efeitos do pilates em mulheres sedentárias

7/30/2019 Efeitos do Pilates em mulheres sedentrias.

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Journal of Bodywork and Movement Therapies (2007) 11, 318326

Bodywork and

Journal of

Movement Therapies

EXERCISE PHYSIOLOGY

Effects of Pilates exercise on trunk strength,

endurance and flexibility in sedentary

adult females

Betul Sekendiza,, Ozkan Altuna, Feza Korkusuza,b, Sabire Aknb

aPhysical Education and Sports Department, Middle East Technical University (METU), TurkeybHealth Centre, METU, Turkey

Received 31 August 2006; received in revised form 28 November 2006; accepted 1 December 2006

KEYWORDSPilates mat exer-cises;Isokinetic musclestrength;Trunk strength;

Flexibility;Endurance;Females;Sedentary

Summary The objective of this study was to examine the effects of Pilatesexercise on abdominal and lower back strength, abdominal muscular endurance andposterior trunk flexibility of sedentary adult females. The body fat and body massindex (BMI) pre- and post-data were also assessed as secondary outcomes. To assessabdominal and lower back strength, posterior trunk flexion and extension data wereobtained concentrically on a Biodex isokinetic dynamometer at speeds of 601 and

1201 s1

. Abdominal muscular endurance was assessed using the crunch test andposterior trunk flexibility was measured using the sit and reach test. Results ofmultivariate analysis revealed a significant difference (po.05) between pre- andpost-measures of 601 s1 flexion/extension and 1201 s1 flexion, and abdominalmuscular endurance and posterior trunk flexibility of the exercise group. It can beconcluded that there was a positive effect of Modern Pilates mat exercises onabdominal and lower back muscular strength, abdominal muscular endurance andposterior trunk flexibility in sedentary adult females regardless of the fact that thebody weight and fat percentages did not differ significantly.& 2007 Elsevier Ltd. All rights reserved.

Introduction

Joseph Pilates had developed a unique systemof hooking springs and straps in hospital beds to

help disabled and immobilized patients regainstrength and movement in order to counteractthe deleterious effects of deconditioning afterWorld War I, which was later going to be calledPilates (Friedman et al., 1980; Latey, 2001; Wilson,2002). With his development of the universalreformer (Latey, 2001) the importance of trainingthe core abdominal and lower back muscles tostabilize the torso and allow the whole body to

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www.intl.elsevierhealth.com/journals/jbmt

1360-8592/$ - see front matter & 2007 Elsevier Ltd. All rights reserved.doi:10.1016/j.jbmt.2006.12.002

Corresponding author. Orta Dogu Teknik Universitesi, BedenEgitimi ve Spor Bolumu, Inonu Bul. PK: 06531, Ankara, Turkiye.Tel.: +90 532547 12 56.

E-mail address: [email protected] (B. Sekendiz).
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move freely was recognized. This method inspiredother exercises to reach the desired level ofmuscular strength and flexibility on simple equip-ments such as mats (Latey, 2001, 2002; Runion,2002).

Within the last two decades Pilates exerciseshave infused new insights into the fitness industry

and lower back rehabilitation methods. CurrentPilates exercise styles can be divided into (a) therepertory approach, and (b) the modern approach(Latey, 2001). The repertory approach being thetraditional method, uses set exercise sequencesand set numbers of repetitions with little amount ofmodification for an individuals different types ofproblems. However, in the modern approach, theinitial emphasis is on understanding the bodyand improving awareness by tailoring the exercisesto clients particular needs, weaknesses andstrengths. In this respect, Modern Pilates mat

exercise trainees should think of their bodies assingle integrated units, with the goal of establish-ing a stable central core around which all move-ments take place (Argo, 1999). Through thisapproach the quality but not the quantity of themovement is imposed (Friedman et al., 1980). Inthis respect, Modern Pilates mat exercises resem-bles the theory of weight training to gain optimumstrength and endurance (Ives and Sosnoff, 2000).

Despite the increased popularity of Pilates matexercises within the last two decades, little researchhas been conducted on the method and its benefitsin a sedentary population. Pilates mat exercises have

been reported to be effective for improving static orpostural balance among a group of dancers (Fittet al., 1993). In recent studies (Geweniger, 2002;Handa et al., 2000; Springen, 2003), it was presentedthat Pilates mat exercises, utilized as a therapytechnique for the rehabilitation of severe low backpain, can be beneficial and effective with improvedresults documented in patients. However, furtherresearch is necessary to ascertain the methodspotential to improve the outcome of Modern Pilatesmat exercises in a sedentary population.

The purpose of this 5-week prospective long-

itudinal study was to investigate the effects ofModern Pilates mat exercises on abdominal andlower back muscular strength, abdominal muscularendurance and posterior trunk flexibility in sedentaryadult females. The body fat and body mass index(BMI) were also assessed as secondary outcomes.

Subjects and method

Independent variables were groups (Pilates andcontrol) and time (before and after exercise).

Dependent variables included: (a) BMI, (b) body fat,(c) abdominal and lower back muscular strength, (d)abdominal muscular endurance, and (e) posteriortrunk flexibility.

Subjects

Randomly selected 45 sedentary academicians in auniversity volunteered to participate in this study,who had not been attending regular exercisesessions, more than 45 min a day, three times aweek for more than a year. Each woman completeda demographic and health history questionnaire.Eighty percent of the participants reported thatthey experienced low back pain from time to time.Informed consent forms regarding information onthe study and possible side effects, such as musclesoreness in the abdominals and back muscles due tofatigue, were signed by the participants prior to

the study. Subjects were randomly assigned to thePilates and control groups.

Four participants of the exercise group and three ofthe control group dropped out of the study. Thereasons for the dropouts were reported to be eitherillness or personal decision. Therefore, the final resultsreproduced data of 21 women (mean age: 3076.6range 2647) of the exercise and 17 women (meanage: 3078.6 range 2647) of the control groups.

Pilates exercise

Exercises were implemented three times a week forfive consecutive weeks. This resulted in a total of 15sessions completed, which is the recommendednecessary number of exercise sessions to measurethe expected outcomes of Modern Pilates matexercises (Stott, 2006). A physical education andsports instructor who had 2 years of experience andcertification in Modern Pilates mat exercises in-itiated the exercises. Participants followed a stan-dardized exercise protocol for beginners that lastedfor 60minday1 (Friedman et al., 1980) (AppendixA). Some of the exercises in the protocol are shownin Figs. 1(a)(c), 2(a), (b), 3(a), (b), and 4(a), (b).

Instrumentation and procedures

Instruments for testing all variables were cali-brated and used by the same researcher in order tocontrol possible inter-tester variation. Both theexercise and the control groups were given pre- andpost-tests on all variables measured. Prior to thetesting, a standardized 5 min warm-up includingbrisk walking and upper-lower body stretchingexercises were completed.

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Effects of Pilates exercise in sedentary adult females 319


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Abdominal and lower back muscular strength

Abdominal and lower back muscular strength wasassessed concentrically on a Biodex System II

Isokinetic Dynamometer (Biodex Inc., Shirley, NY,USA) at speeds of 601 and 1201 s1. These speedsmet the velocity of the range of motion ofthe Modern Pilates mat exercises (Handa et al.,2000; Roetert et al., 1996). Participants werepositioned in the dynamometer seated with theirback and neck supported with the adjustable padsfor safety. The thighs, pelvis and chest wereconstrained by seatbelts to prevent sagittal pelvicrotation and facilitate isolation of the trunk for

flexion/extension testing only. The ankles wereplaced on an adjustable feet pad in neutralposition. Participants were instructed to keeptheir heads and arms in a fixed position throughoutthe test.

Before measurements, each subject was asked toperform a warm-up test of five repetitions. Theactual test of 10 repetitions at the two angularvelocities was then carried out after a 10 s restperiod. Peak torque/body weight ratios werestatistically analyzed as the measure of musclestrength (Jackson and Pollock, 1985).

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Figure 1 (a) The hundred (modified, starting position),(b) and (c) the hundred (modified)arms are parallel tothe floor, hovering 2 inches above it and are pulsed upand down for five inhalations and five exhalations. Pulsesare repeated 10 times to equal 100.

Figure 2 (a) The shoulder bridge (starting position) and(b) the shoulder bridge.

B. Sekendiz et al.320


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Abdominal muscular endurance

Abdominal muscular endurance was assessed as themaximum curl-ups performed without rest in 1 min(Ransdell et al., 2002). Abdominal curl-ups wereperformed in the supine position with the knees flexedat 451 with legs slightly apart and feet on the ground.The arms were extended along the sides of the bodywith hands in prone position and fingers outstretched.Participants were instructed to curl-up to lift theshoulder blades off the mat and slide their fingers from

one end of a 12cm ruler. After each curl-up, the sub-ject was instructed to return to the starting position.

Posterior trunk flexibility

Posterior trunk flexibility was measured by the sitand reach test (Clark et al., 1989). The participantswarmed-up for 5 min and then sat on the floor withtheir heels touching the side of a box. Their fingertips were on the 0cm edge of the box that wasvertically marked in centimeters towards the

opposite edge. To measure flexibility, the partici-pant was instructed to push the yardstick placed atthe edge of the box while holding the legs straightand the hands parallel to the floor as far as shecould. According to the YMCA standards (Goldinget al., 1989), the participant had to hold this reachlong enough for the distance to be recorded. Thefarthest test score of three trials was recorded.

Body fat

Body fat was measured from skin-fold thicknesses usinga Lange skin-fold caliper (16). Skin-fold thicknesseswere measured at the triceps, suprailiac and thighregions. Body fat percentage was calculated using theJackson and Pollock equation (Golding et al., 1989).

Body mass index

BMI was calculated as weight (in kg) divided by height(in m) squared (Sardinha and Teixeira, 2000). Theparticipants were weighed using a pre-calibrated

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Figure 3 (a) The saw (starting position), (b) the saw. Figure 4 (a) Swimming (starting position) and (b) swim-ming.



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digital scale to the nearest .1kg. Height was mea-sured by a stadiometer to the nearest .1 cm.

Statistical analysis

Statistical Package for Social Sciences (SPSS) ver-sion 9.0 (SPSS, Inc., Chicago, IL) was used for the

analysis of the data. A 2 (group) 2 (time) analysisof variance was conducted to evaluate the effect ofexercise on abdominal and back strength, muscularendurance, trunk flexibility, body fat percentageand BMI. In addition to these analyses, one-wayanalysis of covariance was conducted to identifyany effect of body fat on BMI scores.

Results

Each pre-measure of groups was analyzed byindependent sample t-test to delineate whether

or not there is a significant difference betweengroups. Independent sample t-test results revealedthat there was no significant difference betweencontrol and Pilates groups with respect toBMI (t .914, p .367), abdominal 601 s1 (t 1.600, p .118), abdominal 1201 s1 (t .501,p .619), back strength 601 s1 (t .804,

p .427), and back strength 1201 s1

(t 1.072,p .291), body fat (t 1.250, p .220), abdom-inal endurance (t 1.704, p .101), and trunkflexibility (t 1.219, p .231). It can be saidthat all baseline values of groups in the presentstudy did not differ from each other.

Abdominal and lower back strength

The result of the analysis on trunk flexion indicatedthat the Pilates group produced significantly higherpeak torque/body weight values than the control

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Table 1 Changes in abdominal and back strength, muscular endurance, trunk flexibility, body mass index andbody fat percentage.

Variable Exercise group(N 21)(Mean7SD)

Control group(N 17)(Mean7SD)

F p

Abs and back strength

601 FlexionPre 133.0755.8 102.3770.4Post 168.8757.4 95.4761.4 8.564 .006

601

ExtensionPre 95.28729.4 84.9741.2post 142.1762.6 82.0735.0 13.682 .001

1201 FlexionPre 75.3740.4 83.3743.1post 115.4753.1 74.9734.0 10.372 .003

1201 ExtensionPre 78.9727.1 146.47277.3Post 147.7745.8 76.1734.3 3.184 .083

Muscular endurance

Curl-upsPre 14.079.8 21.9716.9

Post 29.279.8 22.6715.8 37.369 .000Trunk flexibility

Sit and reach testPre 23.977.5 20.778.3Post 31.376.8 21.879.4 66.703 .000

Body mass indexPre 22.072.5 22.872.6Post 22.072.7 22.972.7 2.145 .152

% Body fatPre 29.074.0 31.076.0Post 29.475.1 31.176.1 .173 .680



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group in the post-test at both 601, and 1201 s1

(Table 1). Peak torque values relative to total bodyweight were used to compare subjects of differentbody size. Results of the repeated MANOVA testrevealed a significant interaction effect for groupand measurements at 601 s1 flexion (Greenhouse-Geisser F 8.564, po.05), 601 s1 extension

(Greenhouse-Geisser F 13.682, po.05), and1201 s1 flexion (Greenhouse-Geisser F 10.372,po.05). There was a significant difference be-tween pre-and post-measures of strength at 601 s1

flexion/extension and 1201 s1 flexion in the ex-ercise group (Fig. 5(a) and (b)). Pilates exercise

group showed more improvement regarding Ab-dominal and Back Strength results than did thecontrol group.

Abdominal muscular endurance

Results of repeated MANOVA revealed a signifi-

cant interaction effect for group and measure-ments (Greenhouse-Geisser F 37.3, po.05) in-dicating that there was a significant differencebetween pre- and post-measurements of enduranceonly for the exercise group (Table 1) (Fig. 6).Pilates exercise group showed more improvement

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0N =

Control Exercise

5.0

10.0

15.0

20.0

25.0

30.0

GROUP

N =

Control ExerciseGROUP

N =Control Exercise

GROUP

N =Control Exercise

GROUP

16 16 20 20 0

5.0

10.0

15.0

20.0

25.0

30.0

16 16 20 20

0

5.0

10.0

15.0

20.0

25.0

30.0

16 16 20 200

5.0

10.0

15.0

20.0

25.0

30.0

16 16 20 20

Flexion 60-Pre Flexion 120-Post Extension 60-Pre Extension 120-Post

p = 0.006

p = 0.003

p = 0.083

p = 0.001

Flexion 120-Pre Flexion 120-Post Extension 120-Pre Extension 120-Post

a

b

Figure 5 (a) Abdominal and back strength at 601 s1 flexion and extension, (b) abdominal and back strength at 1201 s1

flexion and extension.



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regarding abdominal endurance than did the con-trol group.

Posterior trunk flexibility

Results of multivariate test revealed a significantinteraction effect for group and measurements

(Greenhouse-Geisser F

66.7, po

.001). There wasa significant difference between the pre- and post-measures of flexibility only for the exercise group(Table 1) (Fig. 7). Pilates exercise group showedmore improvement regarding posterior trunk flex-ibility than did the control group.

BMI and body fat

BMI measures and the body fat ratios of the exerciseand control groups were not statistically different.In addition to covariance effect, correlations of pre-and post-measures were calculated. The result ofthis analysis showed that there was a significantcovariance effect of both pre-body fat measures onpre-BMI measures (F 43.918, po.001, Z2 .33)and post-body fat measures on post-BMI measures(F 16.718, po.001, Z2 .32). See Table 2.

Discussion

With regard to the results of this study, ModernPilates mat exercises were found to be an efficient

training method with significant changes in abdom-inal and lower back strength, posterior trunkflexibility and abdominal muscular endurancein sedentary adult females. Difference in themeans of the pre- and post-tests of abdominaland lower back strength of the exercise groupproved to be higher compared to the controlgroup. There was a significant difference between

pre- and post-measurements of abdominal andlower back strength at 601 s1 flexion/extensionand 1201 s1 flexion in the Pilates group. Thesefindings were in line with the literature (Fittet al., 1993) confirming that Modern Pilatesmat exercises increase muscular strength of thetrunk. Abdominal muscular endurance and poster-ior trunk flexibility of the Pilates group weresignificantly higher in the follow-up tests thanthat of the control group, which supportedprevious findings in the relevant literature (Fittet al., 1993).

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0N =

Control Exercise

10

20

30

40

50

GROUP

17 17 21 21

ENDURANCE-Pre ENDURANCE-Post

p = 0.000

Figure 6 Muscular endurance difference between exer-cise and control group.

0N =

Control ExerciseGROUP

17 17 21 21

10

20

30

40

50

FLEXIBILITY-Pre FLEXIBILITY-Post

p = 0.000

Figure 7 Difference in trunk flexibility between exerciseand control group.

Table 2 Characteristics of the exercise andcontrol groups.

Variable Exercise group(N 21)(Mean7SD)

Control group(N 17)(Mean7SD)

Age 30.276.6 30.878.6Height (m) 164.875.7 161.075.8Weight (kg) 61.977.1 57.278.14

BMI (kg/m2) 22.072.5 22.872.6



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Despite the fact that the results of ModernPilates mat exercises were generally positive, somelimitations to the study are also worth mentioning.The finding that there was relatively greaterimprovement in the abdominal muscular strengthcompared to lower back muscles in the exercisegroup was probably due to the exercise protocol

that was used in the study. Put another way, thereason for the insignificant results with the iso-kinetic test may be due to the early fatigue in thelower back muscles. In a future study in order tomaintain similar results in the lower back andabdominal strength, the number of exercises thatwould emphasize lower back muscles could beincreased in the exercise protocol.

As mentioned earlier in the paper, the body fatand BMI pre- and post-data were also assessed assecondary outcomes of this study, however nosignificant changes were noted. One of the leading

reasons for this outcome may be due to the factthat the Modern Pilates mat exercises werepracticed by the subjects for a period of 5 weeksthat can be considered to be a short interval toeffect the body fat and BMI measures. Anotherreason might be the fact that there was notany restriction in the diets of the participants. AsMayo et al. (2003) suggests work involving largerweight losses are entirely diet based. From thisstandpoint, in a future longitudinal study of at least8 weeks, a diet associated with Pilates mat exerciseregimen could be applied to sedentary adultfemales to monitor changes in body fat and BMI

in addition to the hypothesized variables in thisstudy. In a future study it would also be interestingto investigate if the applied Modern Pilatesmat exercises affect psychological variables ofparticipants.

In conclusion, this study showed that ModernPilates mat exercises contributed to increasedquality of life in sedentary adult females throughimprovements in abdominal and lower backstrength, posterior trunk flexibility and abdominalmuscular endurance.

Appendix A. Exercise protocol

Exercise Repetitions

Warm-up

1. Breathing2. Imprint and release3. Spinal rotation4. Cat stretch5. Hip rolls6. Scapula isolation

7. Arm circles8. Scapula elevation

Exercises

1. Ab prep 52. Breast stroke 53. Spine stretch 14. The hundred 10 see Figs.

1(a)(c)5. Half roll back 86. The roll up 87. Leg circles 88. Spine twist 89. Rolling like ball 8

10. Single leg stretch 811. Double leg stretch 812. Criss cross 813. Scissors 814. Shoulder bridge 8 see Figs. 2(a)

and (b)

15. Roll over preparation 816. Hell squeeze prone 817. Single leg kick 818. Breast stroke 819. Spine stretch 120. The saw 8 see Figs. 3(a)

and (b)21. Neck pull preparation 822. Obliques roll back 823. Side kick series 824. Spine stretch forward 525. Swimming 8 see Figs. 4(a)

and (b)26. Leg pull front 527. Leg pull back 5

References

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Clark, B., Osness, W., Adrian, M., Hoeger, W.W.K., Raab, D.,Wiswell, R., 1989. Tests for fitness in older adults: AHHPERDfitness task force. Journal of Physical Education, Recreation

and Dance 60 (3), 66

71.Fitt, S., Sturman, J., McClain-Smith, S., 1993. Effects of Pilates-

based conditioning on strength, alignment, and range ofmotion in university ballet and modern dance majors.Kinesiology and Medicine for Dance 16 (1), 3661.

Friedman, P., Eisen, G., Miller, W.J., Jopseph, H., 1980. PilatesTechniques of Physical Conditioning. Doubleday and Com-pany, New York.

Geweniger, V., 2002. Prevention of back pain with PilatesTraining. Finding a Healthy Balance 55 (10), 747749.

Golding, L.A., Myers, C.R., Sinning, W.E., 1989. The Ys way toPhysical Fitness, third ed. Human Kinetics, Champaign, IL.

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