Modified Pilates as an adjunct to standardphysiotherapy care for urinaryincontinence: a mixed methods pilot for arandomised controlled trial

Background Urinary incontinence (UI) is a distressing condition affecting at least 5 million women in England and Wales. Traditionally, physiotherapy for UI comprises pelvic floor muscle training, but although evidence suggests this can be effective it is also recognised that benefits are often compromised by patient motivation and commitment. In addition, there is increasing recognition that physical symptoms alone are poor indicators of the impact of incontinence on individuals’ lives. Consequently, more holistic approaches to the treatment of UI, such as Modified Pilates (MP) have been recommended. This study aimed to provide preliminary findings about the effectiveness of a 6-week course of MP classes as an adjunct to standard physiotherapy care for UI, and to test the feasibility of a randomised controlled trial (RCT) design. Methods The study design was a single centre pilot RCT, plus qualitative interviews. 73 women referred to Women’s Health Physiotherapy Services for UI at Colchester Hospital University NHS Foundation Trust were randomly assigned to two groups: a 6-week course of MP classes in addition to standard physiotherapy care (intervention) or standard physiotherapy care only (control). Main outcome measures were self-reported UI, quality of life and self-esteem at baseline (T1), completion of treatment (T2), and 5 months after randomisation (T3). Qualitative interviews were conducted with a subgroup at T2 and T3. Due to the nature of the intervention blinding of participants, physiotherapists and researchers was not feasible. Results Post-intervention data revealed a range of benefits for women who attended MP classes and who had lower symptom severity at baseline: improved self-esteem (p = 0.032), decreased social embarrassment (p = 0.026) and lower impact on normal daily activities (p = 0.025). In contrast, women with higher symptom severity showed improvement in their personal relationships (p = 0.017). Qualitative analysis supported these findings and also indicated that MP classes could positively influence attitudes to exercise, diet and wellbeing. Conclusions A definitive RCT is feasible but will require a large sample size to inform clinical practice. Trial registration ISRCTN74075972 Registered 12/12/12 (Retrospectively registered)

PROTOCOL FOR TESTING BEETROOT JUICE ON ANAEROBIC POWER AND PERFORMANCE

G. Greisman, J. Kloubec, K. Morrow, C. Harris, A. Kazaks Bastyr University, Kenmore, WA The nitrates found in beetroot juice (BR) are known to be a precursor of nitric oxide (NO). NO is a known vasodilator which allows more oxygen to travel in the blood and may improve muscle efficiency. PURPOSE: This study aims to set up a testing protocol to evaluate the effects of beetroot juice on anaerobic power and performance in trained CrossFit athletes. METHODS: The protocol was a randomized, cross-over, double-blind, placebo-controlled design to measure 500-meter row time, countermovement jump (CMJ), and blood lactate levels before and after the row. Participants consumed either 2.7 oz shot of BR (6.5 mmol nitrate) or a placebo nitrate-free beetroot juice (PL). Two hours later, they rowed 500 meters at maximum capacity. Measurements of blood lactate and the highest of 3 CMJs were recorded before and after the row. After a 7-day washout period, athletes repeated this sequence with either BR or PL for comparison. This study was performed in Fall 2019 at Mercer Island CrossFit with athletes who had at least six months CrossFit experience and were very familiar with the Concept 2 Rower. RESULTS: Twenty five athletes over age 18 (18 females, age range 25 to 60, average age 44) participated. The range of 500-meter row time was 1:28.8 – 2:26.4 (1:50.9 median). Blood lactate ranged from 0.8 to 5.6 (1.6) mmol before the row and 5.0 to 21.2 (10.2) mmol post row. Net CMJ ranged from 7.5 to 23.9 (11.9) inches pre row to 7.6 to 19.8 (11.4) inches post row. The median of the CMJ remained fairly stable pre and post row as not all athletes experienced muscle fatigue after the row. CONCLUSION: There were some inconsistencies in the measurement of the CMJ as athletes used chalk on their fingers to mark the spot on the wall next to a ruler. Most athletes tolerated the BR, though some had GI distress and others did not like the taste. All athletes were enthusiastic about participating and all but two participants agreed to measure their blood lactate. Overall this protocol for measuring anaerobic power and performance was successful, though modifying the CMJ procedure could eliminate some inconsistencies. Supported by Bastyr student research funding

The Effects of Pilates on the Elderly: An Integrative Review

Introdução: O Método Pilates tem sido considerado um sistema de exercício que visa melhora da flexibilidade, resistência física, força, equilíbrio e coordenação motora. Desta forma, muitos idosos têm procurado o Método em busca da melhora ou manutenção da saúde. Objetivo: O objetivo deste estudo foi revisar os efeitos do Método Pilates em idosos. Método: Esta é uma revisão integrativa, onde foram incluídos estudos com idosos submetidos à intervenção com o Método Pilates associadas ou não a outras técnicas. A questão norteadora considerada dispõe acerca do que já foi produzido na literatura sobre os efeitos do Método Pilates em idosos. As buscas foram realizadas em maio de 2014 nas bases de dados eletrônicas: MEDLINE (PubMed), Scopus e Physiotherapy Evidense Databasa (PEDro). Resultados: Do total de 445 estudos que resultaram da busca, foram incluídos 17 artigos. Diversas variáveis foram analisadas, sendo que o equilíbrio e o risco de quedas foram as mais descritas. Conclusão: As variáveis mais pesquisadas foram o equilíbrio e o risco de quedas e esses estudos são consensuais em relação à melhora dessas variáveis. O aumento da flexibilidade também é consensual, porém em relação aos demais efeitos relatados na literatura, ainda há controvérsia ou dados isolados e consequentemente inconclusivos. Dentre os estudos encontrados, a maioria foi experimental, dentre eles, apenas dois ensaios clínicos randomizados. Sugere-se a realização de outros ensaios clínicos que abordem o tema para que revisões sistemáticas com metanálise possam ser realizadas posteriormente garantindo maior confiabilidade dos resultados sugeridos neste estudo