Clinical Pilates in Practice: Locomotion & Dynamic Posture

This review article explains the networks that the trunk in vertebrates with limbs, and also how the central nervous system acts dynamically on the musculoskeletal system.

Guillaud E, et al. Locomotion and dynamic posture: neuro-evolutionary basis of bipedal gait. Neurophysiologie Clinique/Clinical Neurophysiology (2020), https://doi.org/10.1016/j.neucli.2020.10.012

Key Points: Locomotion & Dynamic Posture

• Dynamic control of gait is supported by:

  → Locomotor activity that is produced by specialized rhythmogenic spinal circuits called central pattern generators (CPGs), and which cyclically drive axial and leg muscle activity (p.8)

  → Posture control systems which involve long spinal/supraspinal loops, and the integration of various sensory inputs (e.g. proprioceptive, visual and vestibular) at various supraspinal levels resulting in long latency responses (p.8).

• Dynamic balance in limbed vertebrates requires proper coordination of all segments of the body.

• To maintain balance during movement, the internal forces generated by muscle movements interacts closely with the external forces (reaction forces and gravity).

• The nervous system, skeletal tissue, and connective tissues are all required components for the dynamic state of organisms.

• Connective tissues play an informative role in locomotion and posture.

• Connective tissues support motor function by serving as “deformable skeletons.”

• This ensures continuity between individual structures, which guarantees their stability while also conveying the mechanical tension that is generated by muscular activities.

• Receptors embedded in connective tissues broadens the field of perception of changes, which triggers remote reflexes beyond the joint.

In bipedal gait, the axial motor command depends on projection-path coupling, as well as interactions between segmental spinal networks.

• Motor pattern features of gait change depending on behavioural task requirements.

• During gait, a rostro-caudal propagation of biomechanical changes occurs along the spine.

• As a person walks faster their trunk stiffens, and lateral flexion decreases during the gait cycle.

• Studies suggest that back muscle vestibulospinal reflexes are relatively inflexible, while leg muscle responses are highly modulated.

Clinical Pilates in Practice

• Consider the rostro-caudal propagation of biomechanical spinal changes when cueing trunk and lower limb patterning exercises, especially those with reciprocal limb movements:

  → Swimming on the Mat.

  → Prancing on the Wunda Chair or Reformer.

  → Flutters on the Trapeze Table.

• Work to support trunk stiffness for reciprocal lower limb exercises, especially as the pace increases:

  → Side lying series can be a great position to work from.

  → Bicycles on the Cadillac will give a greater challenge.

• Consider how this impacts the functional goal of the client you're working with: task requirements will impact the motor pattern that your client can access.