings can assist fitness professionals in designing evidence-based FHP intervention programs for young adults

The effects of yoga on shoulder and spinal actions for women with breast cancer-related lymphoedema of the arm: A randomised controlled pilot study

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Abstract Background: We aimed to evaluate the effect of an 8-week yoga intervention on the shoulder and spinal actions of women with breast cancer-related arm lymphoedema. Method: A randomised controlled pilot trial. The intervention group (n = 12) completed eight weeks of daily yoga sessions while the control group (n = 11) continued with best current care including information on compression sleeves, skin care, risks of temperature variations and recommended safe use of affected arm. Lumbo-pelvic posture, range of motion (ROM) in the shoulder and spine, and strength in shoulder and pectoral major and minor, and serratus anterior were taken at baseline, week 8 and after a 4-week follow-up. Outcome assessors were blinded to allocation. Results: At week eight the intervention group had an improvement in lumbo-pelvic posture, as indicated by a reduction in pelvic obliquity compared to the control group (mean difference = −8.39°, 95 % CI: −15.64 to −1.13°, p = 0.023). A secondary finding was that strength in shoulder abduction significantly increased following the yoga intervention in both the affected (9.5 kg; CI: 0.34 to 18.66, p = 0.042) and non-affected arm (11.58 kg; CI: 0.25 to 22.91; p = 0.045). There were no significant between group changes in any ROM measures as a result of the yoga intervention. Conclusion: This pilot study demonstrates that participation in yoga may provide benefits for posture and strength in women with Breast Cancer Related Lymphoedema. The improvements may be attributed to the focus of yoga on overall postural and functional movement patterns. Further trials with longer intervention that follow this methodology are warranted. Trial registration: The Australian New Zealand Clinical Trials Registry ACTRN12611000202965. Keywords: Yoga, Arm lymphoedema, Breast cancer, Range of motion, Strength testing Abbreviations: BCRL, Breast cancer related lymphoedema; ROM, Range of motion; QOL, Quality of life; RCT, Randomised controlled trial; BIS, Bioimpedance spectroscopy; LPSI, Left posterior superior iliac spine; RPSI, Right posterior superior iliac spine; LACR, Left acromion; RACR, Right acromio

Physiotherapy scoliosis-specific exercises: a comprehensive review of seven major schools

In recent decades, there has been a call for change among all stakeholders involved in scoliosis management. Parents of children with scoliosis have complained about the so-called “wait and see” approach that far too many doctors use when evaluating children’s scoliosis curves between 10° and 25°. Observation, Physiotherapy Scoliosis Specific Exercises (PSSE) and bracing for idiopathic scoliosis during growth are all therapeutic interventions accepted by the 2011 International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT). The standard features of these interventions are: 1) 3-dimension self-correction; 2) Training activities of daily living (ADL); and 3) Stabilization of the corrected posture. PSSE is part of a scoliosis care model that includes scoliosis specific education, scoliosis specific physical therapy exercises, observation or surveillance, psychological support and intervention, bracing and surgery. The model is oriented to the patient. Diagnosis and patient evaluation is essential in this model looking at a patient-oriented decision according to clinical experience, scientific evidence and patient’s preference. Thus, specific exercises are not considered as an alternative to bracing or surgery but as a therapeutic intervention, which can be used alone or in combination with bracing or surgery according to individual indication. In the PSSE model it is recommended that the physical therapist work as part of a multidisciplinary team including the orthopeadic doctor, the orthotist, and the mental health care provider - all are according to the SOSORT guidelines and Scoliosis Research Society (SRS) philosophy. From clinical experiences, PSSE can temporarily stabilize progressive scoliosis curves during the secondary period of progression, more than a year after passing the peak of growth. In non-progressive scoliosis, the regular practice of PSSE could produce a temporary and significant reduction of the Cobb angle. PSSE can also produce benefits in subjects with scoliosis other than reducing the Cobb angle, like improving back asymmetry, based on 3D self-correction and stabilization of a stable 3D corrected posture, as well as the secondary muscle imbalance and related pain. In more severe cases of thoracic scoliosis, it can also improve breathing function. This paper will discuss in detail seven major scoliosis schools and their approaches to PSSE, including their bracing techniques and scientific evidence. The aim of this paper is to understand and learn about the different international treatment methods so that physical therapists can incorporate the best from each into their own practices, and in that way attempt to improve the conservative management of patients with idiopathic scoliosis. These schools are presented in the historical order in which they were developed. They include the Lyon approach from France, the Katharina Schroth Asklepios approach from Germany, the Scientific Exercise Approach to Scoliosis (SEAS) from Italy, the Barcelona Scoliosis Physical Therapy School approach (BSPTS) from Spain, the Dobomed approach from Poland, the Side Shift approach from the United Kingdom, and the Functional Individual Therapy of Scoliosis approach (FITS) from Poland

Risk Assessment and Interventions for Individuals at Risk of Osteoporotic Fractures

Older adults, especially with low bone mass, hyperkyphosis or vertebral fractures (OVF), and individual with spinal cord injury (SCI) are at increased risk of fragility fractures. Individuals with SCI and OVFs are subgroups of people with osteoporosis that are at high risk of fractures and present unique impairments, limitations, and restrictions that require population-specific and individually tailored and interventions. The objectives of this thesis were: 1) to explore potential sources of error during LS bone densitometry and trabecular bone score (TBS) values in individuals with SCI, and the applicability of TBS in fracture risk assessment; 2) to assess the effects of PRT on health-related outcomes in people with low bone mass or hyperkyphosis; 3) to establish recommendations for the non-pharmacological management of osteoporotic vertebral fractures; 4) to co-develop a virtually delivered education and training program on safe movement, pain management, nutrition, and exercise among people with osteoporotic vertebral fractures, and to test its acceptability and usability. Chapter one consists of a review of the literature on the epidemiology of fragility fractures, their consequences in the populations at greater risk, and the knowledge gaps in terms of risk assessment and non-pharmacological management. Chapter two presents the findings from two observational studies. Study 1 explored potential sources of error during LS densitometry in people with chronic SCI. Facet sclerosis and osteophytes and challenges in detecting bone edges are the most common sources of error, and most of the scans presented vertebrae with outlier BMD values. Study 2 described lumbar spine TBS values in a cohort of people with chronic SCI, whether they change over a two-year period, and how TBS affects fracture risk assessment in people with SCI. Individuals with chronic SCI on this cohort presented with normal bone microarchitecture based on TBS. TBS was not different between sexes, people with motor complete and motor incomplete injury or with and without previous fragility fracture. Clinical decisions regarding fracture prevention should not be based on TBS or FRAX® in people with chronic SCI at this time. The third chapter reports the protocols of two systematic reviews. One systematic review investigated the effects of PRT interventions on health-related outcomes in people with low bone mass, while the second investigated the effects of exercise interventions on improving postural and health-related outcomes in people with hyperkyphosis. The fourth chapter reports the outcomes of an International Modified Delphi Consensus process, which established recommendations on the non-pharmacological management of osteoporotic vertebral fractures. We generated recommendations on pain management (e.g., educate on pain expectation; assess pain-related psychological factors; limit prolonged sitting; lying supine with feet flat on surface and knees bent), nutrition (e.g., educating on recommended daily intake of protein, calcium, and vitamin D; refer to dietitian in presence of poor appetite or weight loss), safe movement (e.g., avoid heavy physical exertion, lifting, or activities that exacerbate pain for the first 12 weeks; bend at hip and knees; step to turn; hold objects close to body), and exercise (e.g., timing, intensity, example exercises, goals including improving back extensor endurance, spinal mobility, physical functioning, and balance). There was consensus on limiting bed rest, and on prescribing orthoses only to select patients. The fifth chapter presents the co-development of a virtual intervention for the non-pharmacological management of OVF (VIVA) and its acceptability and usability testing among people with OVF. VIVA has been co-developed to provide education and training on safe movement and pain management techniques, nutrition, and exercise, and involves seven 1-on-1 virtual sessions delivered by a physiotherapist over five weeks. We delivered VIVA to 8 individuals with vertebral fractures, to evaluate acceptability and usability. Participants perceived improvements in pain and felt more confident during the activities of daily living and in self-managing their OVF. All the participants believed that VIVA was very useful and were very satisfied with the 1-on-1 sessions. Three participants found the information received very easy to practice, four participants believed they were easy to practice, and one participant found them somewhat difficult. Four participants were very satisfied and four were satisfied with the supporting resources delivered throughout the program. Participants found accessing the resources easy, but think that logging in and out to access videos and resources, or to track adherence, was cumbersome. Chapter six provides a general discussion of how the present dissertation improved the knowledge in fracture risk assessment and non-pharmacological interventions in people at risk of fractures, and what the next steps to address the knowledge-to-action gaps in populations at high risk of fracture should be