Pilates for Rehab: A Guidebook to Integrating Pilates in Patient Care.

Pilates for Rehab: A Guidebook to Integrating Pilates in Patient Care Smith F, Smith K. Minneapolis, MN 55447, OPTP, 2005, spiralbound, 223 pp, illus, ISBN: 0-9764757-8-2, $57.50.

Pilates for Rehab targets the professional fitness practitioner who wishes to incorporate Pilates principles and exercises into their clients' rehabilitation programs. The basic concepts, such as breathing and pelvic and spinal positioning for stability, along with motor control for integrating mobility, are presented. This book describes the principles of Pilates in an easy-to-read, progessional format with helpful hints to avoid common pitfalls in the application of this philosophy.

Chapters 1 through 5 introduce the basic guidelines of applying Pilates in a rehabilitation program, whereas the later chapters (chapters 6 through 12) integrate these principles in the design of exercise routines and the use of specific exercises in these routines. Although each chapter includes references, the final chapter, chapter 13, provides evidence-based literature for the integration of Pilates exercise in rehabilitation, along with traditional teachings and helpful resources.

Chapter 1 emphasizes the fundamentals of establishing stability before promoting mobility, balance, coordination, and muscle stamina. Chapter 2 presents the motor learning framework using the cognitive, associative, and automatic phases of learning a motor skill, along with an evidence-based discussion to support this conceptual model.

Chapter 3 provides a postural and functional assessment that can be used to integrate the Pilates exercises and principles into the clients' goals. This chapter, along with chapter 4, continues the progression of the basic principles. Next, the core areas of breathing; pelvic, rib cage, and head positioning; and scapular control are discussed in terms of clinical application. Chapter 5 focuses on assessment and the retraining of breathing and the transversus abdominis muscle.

Chapters 6 and 7 begin the actual description of specific exercises to develop the stability on which mobility is built. Lower-extremity patterns in a single plane, as well as multiplane exercises, are illustrated with the pelvis in neutral position and positioned in a posterior tilt. More specific exercises also are described. Each exercise is presented in a similar manner with the following headings: "Illustrated," "Practical Tips," "Purpose," "Clinical Application," "Repetitions," and "Faulty Movement Patterns." The associative phase of motor learning is integrated in these 2 chapters and is carried over to chapter 8, where the use of easily acquired equipment--such as large and small balls, dowels, foam rolls, and unstable surfaces--is demonstrated with Pilates exercises.

In chapter 9, helpful cues are given to more effectively teach Pilates. Imagery is presented in chapter 10 to facilitate learning. Excellent illustrations and ideas suggest activities that help the clinician teach the correct techniques of the basic principles of many of the Pilates exercises.

The integration of the Pilates exercises is demonstrated in chapters 11 and 12. Cases involving clients, such as a person with lordosis, a mother who is postpartum, and a cross-country skier, are used to present the exercises that, depending on each client's goals, can be used to address stability and mobility issues. Chapter 12 illustrates the progression of fitness training with athletes using a 3-phase, Pilates-based protocol. The protocol begins by establishing stability, followed by integrating mobility, and then ending with sport-specific skill training. The chapter presents a case of an athlete with an anterior cruciate ligament injury as an example of using Pilates exercises in preparation for return to play.

In conclusion, this book is easy to follow and easy to apply to the clinical setting. The illustrations of the exercises added to the ease of understanding as well as to the consistency of the presentation, including the most likely faulty patterns that the clinician may encounter.

Rose L Smith, PT, DPT, SCS, ATC 

University of Cincinnati 

Cincinnati, Ohio 

Smith is Assistant Clinical Professor in the Department of Rehabilitation Sciences, Interim Director of the Health Sciences Program, Adjunct Instructor in the Athletic Training Program, and Novacare rehabilitation specialist for the UC Athletic Department.

[DOI: 10.2522/ptj.2006.86.10.1451.1]