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Pilates, the method of exercise and movement gaining in popularity among celebrities in recent years, has proved to be an excellent rehab niche for a hospital-based facility in Wisconsin. Pronounced "puh-lah-tees," the technique is named after Joseph Pilates, who founded the method and first taught it to dancers.
"One of the tremendous things about Pilates is it offers such a variety of rehab training," says Angela Kneale Buckholtz, OTR, occupational therapist with Howard Young Physical Medicine & Rehabilitation in Woodruff, WI.
Rehab therapists can use Pilate machines and techniques to treat patients with low levels of function, such as those who have difficulty moving due to chronic pain or a stroke, or a high-level athlete who is recovering from a hamstring injury, Buckholtz says.
The rehab facility, which has eight beds and satellite sites in Mercer, WI, and Eagle River, WI, purchased a Pilates clinical reformer machine two years ago. The facility’s physiatrist learned about Pilates and pushed for the rehab facility to buy the $3,500 unit, Buckholtz explains.
"The machine is unlike most anything else I’ve ever seen," she says. "It’s described as about the size of a twin-sized bed with a system of springs and a carriage that moves, with a foot bar and lots of adjustments available for tension and positioning."
Clients lie supine on the clinical reformer, which helps to strengthen their muscles and forces them to focus on core control. The a goal if for all their movements to become comfortable, Buckholtz adds. "I work with people who have chronic pain in a variety of body regions, and so this is specifically appropriate for them to strengthen their core control," she says. "You can put people into position and select exercises they’ll be very successful at."
Buckholtz helps chronic pain patients see that they can move without pain on the first set of exercises, and then she builds on that until they can stand and walk more freely. "It helps improve body awareness and posture, confidence in movement," she says. "It’s the ultimate mind-body workout."
People trained on Pilates soon incorporate its method of proper positioning into their daily activities.
Buckholtz uses Pilates techniques chiefly for chronic pain and musculoskeletal patients. She’s also used it when working with patients recovering from a cerebral vascular accident. She hasn’t used it for spinal cord injury or traumatic brain injury patients.
The staff received a day and a half of training on Pilates from a Pilates expert who has a dance background. The trainer showed them how to use the clinical reformer and also how to do some mat exercises that patients could continue to practice while at home. The Pilates reformer arrived with training videos.
Buckholtz received further training through Stott’s Conditioning in Toronto, with the goal of becoming certified for teaching others the technique. Some Pilates courses focus specifically on rehabilitation injuries and special populations, others on dance theory, using the machines, and movement during pregnancy.
Soon after the rehab facility began to use the Pilates equipment and technique, the staff held an open house attended by about 100 people. "We’ve had a lot of interest from healthy people because we all have our little quirks," Buckholtz says.
The one machine has been put to good use, with the facility’s physical therapists and occupational therapists incorporating it into regular therapy for inpatients and outpatients. It’s also incorporated into the multidisciplinary pain management program.
Reimbursement isn’t an issue since the technique doesn’t require a physician’s order, and it’s not reimbursed separately from other therapy interventions, Buckholtz says.
Since the rehab facility currently has space limitations, preventing the purchase of more Pilates machines, there hasn’t been the need for further marketing, she adds. "We hope the program will expand, and we’ll purchase other pieces of equipment."
Although the rehab facility has not measured outcomes from the use of Pilates, Buckholtz says the anecdotal evidence proves its value.
"I’ve seen people learn to move comfortably for the first time in a very long time in their lives, and especially those with chronic pain," Buckholtz says. "They’ve been able to successfully relearn and rebalance muscles, relearn motor control, and become comfortable with activities in their daily lives."
• Angela Kneale Buckholtz, OTR, Occupational Therapist, Howard Young Physical Medicine & Rehabilitation, 240 Maple St., Woodruff, WI 54568. Telephone: (715) 356-8870. Fax: (715) 356-8079.