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Pilates Training for Use in Rehabilitation after Total Hip and Knee Arthroplasty: A Preliminary Report

  • Symposium: Advanced Techniques for Rehabilitation after Total Hip and Knee Arthroplasty
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Recently, a strong emphasis has been placed on establishing rehabilitation protocols after primary total hip and knee arthroplasty in an attempt to shorten, improve, and standardize the postoperative period of recovery. Less invasive surgical techniques, patient demands, and the pressure of insurance regulations have forced postoperative rehabilitation to be placed on an expedited scale. With these concerns in mind, we introduce a pre- and postarthroplasty program involving the Pilates method. Modified exercises have been developed to account for the postoperative precautions and needs of total hip and knee arthroplasty patients. A patient-driven interest in the use of Pilates for postoperative rehabilitation has led to the development of our programs following total hip or knee arthroplasty. In reviewing our early observations of a small series of patients, it appears this technique can be utilized without early complications; however, further studies are necessary to confirm its utility and safety.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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References

  1. Adamand K, Loigerot D. The Pilates Edge: An Athlete’s Guide to Strength and Performance. New York, NY: Penguin Books; 2004.

    Google Scholar 

  2. American Sports Data Inc. Available at http://www.americansportsdata.com. Accessed March 4, 2008.

  3. Beck R. Getting to the core. Using pilates to promote overall wellness during rehabilitation. Rehab Manag. 2008;21:34–36.

    PubMed  Google Scholar 

  4. Bennett D, Ogonda L, Elliott D, Humphreys L, Lawlor M, Beverland D. Comparison of immediate postoperative walking ability in patients receiving minimally invasive and standard-incision hip arthroplasty: a prospective blinded study. J Arthroplasty. 2007;22:490–495.

    Article  PubMed  Google Scholar 

  5. Berger RA. A comprehensive approach to outpatient total hip arthroplasty. Am J Orthop. 2007;36(9 Suppl):4–5.

    PubMed  Google Scholar 

  6. Berger RA, Jacobs JJ, Meneghini RM, Della Valle C, Paprosky W, Rosenberg AG. Rapid rehabilitation and recovery with minimally invasive total hip arthroplasty. Clin Orthop Relat Res. 2004;429:239–247.

    Article  PubMed  Google Scholar 

  7. Berry DJ, Berger RA, Callaghan JJ, Dorr LD, Duwelius PJ, Hartzband MA, Lieberman JR, Mears DC. Minimally invasive total hip arthroplasty. Development, early results, and a critical analysis. Presented at the Annual Meeting of the American Orthopaedic Association, Charleston, South Carolina, USA, June 14, 2003. J Bone Joint Surg Am. 2003;85:2235–2246.

    Google Scholar 

  8. Blum CL. Chiropractic and Pilates therapy for the treatment of adult scoliosis. J Manipulative Physiol Ther. 2002;25:E3.

    Article  PubMed  Google Scholar 

  9. Brosseau L, MacLeay L, Robinson V, Wells G, Tugwell P. Intensity of exercise for the treatment of osteoarthritis. Cochrane Database Syst Rev. 2003;2:CD004259.

    Google Scholar 

  10. Donzelli S, Di Domenica E, Cova AM, Galletti R, Giunta N. Two different techniques in the rehabilitation treatment of low back pain: a randomized controlled trial. Eura Medicophys. 2006;42:205–210.

    PubMed  CAS  Google Scholar 

  11. Duschatko DM. Certified pilates and gyrotonics trainer. J Bodyw Mov Ther. 2000;4:13–19.

    Article  Google Scholar 

  12. Foucher KC, Hurwitz DE, Wimmer MA. Preoperative gait adaptations persist one year after surgery in clinically well-functioning total hip replacement patients. J Biomech. 2007;40:3432–3437.

    Article  PubMed  Google Scholar 

  13. Ganz SB, Wilson PD, Jr, Cioppa-Mosca J, Peterson MG. The day of discharge after total hip arthroplasty and the achievement of rehabilitation functional milestones: 11-year trends. J Arthroplasty. 2003;18:453–457.

    Article  PubMed  CAS  Google Scholar 

  14. Herrington L, Davies R. The influence of Pilates training on the ability to contract the transversus abdominis muscle in asymptomatic individuals. J Bodyw Mov Ther. 2005;9:52–57.

    Article  Google Scholar 

  15. Hurwitz DE, Ryals AR, Block JA, Sharma L, Schnitzer TJ, Andriacchi TP. Knee pain and joint loading in subjects with osteoarthritis of the knee. J Orthop Res. 2000;18:572–579.

    Article  PubMed  CAS  Google Scholar 

  16. Jago R, Jonker ML, Missaghian M, Baranowski T. Effect of 4 weeks of Pilates on the body composition of young girls. Prev Med. 2006;42:177–180.

    Article  PubMed  Google Scholar 

  17. Keays KS, Harris SR, Lucyshyn JM, MacIntyre DL. Effects of Pilates exercises on shoulder range of motion, pain, mood, and upper-extremity function in women living with breast cancer: a pilot study. Phys Ther. 2008;88:494–510.

    PubMed  Google Scholar 

  18. Klein GR, Levine BR, Hozack WJ, Strauss EJ, D’Antonio JA, Macaulay W, Di Cesare PE. Return to athletic activity after total hip arthroplasty. Consensus guidelines based on a survey of the Hip Society and American Association of Hip and Knee Surgeons. J Arthroplasty. 2007;22:171–175.

    Article  PubMed  Google Scholar 

  19. Lawlor M, Humphreys P, Morrow E, Ogonda L, Bennett D, Elliott D, Beverland D. Comparison of early postoperative functional levels following total hip replacement using minimally invasive versus standard incisions. A prospective randomized blinded trial. Clin Rehabil. 2005;19:465–474.

    Article  PubMed  Google Scholar 

  20. Levine B, Kaplanek B, Scafura D, Jaffe WL. Rehabilitation after total hip and knee arthroplasty: a new regimen using Pilates training. Bull NYU Hosp Jt Dis. 2007;65:120–125.

    PubMed  Google Scholar 

  21. Maher CG. Effective physical treatment for chronic low back pain. Orthop Clin North Am. 2004;35:57–64.

    Article  PubMed  CAS  Google Scholar 

  22. Ogonda L, Wilson R, Archbold P, Lawlor M, Humphreys P, O’Brien S, Beverland D. A minimal-incision technique in total hip arthroplasty does not improve early postoperative outcomes. A prospective, randomized, controlled trial. J Bone Joint Surg Am. 2005;87:701–710.

    Article  PubMed  Google Scholar 

  23. Pearse EO, Caldwell BF, Lockwood RJ, Hollard J. Early mobilisation after conventional knee replacement may reduce the risk of postoperative venous thromboembolism. J Bone Joint Surg Br. 2007;89:316–322.

    Article  PubMed  CAS  Google Scholar 

  24. Pilot P, Bogie R, Draijer WF, Verburg AD, van Os JJ, Kuipers H. Experience in the first four years of rapid recovery; is it safe? Injury. 2006;37(Suppl 5):S37–40.

    Article  PubMed  Google Scholar 

  25. Rydeard R, Leger A, Smith D. Pilates-based therapeutic exercise: effect on subjects with nonspecific chronic low back pain and functional disability: a randomized controlled trial. J Orthop Sports Phys Ther. 2006;36:472–484.

    PubMed  Google Scholar 

  26. Shakoor N, Hurwitz DE, Block JA, Shott S, Case JP. Asymmetric knee loading in advanced unilateral hip osteoarthritis. Arthritis Rheum. 2003;48:1556–1561.

    Article  PubMed  Google Scholar 

  27. Shand D. Pilates to pit. Lancet. 2004;363:1340.

    Article  PubMed  Google Scholar 

  28. Siler B. The Pilates Body. New York, NY: Broadway Books; 2000.

    Google Scholar 

  29. Tanavalee A, Thiengwittayaporn S, Itiravivong P. Progressive quadriceps incision during minimally invasive surgery for total knee arthroplasty: the effect on early postoperative ambulation. J Arthroplasty. 2007;22:1013–1018.

    Article  PubMed  Google Scholar 

  30. Thien TM, Ahnfelt L, Eriksson M, Stromberg C, Karrholm J. Immediate weight bearing after uncemented total hip arthroplasty with an anteverted stem: a prospective randomized comparison using radiostereometry. Acta Orthop. 2007;78:730–738.

    Article  PubMed  Google Scholar 

  31. Thorp LE, Sumner DR, Block JA, Moisio KC, Shott S, Wimmer MA. Knee joint loading differs in individuals with mild compared with moderate medial knee osteoarthritis. Arthritis Rheum. 2006;54:3842–3849.

    Article  PubMed  Google Scholar 

  32. Ungaro A. Pilates Body in Motion. New York, NY: DK Publishing; 2002.

    Google Scholar 

  33. Willson JD, Dougherty CP, Ireland ML, Davis IM. Core stability and its relationship to lower extremity function and injury. J Am Acad Orthop Surg. 2005;13:316–325.

    PubMed  Google Scholar 

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Acknowledgments

We thank Beth Kaplanek and Dina Scafura for developing the following protocol: Specified Pilates Techniques for Hip and /or Knee Syndromes®.

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Authors and Affiliations

  1. Midwest Orthopaedics at Rush, 1725 W. Harrison St., Suite 1063, Chicago, IL, 60612, USA

    Brett Levine MS, MD

  2. The Pilates Center of Long Island, Huntington, NY, USA

    Beth Kaplanek RN

  3. New York University Hospital for Joint Diseases, New York, NY, USA

    William L. Jaffe MD

Authors
  1. Brett Levine MS, MD
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  2. Beth Kaplanek RN
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  3. William L. Jaffe MD
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Corresponding author

Correspondence to Brett Levine MS, MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at New York University Hospital for Joint Diseases.

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Levine, B., Kaplanek, B. & Jaffe, W.L. Pilates Training for Use in Rehabilitation after Total Hip and Knee Arthroplasty: A Preliminary Report. Clin Orthop Relat Res 467, 1468–1475 (2009). https://doi.org/10.1007/s11999-009-0779-9

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  • DOI: https://doi.org/10.1007/s11999-009-0779-9

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