Pilate‟s method for paraplegic spinal cord injury patients during rehabilitation

Abstract

Spinal Cord Injury is a devastating injury which causes various types of health related problems. It also affect daily life activities and also they suffered by depression where female SCI patients are more vulnerable. To improve paraplegic patient‟s strength, core muscle strengthening is most important and core stability exercises improve the hip and trunk muscle strength, endurance and the ability to maintain pelvic & spinal alignment. Pilate‟s method is the exercise program which helps to improve core muscles strength, flexibility of muscles, improve balance and overall functions of patients. Objectives: To assess the effectives of Pilates method on balance, flexibility, pelvic floor & core muscles strength and function in the paraplegic SCI patients. Methodology: The study was a quantitative exploration of RCT. Pilate‟s method combined with conventional physiotherapy applied to the trial group and only conventional physiotherapy and Strengthening program for control group. Where 70 participants with paraplegic were recruited and a hospital randomization was used for group allocation and patient selection. SCIM scale, BBS and Sit & Reach Test was used for measurement of functional independence, Balance and flexibility. Between groups analysis was calculated by Mann-Whitney U-test and flexibility by unpaired t test. Within group was analyzed by Wilcoxon signed rank test. Results: Both groups were similar in baseline characteristics. Overall SCIM score was (.007), which indicated p values were less than 0.05, there was a significant difference between the Pilates exercise and conventional physiotherapy exercises. The treatment may be applied to improve functional independence on the basis of data which were used. In the BBS score, p values was (.813) was greater than 0.05, so the test for balance level was not significant. The study used 8 weeks of treatment to improve the balance and it seems to be that if the treatment period increased then the results may vary. The Wilcoxon test Z score (5.027) and a p value (.000) for subtotal SCIM score for trial group and also Z score (5.165) and a p value (.000) for the control group. Z score (5.173) and a p value (.000) for BBS scale within the experimental group. And also this result shows that Z score (5.174) and a p value (.000) for BBS scale score within the control group. So this result indicated that there was a significant difference between before and after balance levels at significant level 5%. But when we compare between groups, we can expect better result from the experimental group as because of treatment protocol. At the observed t value (.634) has a p value of (.528) at experimental group, so no significant difference in the effect of the Pilates exercise in flexibility. Conclusions: Pilates exercise with conventional physiotherapy was effective than only conventional physiotherapy but there was also a positive effect in within group analysis at before & after Pilates exercise with conventional physiotherapy as well as only conventional physiotherapy. There was no statistically positive effect on balance and flexibility level at between group analyses. Key Word: Pilate’s method, incomplete paraplegic SCI, independence level.