by Mary Kay Hausladen Foley, PT, GCFP

Foley (r.) with a patientPilates instructors know well that the Reformer is an excellent tool to work on strength, flexibility, motor control and balance. For these reasons, the Reformer is also an extremely useful tool for working with people with multiple sclerosis. I have worked with a wide variety of MS patients over the last 23 years, as a physical therapist and as a Pilates Reformer instructor, in association with The Heuga Center for Multiple Sclerosis (the mission of which is to empower MS patients; its motto is “Can Do”). Some patients have such mild symptoms that an outsider would never guess that they have the disease, while others can be quite debilitated it. For the MS population, the Reformer can be invaluable for work on functional changes in areas where motor control or muscle function is compromised.

Multiple sclerosis is an autoimmune disease that affects the central nervous system. It is a chronic and usually progressive disease in which the immune system attacks the myelin—the layer of insulation around nerve fibers—in the brain and spinal cord. This leads to a decrease in nerve function, which causes symptoms that vary from patient to patient and in severity, such as weakness, fatigue, spasticity (a condition we’ll discuss later on in this article), bladder dysfunction, pain, vertigo, decreased balance, cognitive deficits and speech and swallowing difficulties. Because multiple sclerosis affects motor control, the majority of people diagnosed with the disease experience walking difficulty at some point. Research indicates that number is somewhere between 64 and 85 percent. In fact, 70 percent of MS patients report that walking is the most challenging aspect of their disease. Within 15 years of diagnosis, 50 percent of multiple sclerosis patients require assistance walking and, in later stages, up to a third of patients are completely unable to walk. More than 400,000 Americans have multliple sclerosis: most are between the ages of 20 and 50, and women are twice to three times as likely to be affected than men. Worldwide, MS may affect 2.5 million individuals.

Though Pilates exercise will not change the disease process, it can help people maintain strength and function longer than would otherwise be possible. There are, however, special considerations that a Pilates instructor should be aware of when working with someone with MS.

The Pilates studio at Nike World Headquarters in Beaverton, OR
By Christine Binnendyk
With recession-strapped clients groaning at the cost of private Pilates sessions, you may find yourself thrust into a new style of teaching – group Pilates Reformer classes. The incentive for trainers is a higher per-hour wage, yet you’ll now find yourself challenged to make the leap from focusing on one or two clients at a time to observing, correcting and safe-keeping six, eight or more bodies at once.

I train 12 people at a time at the Nike World Headquarters. Any given group class can include professional athletes, people managing bulging discs, Olympic-hopeful runners, harried executives, new moms and pregnant employees. Over the years, I’ve learned a lot about how to make these classes work. Follow my guidelines, and you’ll have a map for:

• Gathering a group you feel comfortable teaching
• Choosing the exercise variations to keep that group interested
• Keeping all learning styles engaged
• Developing a successful communication style