Reformer Pilates research papers



Motor control exercise for nonspecific low back pain – a Cochrane review

Bruno T. Saragiotto MSc et al. 2016

“MCE is probably more effective than a minimal intervention for reducing pain, but probably does not have an important effect on disability, in patients with chronic LBP. There was no clinically important difference between MCE and other forms of exercises or manual therapy for acute and chronic LBP.”

Spine stabilisation exercises in the treatment of chronic low back pain: a good clinical outcome is not associated with improved abdominal muscle function

A. F. Mannion et al. 2012

“Neither baseline lateral abdominal muscle function nor its improvement after a programme of stabilisation exercises was a statistical predictor of a good clinical outcome. It is hence difficult to attribute the therapeutic result to any specific effects of the exercises on these trunk muscles.”

An update of stabilisation exercises for low back pain: a systematic review with meta-analysis

Benjamin E. Smith, Chris Littlewood and Stephen May, 2014

“There is strong evidence stabilisation exercises are not more effective than any other form of active exercise in the long term. The low levels of heterogeneity and large number of high methodological quality of available studies, at long term follow-up, strengthen our current findings, and further research is unlikely to considerably alter this conclusion.”


Optimizing motivation and attention for motor performance and learning

Rebecca Lewthwaite and Gabriele Wulf, 2017

“An external focus of attention on desired movement effects is consistently effective.”

Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning

Gabriele Wulf and Rebecca Lewthwaite, 2016

“We consider the influence of an external focus for the establishment of efficient functional connections across brain networks that subserve skilled movement. We speculate that enhanced expectancies and an external focus propel performers’ cognitive and motor systems in productive “forward” directions and prevent “backsliding” into self- and non-task focused states.”

Triple play: Additive contributions of enhanced expectancies, autonomy support, and external attentional focus to motor learning

Gabriele Wulf et al. 2018

“3 factors are postulated to facilitate learning: enhanced expectancies (EE) for performance, autonomy support (AS), and an external focus (EF) of attention. In 3 recent studies, combinations of 2 of these variables resulted in superior learning relative to the presence of only 1 variable, or none…The findings provide evidence that enhanced expectancies, autonomy support, and an external focus can contribute in an additive fashion to optimize motor learning.”


Is strength training associated with mortality benefits? A 15 year cohort study of US older adults

Jennifer L. Kraschnewski et al. 2016

“Older adults who reported guideline-concordant ST [strength training twice each week] had 46% lower odds of all-cause mortality than those who did not… The association between ST and death remained after adjustment for past medical history and health behaviors.”


Muscle mass index as a predictor of longevity in older adults

Preethi Srikanthan, MD, MS and Arun S. Karlamangla, MD, PhD, 2014

“All-cause mortality was analyzed by the year 2004 in 3659 participants…who were aged 55 years or more (65 years if women)…Muscle mass is associated inversely with mortality risk in older adults independently of fat mass and cardiovascular and metabolic risk factors….In the fully adjusted models, mortality in the third and fourth highest quartiles of muscle mass index was significantly lower than in the bottom quartile but not different from each other…In contrast, mortality risk (likewise, mortality rate) remained essentially unchanged from the lowest to the highest sex-specific quartile of nonmuscle mass index…in older Americans, muscle mass relative to body height was associated inversely with all-cause mortality over a 10- to 16-year follow-up. This inverse relationship was not explained by traditional cardiovascular risk factors (dyslipidemia, hypertension, and inflammation) or glucose dysregulation (pre-diabetes, diabetes, insulin resistance, and dysglycemia), suggesting that relative muscle mass is an independent prognostic marker for survival in older adults.”


Assessment of the degree of pelvic tilt within a normal asymptomatic population

Lee Herrington, 2011

“120 healthy subjects (65 males, 55 females)…85% of males and 75% of females presented with an anterior pelvic tilt, 6% of males and 7% of females with a posterior tilt and 9% of males and 18% of females presented as neutral.”

The elephant in the room: too much medicine in musculoskeletal practice

Jeremy S. Lewis, PT, PhD et al. 2020

“Another concern in musculoskeletal health care is medicalizing normality—when a normal human function or condition is labeled as abnormal. In this Viewpoint, the authors argue that medicalizing normality creates health concerns where none exist…the mislabeling of normal and age-related variations in posture and structure as “pathological” and/or the basis for presenting symptoms. [Example:] Postural “Abnormalities” Ankylosing spondylitis and severe kyphosis and scoliosis may be associated with symptoms. However, for the majority of musculoskeletal presentations, most posture “abnormalities” are likely to be variations of normal and do not differentiate between people with and without pain. Observing a person’s static posture based on the plumb-line assessment of cervical, thoracic, and shoulder posture, then advising that the symptoms are due to subtle variations in postural alignment, is medicalizing normality.”

Exercise therapy may affect scapular position and motion in individuals with scapular dyskinesis: a systematic review of clinical trials

Afsun Nodehi Moghadam PhD et al. 2020

“There is a lack of evidence for beneficial effects of exercise in improving scapular position and motion in individuals with scapular dyskinesis. However, exercise is beneficial in reducing pain and disability in individuals with SIS.”

The fall of the postural-structural-biomechanical model in manual and physical therapies: Exemplified by lower back pain

Eyal Lederman PhD DO, 2011

“The lack of association between PSB factors and back pain has far-reaching implications for the way we conceptualize musculoskeletal conditions, the clinical examination and the goals/objectives of the techniques and the exercise prescribed…From the evidence so far many of the clinical examinations assessing PSB factors have no obvious value in explaining why the patient has developed their back condition. It implies that the PSB model and the related clinical examinations are mostly redundant…The lack of association between PSB factors and LBP has also important implications for what we aim to achieve and for our choice of techniques and exercise used to manage the condition. We can no longer justify the use of manual techniques to readjust, correct or balance-out the mis-aligned structure.”

Non-surgical interventions for excessive anterior pelvic tilt in symptomatic and non-symptomatic adults: a systematic review

Anders Falk Brekke et al. 2020

“No overall evidence for the effect of non-surgical treatment in reducing excessive anterior pelvic tilt and potentially related symptoms was found.”

Is neck posture subgroup in late adolescence a risk factor for persistent neck pain in young adults? A prospective study

Karen V. Richards et al. 2021

“Females in late adolescence who sat in slumped thorax/forward head or intermediate posture rather than upright sitting posture had a lower risk of PNP as a young adult. The practice of generic public health messages to sit up straight to prevent neck pain needs rethinking.”

The relationships between low back pain and lumbar lordosis: a systematic review and meta-analysis

Se-Woong Chun MD, MS etal. 2017

“This meta-analysis demonstrates a strong relationship between LBP (lower back pain) and decreased LLC (lumbar lordotic curvature [anterior pelvic tilt])…Among specific diseases, LBP by disc herniation or degeneration was shown to be substantially associated with the loss of LLC.”

A review of resistance exercise and posture realignment

C. Hrysomallis and C. Goodman, 2001

“Exercise has been promoted in an attempt to correct postural deviations, such as excessive lumbar lordosis, scoliosis, kyphosis, and abducted scapulae. One of the assumed causes of these conditions is a weak and lengthened agonist muscle group combined with a strong and tight antagonist muscle group…A review of the literature has found a lack of reliable, valid data collected in controlled settings to support the contention that exercise will correct existing postural deviations… It is likely that exercise programs are of insufficient duration and frequency to induce adaptive changes in muscle-tendon length. Additionally, any adaptations from restricted range-of-movement exercise would likely be offset by daily living activities that frequently require the body segments to go through full ranges of motion.”

Variation in pelvic morphology may prevent the identification of anterior pelvic tilt

Stephen J. Preece, PhD et al. 2008

“The study found a range of values for the ASIS-PSIS of 0–23 degrees, with a mean of 13 and standard deviation of 5 degrees. Asymmetry of pelvic landmarks resulted in side-to-side differences of up to 11 degrees in ASIS-PSIS tilt and 16 millimeters in innominate height. These results suggest that variations in pelvic morphology may significantly influence measures of pelvic tilt and innominate rotational asymmetry.”


Body composition and morphological characteristics in women reformer Pilates practitioners

Raquel Vaquero Cristóbal et al. 2014

“Anthropometric characteristics, somatotype, proportionality and body composition were analyzed in a sample of 78 adult women (mean age: 44.00 ± 9.01 years) who practiced reformer Pilates 1 hour two times/week. Anthropometric variables were measured by a Level 2 anthropometrist certified by the International Society for the Advancement of Kinanthropometry. Two groups were made based on the women’ years of practice: a group 1 (two or less years of practice) and a group 2 (more than two years of practice). The group 2 showed significant lower values in absolute size and Z-scores in body mass, six and eight skinfold sums, individual skinfolds and most of limbs and trunk girths (arm relaxed, chest, waist, gluteal, thighs and/or corrected calf girths) than the group 1. Significantly higher values in mesomorphy, ectomorphy and muscle mass and lower values in endomorphy and fat mass were also observed in the second group. In conclusion, the practice of reformer Pilates may generate positive adaptations in anthropometric characteristics, body composition and somatotype.”

Pilates Reformer exercises for fall risk reduction in older adults: A randomized controlled trial

Margaret Roller et al. 2017

“Pilates Reformer exercises performed once per week for 10 weeks resulted in reduced fall risk and significant improvements in static and dynamic balance, functional mobility, balance self-efficacy, and lower extremity AROM [active range of motion] in adults age 65 and older at risk for falling, whereas the control group did not significantly improve in any measures. Pilates Reformer exercises are more effective compared to no exercise intervention at improving hip and ankle AROM.”


The effects of stretching on strength performance

Ercole C. Rubini, André L. L. Costa and Paulo S. C. Gomes, 2007

“Stretching exercises are regularly recommended, even in many textbooks, with the claimed purpose of preventing injury and muscle soreness, or even enhancing performance. However, as highlighted in recent review articles, this recommendation lacks scientific evidence…most studies have found acute decreases in strength following stretching, and that such decreases seem to be more prominent the longer the stretching protocol…when recommending flexibility exercises, one should consider other underlying issues, such as the safety of the participants, possible increases in injury risks and the unnecessary time expenditure.”

Effect of acute static stretch on maximal muscle performance: a systematic review

Anthony D Kay and Anthony J Blazevich, 2012

“The detrimental effects of static stretch are mainly limited to longer durations (≥ 60 s), which may not be typically used during preexercise routines in clinical, healthy, or athletic populations. Shorter durations of stretch (<60 s) can be performed in a preexercise routine without compromising maximal muscle performance.”