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Intra-abdominal pressure during Pilates: unlikely to cause pelvic floor harm

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Abstract

Introduction and hypothesis

The objective was to describe the intra-abdominal pressures (IAP) generated during Pilates Mat and Reformer activities, and determine whether these activities generate IAP above a sit-to-stand threshold.

Methods

Twenty healthy women with no symptomatic vaginal bulge, median age 43 (range 22–59 years), completed Pilates Mat and Reformer exercise routines each consisting of 11 exercises. IAP was collected by an intra-vaginal pressure transducer, transmitted wirelessly to a base station, and analyzed for maximal and area under the curve (AUC) IAP.

Results

There were no statistically significant differences in the mean maximal IAP between sit-to-stand and any of the Mat or Reformer exercises in the study population. Six to twenty-five percent of participants exceeded their individual mean maximal IAP sit-to-stand thresholds for 10 of the 22 exercises. When measuring AUC from 0 cm H2O, half the exercises exceeded the mean AUC of sit-to-stand, but only Pilates Reformer and Mat roll-ups exceeded the mean AUC of sit-to-stand when calculated from a threshold of 40 cm H2O (consistent with, for example, walking).

Conclusion

Our results support recommending this series of introductory Pilates exercises, including five Mat exercises and six Reformer exercises to women desiring a low IAP exercise routine. More research is needed to determine the long-term effects of Pilates exercise on post-surgical exercise rehabilitation and pelvic floor health.

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References

  1. Nygaard I, Barber MD, Burgio KL et al (2008) Prevalence of symptomatic pelvic floor disorders in US women. J Am Med Assoc 300:1311–1316

    Article  CAS  Google Scholar 

  2. Boyles S (2003) Procedures for pelvic organ prolapse in the United States, 1979–1997. Am J Obstet Gynecol 188:108–115. doi:10.1067/mob.2003.101

    Article  PubMed  Google Scholar 

  3. Boyles SH, Weber AM, Meyn L (2003) Procedures for urinary incontinence in the United States, 1979–1997. Am J Obstet Gynecol 189:70–75. doi:10.1067/mob.2003.376

    Article  PubMed  Google Scholar 

  4. Olsen AL, Smith VJ, Bergstrom JU et al (1997) Incidence and clinical characteristics of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506

    Article  CAS  PubMed  Google Scholar 

  5. Weir LF, Nygaard IE, Wilken J et al (2006) Postoperative activity restrictions: any evidence? Obstet Gynecol 107:305

    Article  PubMed  Google Scholar 

  6. Guttormson R, Tschirhart J, Boysen D, Martinson K (2008) Are postoperative activity restrictions evidence-based? Am J Surg 195:401–404

    Article  PubMed  Google Scholar 

  7. FitzGerald MP, Shisler S, Shott S, Brubaker L (2001) Physical limitations after gynecologic surgery. Female Pelvic Med Reconstr Surg 7:136–139

    Google Scholar 

  8. Ottesen M, Møller C, Kehlet H, Ottesen B (2008) Substantial variability in postoperative treatment, and convalescence recommendations following vaginal repair. Acta Obstet Gynecol Scand 80:1062–1068

    Google Scholar 

  9. Coleman TJ, Thomsen JC, Maass SD et al (2012) Development of a wireless intra-vaginal transducer for monitoring intra-abdominal pressure in women. Biomed Microdevices 4:347–355

    Article  Google Scholar 

  10. Hsu Y, Coleman TJ, Hitchcock RW et al (2012) Clinical evaluation of a wireless intra-vaginal pressure transducer. Int Urogynecol J 23:1741–1747

    Article  PubMed Central  PubMed  Google Scholar 

  11. Pilates Method Alliance (2014) Available at: http://www.pilatesmethodalliance.org. Accessed 9 October 2014

  12. Latey P (2001) The Pilates method: history and philosophy. J Bodyw Mov Ther 5:275–282

    Article  Google Scholar 

  13. Levine B, Kaplanek B, Jaffe WL (2009) Pilates training for use in rehabilitation after total hip and knee arthroplasty: a preliminary report. Clin Orthop Relat Res 467:1468–1475. doi:10.1007/s11999-009-0779-9

    Article  PubMed Central  PubMed  Google Scholar 

  14. Cozen DM (2000) Use of Pilates in foot and ankle rehabilitation. Sports Med Arthrosc Review 8:395–403

    Article  Google Scholar 

  15. Bryan M, Hawson S (2003) The benefits of Pilates exercise in orthopaedic rehabilitation. Tech Orthop 18:126–129

    Article  Google Scholar 

  16. Johnson EG, Larsen A, Ozawa H et al (2007) The effects of Pilates-based exercise on dynamic balance in healthy adults. J Bodyw Mov Ther 11:238–242

    Article  Google Scholar 

  17. Kloubec JA (2010) Pilates for improvement of muscle endurance, flexibility, balance, and posture. J Strength Cond Res 24:661–667

    Article  PubMed  Google Scholar 

  18. Culligan PJ, Scherer J, Dyer K et al (2010) A randomized clinical trial comparing pelvic floor muscle training to a Pilates exercise program for improving pelvic muscle strength. Int Urogynecol J 21:401–408

    Article  PubMed  Google Scholar 

  19. Pate RR, Pratt M, Blair SN et al (1995) Physical activity and public health. J Am Med Assoc 273:402–407

    Article  CAS  Google Scholar 

  20. Shaw JM, Hamad NM, Coleman TJ et al (2014) Intra-abdominal pressures during activity in women using an intra-vaginal pressure transducer. J Sports Sci 32:1176–1185

    Article  PubMed Central  PubMed  Google Scholar 

  21. Thomas S, Reading J, Shephard RJ (1992) Revision of the physical activity readiness questionnaire (PAR-Q). Can J Sport Sci 17:338–345

    CAS  PubMed  Google Scholar 

  22. Isacowitz R (2006) Pilates: your complete guide to mat work and apparatus exercises. Human Kinetics, Champaign, IL

    Google Scholar 

  23. Hamad N, Shaw J, Nygaard I et al (2013) More complicated than it looks: the vagaries of calculating intra-abdominal pressure. J Strength Cond Res 27:3204–3215

    Article  PubMed  Google Scholar 

  24. Coleman TJ, Hamad NM, Shaw JM et al (2014) The effects of walking speeds and carrying techniques on intra-abdominal pressure in women. Int Urogynecol J. doi:10.1007/s00192-014-2593-5

    PubMed  Google Scholar 

  25. Lilliefors HW (1967) On the Kolmogorov-Smirnov test for normality with mean and variance unknown. J Am Stat Assoc 62:399–402

    Article  Google Scholar 

  26. Bø K, Bratland-Sanda S, Sundgot-Borgen J (2011) Urinary incontinence among group fitness instructors including yoga and Pilates teachers. Neurourol Urodyn 30:370–373

    Article  PubMed  Google Scholar 

  27. Addington WR, Stephens RE, Phelipa MM et al (2008) Intra-abdominal pressures during voluntary and reflex cough. Cough 4:2. doi:10.1186/1745-9974-4-2

    Article  PubMed Central  PubMed  Google Scholar 

  28. Pruessner JC, Kirschbaum C, Meinlschmid G, Hellhammer DH (2003) Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology 28:916–931. doi:10.1016/S0306-4530(02)00108-7

    Article  CAS  PubMed  Google Scholar 

  29. Hagins M, Pietrek M, Sheikhzadeh A et al (2004) The effects of breath control on intra-abdominal pressure during lifting tasks. Spine 29:464

    Article  PubMed  Google Scholar 

  30. Dolan LM, Dixon WE, Brown K et al (2005) Randomized comparison of vaginal and rectal measurement of intra-abdominal pressure during subtracted dual-channel cystometry. Urology 65:1059–1063

    Article  PubMed  Google Scholar 

  31. Rosenbluth EM, Johnson PJ, Hitchcock RW, Nygaard IE (2010) Development and testing of a vaginal pressure sensor to measure intra-abdominal pressure in women. Neurourol Urodyn 29:532–535. doi:10.1002/nau.20794

    PubMed Central  PubMed  Google Scholar 

  32. Lewis Wall L, Hewitt JK, Helms MJ (1995) Are vaginal and rectal pressures equivalent approximations of one another for the purpose of performing subtracted cystometry? Obstet Gynecol 85:488–493

    Article  Google Scholar 

  33. Junginger B, Baessler K, Sapsford R et al (2003) Interaction between bladder neck elevation, intra-abdominal pressure and activity of the pelvic floor and abdominal muscles during abdominal and pelvic floor manoeuvres. Int Urogynecol J 21:69–77

    Article  Google Scholar 

  34. Ottesen M, Sorensen M, Kehlet H, Ottesen B (2003) Short convalescence after vaginal prolapse surgery. Acta Obstet Gynecol Scand 82:359–366

    Article  PubMed  Google Scholar 

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Acknowledgements

We would like to thank Pinnacle Performance for their use of the facility and equipment. We would also like to thank Sarah Holdsworth and Shauna North for their assistance in conducting the exercise protocol and Johanna de Gennaro for her help building the sensors that were used in this study.

Funding

The project described was supported by grant number R01HD061787-01 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Its content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Conflicts of interest

None.

Authors’ contributions

Tanner J. Coleman: project development, exercise protocol development, data collection, data analysis, data interpretation, manuscript writing; Ingrid E. Nygaard: project development, data interpretation, manuscript writing/editing; Dannielle N. Holder: project development, exercise protocol development, data collection, manuscript editing; Marlene J. Egger: data analysis, manuscript editing; Robert Hitchcock: project development, manuscript editing.

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Authors and Affiliations

  1. Department of Bioengineering, University of Utah, 36 S. Wasatch Drive, Room 4202, Salt Lake City, UT, 84112, USA

    Tanner J. Coleman & Robert Hitchcock

  2. Department of Obstetrics and Gynecology, School of Medicine, University of Utah, 30 N. 1900 E., Room 2B200, Salt Lake City, UT, 84132, USA

    Ingrid E. Nygaard

  3. Pinnacle Performance, 1515 S. 1100 E, Salt Lake City, UT, 84105, USA

    Dannielle N. Holder

  4. Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Ste A, Salt Lake City, UT, 84108, USA

    Marlene J. Egger

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  1. Tanner J. Coleman
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  2. Ingrid E. Nygaard
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  4. Marlene J. Egger
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Corresponding author

Correspondence to Ingrid E. Nygaard.

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Coleman, T.J., Nygaard, I.E., Holder, D.N. et al. Intra-abdominal pressure during Pilates: unlikely to cause pelvic floor harm. Int Urogynecol J 26, 1123–1130 (2015). https://doi.org/10.1007/s00192-015-2638-4

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  • DOI: https://doi.org/10.1007/s00192-015-2638-4

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