Jbmt 00 maximizing the benets of

Maximizing the bene®ts ofPilates-inspired exercise for

learning functional motor skills. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Claudia Lange,Viswanath Unnithan,Elizabeth Larkam, Paula M. Latta

Abstract Joseph Pilates (1880±1967) created a system of ®tness exercises that are still

practiced in a more or less modi®ed form. Within the last two decades, there has been

a signi®cant increase in the popularity of such Pilates-inspired (PI) exercises. This

paper describes current claims for the e�ectiveness of PI exercises and comments on

their validity. Motor learning principles and ®ndings are applied to make

recommendations for using PI exercises to enhance the execution of functional

movement tasks. The learning-performance distinction, augmented information

feedback, contextual interference, skill transfer and augmented verbal cues are

discussed. Finally, suggestions are made for aspiring PI practitioners seeking training

and certi®cation. # 2000 Harcourt Publishers Ltd

Claudia Lange PhD

Viswanath B. Unnithan PhD

Department of Exercise and Sport Science,

University of San Francisco

R E V I E W

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Journal of Bodywork and Movement Therapies (2000)4(2), 99^108# 2000 Harcourt Publishers Ltd

Elizabeth Larkam MA

Center for Sports Medicine, Saint Francis Memorial

Hospital, San Francisco

Paula M. Latta BS

Peninsula RSI, Redwood City, CA

Correspondence to: C. Lange

Department of Exercise and Sport

Science, University of San Francisco,

2130 Fulton St, San Francisco,

CA 94117-1080, USA.

Tel.: +1 415 422 6874; Fax: +1 415 422 6040;

E-mail: [email protected]

This research was conducted in the Department of

Exercise and Sport Science, University of San

Francisco, 2130 Fulton St, San Francisco,

CA 94117-1080, USA

Received October 1999

Revised November 1999

Accepted December 1999

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Joseph Pilates andContrology

Joseph Pilates was born in Germanyin 1880. A sickly child, he usedphysical exercise to turn himself intoa ®t adult. In 1912, Pilates moved tothe UK and held a variety ofoccupations, including boxer andself-defense trainer. During WorldWar I, while interned in a prisoncamp for German nationals, hetaught his ®tness exercises toinmates. Upon returning toGermany after the war, he gaveexercise classes to police andmilitary personnel and interactedwith members of the avant-gardedance community, such as Rudolfvon Laban and Hanya Holm. In1926, he moved to New York City

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ODYWORK AND MOVEMENT THERAPIE

and soon opened an exercise studiowith his wife Clara. Pilates wrote aslender volume (1934) outlining hissystem of Contrology, which hedescribed as a set of healthfullifestyle changes and correctiveexercises. A later booklet (Pilates& Miller 1945) features a number ofthe exercises. His methods andspecialized ®tness equipmentachieved popularity with danceprofessionals such as GeorgeBalanchine and Martha Graham,but were largely unknown to thegeneral public. Pilates died in 1967.A handful of students have carriedon his teachings and in¯uencednumerous other individuals to learnand teach his exercises. As a result,the name Pilates has becomeassociated with a form of movement

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Box1 De¢ning characteristics of Pilates-inspiredexercises

. Progressively enhance breath, core (body center), shoulder girdle, and limb control.

. Movements are slow and deliberate, with few repetitions (usually 5±10).

. Programs are highly individualized. One-on-one, dyad, and small group sessions are

conducted.

. Exercises are done on ¯oor mats and equipment.

. Exercises are done from lying, sitting, kneeling, standing and other postures.

. Some equipment uses springs to provide variable resistance.

. Main piece of equipment is the Universal Reformer, a frame with a padded carriage

that slides back and forth within the frame. Adjustable springs attach from the carriage

to the frame. The carriage may be moved by pushing it, or by pulling on straps placed

around arms or legs.

. Other large pieces of equipment include the TrapezeTable (Cadillac), Combo (Wunda)

Chair, Ladder and Step Barrels, and Ped-a-Pul.

. Small pieces of equipment include exercise balls, foam rollers, rotating disks, balance

boards, resistance rings, small arcs, and boxes.

Lange et al.

that is increasingly popular inclinical and ®tness settings.

Pilates (1934; Pilates & Miller1945) made bold claims for thebene®ts of Contrology. Forexample, he stated that it wouldprevent coronary heart disease,increase muscular power, and reducethe risk of respiratory ailments. Healso stated that it would result incomplete voluntary control of thebody. He described Contrology as a`balance' or `complete coordinationof body, mind, and spirit' achievedby relinquishing strenuous exercisesand deliberately performingfunctional activities in a posturallyappropriate manner. Despite Pilates'assurances (1934, Pilates & Miller1945) that he had `scienti®cally'proven the e�ectiveness of hisapproach, he did not subject hisclaims to experimental testing andmaintained that such testing wasunnecessary.

Within the last two decades, therehas been a signi®cant increase in thepopularity of exercises based onPilates' teachings. In the USA alone,more than 700 studio andrehabilitation sites use his methods(Larkam & Brownstein 1998). Adirectory of UK practitioners (BodyControl Pilates 1999) lists roughly100 studios. Practitioners can alsobe found in Africa, Asia, Australiaand New Zealand, Europe andSouth America. In order tounderstand the signi®cance ofPilates for functional skillimprovement, it is necessary to beaware of claims made by currentpractitioners regarding the learningbene®ts of their exercise sessions.This can serve as a basis forpractical recommendations aboutimproving the quality of sessions.Such recommendations cangenerically be derived from the®ndings of existing experiments onmotor skill learning. However, morePilates-speci®c recommendationscan only emerge with scienti®c studyof Pilates-type exercises themselves.

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Considering the widespreadapplication and adaptation of theseexercises, there is a growing need toobjectively assess their outcomesand bene®ts.

The purpose of this paper is toevaluate current claims on thelearning bene®ts of exercises derivedfrom the system developed byPilates. Motor learning principlesand ®ndings will be used as a modelto make recommendations foradministering Pilates-type exercisesto enhance functional movementskills. Finally, suggestions will bemade for aspiring practitioners ofthese exercises seeking training andcerti®cation.

Claims on the learninge¡ectiveness ofPilates-inspiredexercises

The legacy of Pilates

Pilates was in¯uenced by hathayoga, gymnastics, modern danceand other movement systems. Hedesigned about 40 mat exercises andhundreds of exercises for hisspecialized equipment (Larkam &Nichols 1999). His exercises havebeen further in¯uenced by ®elds asdiverse as physical therapy, somatics(e.g. Feldenkrais MethodTM, Body/Mind Centering1, Bartenie�

100


Fundamentals), and Chinesemedicine. Today, these (more or lessmodi®ed) exercises are knowncollectively as Pilates, Pilates-basedor Pilates-evolved. It is not the goalof this paper to distinguish amongdi�erent exercise styles that arebased on Pilates' teachings. Rather,all exercises emanating from thoseestablished by Pilates will be de®nedas Pilates-inspired (PI). There is anongoing discourse between Pilates'central ideas and movementroutines, and other systems ofmovement and rehabilitation. Thede®ning characteristics of PIexercises are listed in Box 1.Examples of equipment andexercises based on Pilates' designsare shown in Figures 1±5.

Current claims forPilates-inspired exercises

A sampling of relevant sourcesreveals three categories of claims onthe bene®ts of PI exercises:enhanced physiological functioning,enhanced psychological functioningand learning or re-learning offunctionally e�ective postural setsand motor patterns (e.g. Robinson& Thomson 1997, Balanced Body1

1999, Gallagher & Kryzanowska1999, Physicalmind Institute 1999,Stott Conditioning 1999, TheBalanced Body Studio 1999, Pilates

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Fig. 1 A golfer has been diagnosed with spinal facette lock. During rehabilitation, the therapist is

giving verbal and tactile information to guide her to the appropriate position of spine extension

and rotation. The patient is lying on the Trapeze Table and is using the spring-loaded pedals of

the Combo (Wunda) Chair to assist her action. Desired functional activity might be a golf swing.

Reproduced by kind permission of Balanced Body1, Inc. (1999) and Polestar1 EducationLLC(1999).

Box 2 Claimsmade on the e¡ectivenessof Pilates-inspiredexercises

Enhanced physiological functioning

. ¯exibility and range of motion

. muscular strength

. muscular endurance

. muscular power

. cardiorespiratory ®tness

Enhanced psychological functioning

. mood

. motivational state

. attentional focus

. enjoyment of life

. energy and zest

Enhanced motor learning

. core control

. static and dynamic posture

. intralimb and interlimb coordination

. aesthetically pleasing movement form

. body awareness

. static and dynamic balance

Pilates-inspired exercise

Institute 1999). To give an idea ofthe extent of these claims, examplesare listed in Box 2.

Of speci®c interest to this paperare claims related to motor learning.A main aspect of PI sessionsmarketed to the ®tness consumer isthe aesthetic bene®t of a longer,leaner appearance that comes fromimproved posture. Dancers are toldthey can develop more gracefulmovement patterns. Athletes areassured they will maximize theirbiomechanical e�ciency throughmore appropriate muscle synergies.A growing number of rehabilitationprofessionals are attracted to PIexercises due to the promise ofregained function after events that

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disrupt normal coordination, suchas orthopedic surgery, stroke, andhead trauma. They also see PIexercises as a possible tool formanagement or improvement ofphysical ailments including multiplesclerosis, ®bromyalgia and chronicpain.

The claims made by current PIpractitioners regarding the motorlearning bene®ts of their exercisesare overwhelminglyunsubstantiated. Only a smallnumber of published experimentalstudies document measuredimprovements in posture orfunctional tasks that areunequivocally attributable to PIexercises (Parrott 1993, Fitt et al.

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1994, Krasnow et al. 1997,McMillan et al. 1998). Roughly anequal number of studies also reportthe failure of PI exercises to elicitimprovements (Fitt et al. 1994,Krasnow et al. 1997, McLain et al.1997). Despite the lack ofsupportive, research-based data onPI exercises, anecdotal reports bypractitioners and clients indicatethat signi®cant bene®ts do indeedexist. It is therefore worthwhile tomake preliminary recommendationsfor maximizing the bene®ts of PIexercises to enhance coordination,sensory awareness, and performanceon functional tasks. Theserecommendations are derived fromthe ®eld of motor learning, whichdeals with the experimental study ofskill acquisition and performance.

Recommendationsto practitionersof Pilates-inspiredmovement

Practitioner goals

PI practitioners have threeimportant learning goals, which are

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Fig. 2 In a health club, clients are kneeling on the spring-loaded carriages of portable Reformers

and using their pectoral, biceps brachii, and anterior deltoid muscles to pull against the arm

straps. This action results in a backward movement of the spring-loaded carriage. Equal attention

is paid to concentric and eccentric contractions. The group exercise instructor is providing verbal

cues and imagery. Desired functional activities include any actions requiring dynamic trunk and

scapular stabilization. Reproduced by kind permission of Balanced Body1, Inc. (1999) and

Polestar1 EducationLLC (1999).

Lange et al.

outlined in Box 3. First, they wantclients to retain the exercises they areteaching. In other words, they wantclients to develop independentcontrol of new movement patterns.

Box 4 How to increase the e¡ectivenessof Pilate

. Observe the learning-performance distinctio

. Use augmented verbal cues, self-talk and im

. Use augmented information feedback judici

. Vary the context of practice trials.

. Use the right practice tasks to maximize tra

Box 3 Learninggoals of Pilates-inspiredpractitio

. Clients retain PI exercises taught by practiti

practitioner's corrections.

. Breathing, core control, body awareness, an

exercises transfer to functional tasks.

. Practice is structured to facilitate retention a

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Second, practitioners want clients tobe able to transfer the coordinationpatterns and sensory awarenesslearned during sessions to functionaltasks outside of the practice

s-inspiredexercises

n.

agery.

ously.

nsfer to functional tasks.

ners

oner and can perform PI exercises without

d coordination patterns learned from PI

nd transfer.

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DYWORK AND MOVEMENT THERAPIE

environment. Such tasks includewalking, reaching, lifting and otheractivities of daily living and work.They also include complexmovement sequences executed byathletes and performing artists.Third, practitioners want tostructure practice to facilitateretention and transfer.

Though practice by itself is oftenconsidered the most importantvariable for successful retention andtransfer-hence the adage thatpractice makes perfect-it is certainlynot the only one. The conditionsunder which practice takes placehave a great in¯uence on theamount of skill learning. Somepractice conditions appear to have apositive e�ect on learning, whereasothers seem to result in lesssuccessful learning. It is beyond thescope of this paper to provide athorough discussion of all practiceconditions. For more in-depthinformation, the reader is referred toseveral appropriate sources (Feltz &Landers 1983, Landin 1994, Magill1998, McCullagh 1993, Rose 1997,Schmidt & Lee 1999, Shea et al.1993). The structure of practicebecomes all the more relevant for PIroutines, because the latter rely onlow numbers of repetitions. Pilates(1934, Pilates & Miller 1945)stressed the importance of fewrepetitions (usually less than 10 perexercise). Instead, he emphasizeddeliberate practice during whichconscious attention is focused onrelevant task-related stimuli andprocesses. Current PI practitionersfollow his lead and recommend 5±10repetitions for most exercises (e.g.Robinson & Thomson 1997; Evans& Stott Merrithew 1998a, 1998b;Gallagher & Kryzanowska 1999).Hence, the amount of practice maybe less critical for learning than theconditions of practice, and PIpractitioners play an essential role instructuring these conditions. Fiveimportant recommendations forhow practice conditions may be

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Fig. 3 In a studio setting, a client is straddling the Ladder Barrel. She is lifting the pelvis o� the

barrel by activating her adductors, hamstrings, pelvic ¯oor muscles, and external rotators. This

complex posture can also be done with feet parallel. The instructor may provide cues or feedback.

Examples of applications include ballet and horseback riding. Reproduced by kind permission of

Elizabeth Larkam and Balanced Body1, Inc. (1999).


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JOURNAL OF BODYWORK AND MOVEMENT THERAPIE

structured, in order to accomplishthe goals of retention and transfer,will be described in the followingparagraphs. Recommendations aresummarized in Box 4.

Recommendations forpractitioners

Recommendation1: observe thelearning-performance distinctionMotor learning has been de®ned as`a set of processes associated withpractice or experience leading torelatively permanent changes in thecapability for movement' (Schmidt& Lee 1999). One important aspectof this de®nition is the so-calledlearning-performance distinction.Learning is not a merely a change inbehaviour, because changes can betransient. For instance, augmentedinformation feedback (AIF) can beprovided to learners about thesuccess of their movements in theenvironment, or about the quality oftheir movement patterns. An

Fig. 4 In a studio or rehabilitation setting, a

ballet dancer is using the Trapeze Table

(Cadillac) to increase awareness of proper

hamstring and hip extensor activation, in

conjunction with core control and spine

articulation. She is pressing with her left foot

against a spring-loaded bar. A therapist may

spot for safety by placing a hand over the

dancer's left foot to prevent it from slipping

o� the bar. This exercise can be done in many

variations to facilitate intratask transfer.

Reproduced by kind permission of Elizabeth

Larkam and Balanced Body1, Inc. (1999).

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Fig. 5 During an advanced mat class, a ®tness client is executing a front leg pull. This action

requires activation of deep abdominal and spinal musculature, as well as posterior shoulder girdle

stabilizers. It can also be done prone (facing down) as well as sidelying. Switching among di�erent

postures assists the client in maintaining axial elongation and core control during a variety of

upright functional activities and is a precursor to sport-speci®c conditioning. Reproduced by kind

permission of Elizabeth Larkam and Balanced Body1, Inc. (1999).

Lange et al.

example of AIF might be apractitioner's verbal or tactileinformation about the degree ofspine extension and rotationachieved during the prone Chairexercise depicted in Figure 1. Untilrecently, it was thought thatproviding a lot of AIF was better forlearning. Indeed, laboratoryexperiments show that whenlearners receive AIF after eachpractice trial, their performance isusually better when compared tothat of learners who receivefeedback after fewer trials.However, once AIF is removed andlearners must rely on their ownrecollection of the movement, thosewho received less in practice aretypically more successful (Salmoni etal. 1984, Schmidt 1991a, Schmidt &Lee 1999).

It is evident from the example ofAIF that one cannot always predictlearning from the quality ofperformance during practice

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sessions. Rather, the temporary andrelatively permanent in¯uences ofinstructional methods must be takeninto account. The learning-performance distinction is a crucialaspect of evaluating the success ofany rehabilitation or conditioningsystem. Practitioners should striveto be aware of this distinction andunderstand that clients may beperforming PI exercises orfunctional tasks very di�erentlywhen not in the rehabilitation centeror studio. One way to assess learningis to ask the client at the beginningof the session to demonstrate anexercise or functional activity thatwas practiced last session. This typeof approach can give an estimate ofhow much was learned.

Recommendation 2: use augmentedverbal cues, self-talk, and imageryAugmented verbal cues (AVC) areconcise phrases, often consisting ofone or two words, which are used by

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instructors to direct the learner'sattention to task-relevant stimuliand to prompt correct taskexecution (Landin 1994).Furthermore, cue words can be usedby learners themselves prior tocarrying out a task, in which casethey are referred to as self-talkregimens (STR). Short-term memoryis considered to be limited to ®ve tonine separate pieces of information(Miller 1956; Rose 1997). Thenumber may be lower for somepopulations, such as stroke patients.Therefore, too many instructionsmay overload a learner trying toattend to task-relevant stimuli andorganize a new response. AVC aresomewhat like instructions, butbecause they consist of fewer wordsand only address a few importantaspects of the task, they are thoughtto place less load on short-termmemory and increase chances thatthe learner will retain the correctmotor pattern. For example, in theReformer group exercise depicted inFigure 2, the practitioner might usethe cue `funnel your ribs into yourpelvic bowl.' Such a cue might bemore e�ective than giving a detailedexplanation on how to use the deepabdominal, spinal and pelvic ¯oormuscles for dynamic trunkstabilization. Similarly, in theLadder Barrel exercise inFigure 3, the phrase `sit tall in thesaddle' may be more e�ective inconstraining the body's degrees offreedom than telling the client toactivate a variety of separatemuscle groups.

Although AVC and STR have notbeen as extensively studied as someother instructional methods,research evidence (Landin 1994)suggests they are quite useful.Landin makes severalrecommendations for using verbalcues: First, he suggests using twowords or less for STR, and up tofour words for AVC. Second, if cuesaddress di�erent parts of a task, it isimportant to consider how those

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parts are interrelated. Cues shouldnot disrupt the normal rhythm ofthe movement pattern by drawingtoo much attention to one part ofthe task and creating arti®cialbreaks between parts. For example,breathing relies on a smoothtransition between in-breath andout-breath. Too much emphasis onthe in-breath can create breathholding and destroy the movement's¯ow. Landin's thirdrecommendation is to consider thevariability of the environment andwhether it is important for thelearner to focus on internal bodystimuli, or external environmentalstimuli, or both. Many tasks in sportand everyday life require switchingattention between internal andexternal stimuli (Nide�er 1993). PIexercises typically focus the learnerentirely on internal body sensations,which may be necessary duringinitial phases of recovery orconditioning, or when an exercise is®rst introduced. However, ifswitching between an internal andexternal focus is part of thefunctional activities the client mustperform, practitioners should createsituations that require switching.Fourth, Landin states that STR canbe used in some cases to supplantAIF by priming the correct actionbefore it takes place. This isparticularly useful in group exerciseclasses, outside of class when theinstructor is not present, or if thereis only one chance to `do it right', asituation that exists in manycompetitive sports. Finally, skilllevel must be considered whendesigning cues. Beginners need cuesthat re¯ect their less re®nedunderstanding of the task and allowthem to get the general idea of thecorrect action, whereas moreadvanced learners may need to focuson speci®c errors. Rose (1997)makes the additionalrecommendation that cues shouldhelp evoke task-relevant imagery.Mental imagery can be used during

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physical practice. It can also be usedby itself, in which case it is calledmental practice. Although notalways e�ective, telling learners tomentally imagine or mentallypractice the correct movementpattern frequently appears to havepositive e�ects on retentionFeltz & Landers 1983, Schmidt &Lee 1999). Therefore, cuessuch as `funnel your ribs' or`sit tall' may act like mnemonicprompts that help evoke task-relevant muscular activity duringexercises or related functionalactivities.

Recommendation 3: use augmentedinformation feedback judiciouslyAs already stated, AIF is task-related information that helps thelearner correct errors in themovement's outcome and pattern.Research suggests that it should beused judiciously. First and mostimportantly, too much informationabout errors may overload thelearner's short-term memory, directattention away from importantsensory stimuli, and prevent thedevelopment of proper coordinationpatterns. Therefore, PI practitionersshould resist the temptation to pointout all the errors a learner is makingand suggest corrections. It is moreuseful to select one or two errorsappropriate to skill level. Forexample, beginners might needcorrections related to breathing andmaintaining a neutral spine whiledoing supine leg circles on the mat.More advanced clients might needpointers on how to maintaindynamic trunk alignment andscapulo-humeral rhythm whendoing any exercises involving trunklateral ¯exion and arm reaching. Asecond recommendation for usingAIF is to taper o� the amount offeedback as the learner becomesmore pro®cient and can increasinglyrely on internal representations andsensory awareness of the correct

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action (Winstein & Schmidt 1990).A third guideline for AIF is that thelearner must know how to interpretit (Schmidt 1991b). A person withlittle knowledge of anatomy will notbe able to understand a statementsuch as `you aren't using yourintercostals.' Finally, giving AIFduring, or right after, a movementmay not always be a good idea. Alearner who is trying to master anexercise involving all four limbswhile maintaining core control, suchas the Trapeze Table exercise inFigure 4, may be overly distracted ifthe practitioner interrupts withhelpful advice. For extended PIroutines that last 30 s or more, itmay be best to give AIFperiodically. For discrete PImovements like doing a head andspine roll-up to a sitting position, itmay be best to wait a few secondsafter a trial before giving AIF. Thismay give the learner an opportunityto focus on the ¯eeting sensoryimpression of what the movementfelt like, before receivinginformation about its correctness(Swinnen et al. 1990).

Recommendation 4: vary the contextof practice trialsWhereas practice conditions such asfrequent AIF temporarily enhanceperformance but degrade learning,others have the opposite e�ect. Oneexample for this occurs whencontextual interference ismanipulated during practice. Lowcontextual interference occurs whenall repetitions of Task A arefollowed by all repetitions of TaskB, all repetitions of Task C, and soon. For example, a client might do 8supine leg presses on the Reformer,followed by eight toe raises andeight jumps. By contrast, highcontextual interference is presentwhen one repetition of Task A isfollowed by one repetition of TaskB, one repetition of Task C, and soon. In other words, a leg press isfollowed by a toe raise, a jump,

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Lange et al.

another leg press, another toe raise,another jump, and so on. Highcontextual interference is thought torepresent a number of `real-life'movement conditions withconstantly alternating tasks.

Compared to low contextualinterference, high contextualinterference tends to depressperformance during practice.Beginners sometimes report feelingfrustrated or confused by highcontextual interference. It istherefore tempting to conclude thatit also causes less skill learning.However, numerous experimentshave shown that even for beginners,high contextual interference is oftenmore bene®cial to skill learning thanlow contextual interference (Magill1998, Schmidt & Lee 1999).Therefore, practice under high-interference conditions may actuallybe preferable in the long run.Practitioners should be aware thatlearners will be often be performingfunctional tasks under conditions ofhigh contextual interference andshould create routines thatprogressively approximate theseconditions. Using the example of themat exercise in Figure 5, a clientmight do 1±2 repetitions of aposture that requires supine trunkand shoulder girdle stabilization,followed by 1±2 repetitions of thesame posture in a prone position,and 1±2 sidelying. The client ischallenged to exert sensoryawareness, and proper control ofcore and shoulder girdle muscles,while switching tasks.

Recommendation 5: use the rightpractice tasks tomaximize skilltransferLearning is typically evaluatedthrough retention and transfer tests.Retention involves executing a givenmovement at a later time, whereastransfer is the application of apreviously acquired movement skillto new situations. Formally, transfer

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has been de®ned as a gain or loss inthe capability for performing acriterion task as a result of priorexperience with a practice task (Ellis1965, Schmidt & Young 1987). Onegoal of practice is to develop thecapability to adapt a previouslylearned action to new settings, or toperform variations of the action.This is called near transfer orintratask transfer (Sage 1984, Magill1998, Schmidt 1991b). For example,during the hip extensor andhamstring exercise performed on theTrapeze Table in Figure 1, positiveintratask transfer means successfullydoing the movement with internal orexternal hip rotation, with the entirespine resting on the Table, with bothlegs at once, and othermodi®cations. On the whole,intratask transfer as described abovetends to be positive, though notalways very large (Schmidt & Young1987).

A second goal of practice is to useprior experience with one action tosuccessfully execute a di�erentaction. This is called far transfer orintertask transfer (Sage 1984, Magill1998, Schmidt 1991b). The overallsimilarity of coordination patternsseems to be one of several factorsdetermining the degree of positiveintertask transfer. Very di�erentpatterns, such as swimming andvolleyball, do not transfer positivelyto one another (Nelson 1957,Schmidt & Lee 1999). The sameprinciple probably applies totwo PI exercises that use bothdi�erent pieces of equipment anddi�erent body parts, suchas lateral trunk ¯exion on theReformer and seated legextension on the Chair. Whenmovement patterns are reasonablysimilar, intertask transfer isfrequently small-to-moderate andpositive (Schmidt & Lee 1999). Forexample, doing a pelvic bridge onthe mat may transfer positively todoing the same exercise on theReformer.

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However, even when movementpatterns appear similar, positivetransfer can be negligible. Forexample, supine jumps on theReformer are practiced to preparedancers and athletes for standingvertical jumps. Yet researchindicates that supine jumpingpractice does not necessarily resultin positive transfer to uprightjumping (McLain et al. 1997). Theauthors of the latter study remarkedthat a during a jump on theReformer, the legs may be placed upto 30 degrees above the plane of thebody, creating signi®cant di�erencesin jump strategies between thesupine and standing conditions andpossibly reducing successfultransfer. In a biomechanical study,Self et al. (1994) found a di�erentrelationship between force and kneeangle during a supine plieÂ on theReformer and a standing plieÂ ,suggesting that the two tasks aredi�erent.

PI practitioners should bear inmind that two overtly similar tasksmay in fact require di�erent musclesynergies and be accompanied bydi�erent sensory input. Experiencewith one task may not give thelearner the necessary capability todo the other task. Conversely, twotasks that appear dissimilar mayactually involve similar underlyingmuscle synergies, sensory stimuli, orcognitive strategies. This principle isreferred to as transfer-appropriateprocessing (Lee 1988, Rose 1997).Practitioners should ask themselveswhether the exercises they assignprovide learners with anopportunity to practice the internalprocessing they will need forfunctional activities in sport, dance,or everyday life. Care should betaken to ensure a transition fromsupine, non-weight bearing activitiesto bipedal weightbearing activities(Loosli & Herold 1992). Practicewith supine exercises alone may nottranslate into improved alignmentor stability when standing up.

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Box 5 Checklist foraspiringpractitioners

. Investigate a number of programs.

. Consider program availability, cost, and duration.

. Trainers and certi®ers must have su�cient experience with the desired client population.

. Instructional modules dealing with anatomy, physiology, and clinical populations should

be overseen by individuals with proper training.

. Certi®cation examinations should include oral, written, and case study portions.

. To avoid con¯ict of interest, trainers should not have dual roles as certi®ers.

. Trainers should have up-to-date knowledge of motor learning principles and ®ndings.


Summary andrecommendations forthe future

In the preceding paragraphs, severalrecommendations for maximizingthe learning bene®ts of PI sessionswere introduced. However, theserecommendations are onlypreliminary. To date, no publishedstudies have been conducted inwhich an attempt was made todiscover causal links betweenpractice conditions, such as the onesdescribed in this paper, andimprovements on PI exercises orfunctional skills. This oversightshould certainly be remedied.

A second critical issue is thetraining and certi®cation that PIpractitioners receive. Assumptionsabout learning, and the instructionaltechniques that practitionersthemselves are taught, may be themost important sources of in¯uenceon their own teaching methods andbehaviours (Larkam 1999).Therefore, the selection of a suitabletraining and certi®cation program iscritical for the aspiring practitioner.A checklist of importantconsiderations is provided in Box 5.Training courses typically introducethe practitioner to functionalanatomy, a wide range of mat andequipment exercises, and supervisedhands-on teaching experiences.Written and/or oral certi®cationexaminations are also provided(e.g. Body Control Pilates 1999,Physicalmind Institute 1999, PilatesInstitute 1999, Pilates1 Method

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1999, Polestar1 Education 1999,Stott Conditioning 1999). Sometraining centers also mentionpractice conditions and teachingstrategies in their informationalliterature (e.g. PhysicalmindInstitute 1999, Polestar1 Education1999, Stott Conditioning 1999, ThePilates Center 1999), which suggeststhat the trainers have some formalknowledge of motor learningprinciples. However, it is best forprospective students to inquirebefore beginning any program.

This paper was intended toprovide an overview of currentclaims on the e�ectiveness of PIexercises. Readers were introducedto several practice conditions andprinciples of motor learning thatmay enhance the usefulness of PIexercises for improving functionalmovement. Suggestions were madefor aspiring practitioners seekingtraining and certi®cation. Finally, itmust again be stated that controlledexperimental studies are urgentlyneeded to verify the e�ectiveness ofPI exercises for enhancingfunctional skills in a diversity ofpopulations.

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Feltz DL, Landers DM 1983 The e�ects of

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Fitt S, Sturman J, McClain-Smith S 1994

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