Influence of Pilates Training on the Quality of life of Chronic Stroke Patients
by Seok-Min Yun, PhD, Sang-Kyoon Park, PhD, and Hee Sung Lim, PhD
Published online 2017 Oct 21.
Link to full article and detailed methodology/results: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684021/
INTRODUCTION
Stroke is a chronic disorder that is mainly caused by a decrease in the number of brain cells, resulting from lack of oxygen due to a blockage or rupture in cerebral blood flow1). Furthermore, stroke is the second highest cause of death after cancer, with 17 million occurrences annually worldwide. It is also the disorder with the third highest proportion of disability occurrences, with numbers increasing annually2). There are varying disabilities found in >85% of patients surviving stroke, including physical disabilities due to stiffness, lack of physical coordination, or sensory paralysis, decrease in intellectual abilities due to decreased focus or memory loss and other language disabilities, mental disabilities due to sense of loss, etc3, 4).
In 1997, the World Health Organization (WHO) defined “quality of life” as a person’s views regarding their position in society, including physical, social, and psychological domains. Moreover, they stated that higher or lower quality of life is determined according to an individual’s health, lifestyle and satisfaction, psychological and mental state, independence, social environment, etc5). Therefore, the quality of life in the majority of stroke patients, who are limited in their ability to perform basic activities that are inherent to “quality of life” that is greatly influenced by a person’s health or disorder, was found to be remarkably low6,7,8,9,10). After being discharged from the hospital, patients who had stroke are typically unable to participate in consistent rehabilitation training to recover their functionality due to time and financial difficulties. As a result, patients often experience decreased will and tend to live on their own without any social relations. Such results show that stroke patients experience decreased quality of life from the physical, mental, and social perspectives after onset, and their quality of life drastically decreases for 4 years after the stroke8, 11).
The rehabilitative objective of stroke patients is based on independent living by improving their functional disabilities12). Therefore, rehabilitation training for stroke patients focuses on improving flexibility, muscular strength, coordination, and sense of balance to maintain an independent lifestyle through the recovery of physical functions; thus, requiring consistent and long-term treatment13, 14). However, a method that promotes the meaning of life and qualitative value of life is an important factor to consider when planning rehabilitation treatment in addition to preserving and extending life with respect to stroke, which is a chronic illness that negatively affects an individual’s quality of life15, 16). Therefore, a creative rehabilitation program must be offered that considers mental aspects on top of medical treatment for improving a patient’s balance and ability to walk when using exercise therapy for recovering functions in stroke patients.
Pilates training, which was developed by Joseph Pilates based on regulatory exercise training from spinal neutrality, was found to be highly effective for recovering physical functions such as improving sense of balance, flexibility, and muscle and cardiopulmonary functions in stroke patients in studies regarding the potential for Pilates training programs to be applied to patients who were neurologically diagnosed with chronic stroke17, 18). Further, Pilates training goes beyond physical development by using exercise methods or equipment and addresses all aspects of exercise that require mental control based on eight principles: control, breathing, flowing movement, precision, centering, stability, range of motion, and opposition, and improves an individual’s health in terms of their mind and body and even their quality of life16, 19, 20). Pilates training also includes various programs that enable the participation of patients who cannot participate in normal exercises due to injury or vulnerable health issues through supportive equipment, such as Reformers, Cadillacs, Wunda Chairs, Magic Rings, Magic Circles, and various types of Foot Correctors, Sandbags, in addition to mat-based exercises21). Independent exercises can be created within each exercise process to match each individual’s needs22, 23). Therefore, because Pilates is a type of supervised training, it can be an ideal method of exercise for stroke patients who are unable to exercise without help. It is a valuable rehabilitation exercise program that reduces secondary obstacles with respect to rehabilitation exercises for stroke patients, helps improve quality of life, and helps individuals exercise on their own with a sense of independence.
However, most studies on Pilates training programs are conducted based on orthopedic rehabilitation exercises17, 24,25,26). Based on studies on Pilates conducted on normal adults, consistent Pilates training resulted in increased abdominal strength, endurance, and trunk flexibility27), increased endurance in the trunk extensor and flexor28), and improved dynamic balance29). Studies conducted on senior citizens reported that Pilates was effective in improving static and dynamic balance30, 31), and improving functions and strength in the lower extremities32).
As such, the effects of Pilates training on physical functions have been verified in various age groups, particularly the elderly, but there are not yet any studies on the correlation between exercise in chronic stroke patients and quality of life. Therefore, this paper will conduct an in-depth survey on the influence of the Pilates training program on the quality of life in chronic stroke patients, and provide meaningful basic data that can be used for developing exercise programs that increase rehabilitative effects for stroke patients.
Abstract
Purpose
This study was to observe the influence of Pilates training on the quality of life in chronic stroke patients.
Subjects and Methods
Forty chronic stroke patients participated in this study. They were divided into same number of experimental group (EG) and control group (CG). EG participated in a 60-min Pilates training program, twice a week for 12 weeks, while the CG did not participate in any exercise-related activities for the duration and participating in general occupational therapy without any exercise-related activities. Then the MMSE-K was performed before and after Pilates training to observe the influence of Pilates training on the quality of life in chronic stroke patients.
Results
Statistically significant improvement in the physical, social, and psychological domains was found in EG after the training. No statistically significant difference was found in all three quality of life domains for the CG. EG experienced a statistically significant improvement in all quality of life domains compared with that of CG.
Conclusion
Therefore, participation in Pilates training was found to effectively improve the quality of life in stroke patients. Pilates training involves low and intermediate intensity resistance and repetition that match the patient’s physical ability and can be a remedial exercise program that can improve physical ability and influence quality of life.
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