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Updates to the Clinical Exercise and Pilates Program, Full Body Assessment and Other changes in the last 12 months

In the last 12 months, we have continued to work behind the scenes to improve and update the our Clinical Pilates program.  This includes our Clinical Exercise and Pilates program and our Full Body Assessment process.  Our aim is to improve your outcomes, reduce your aches and pain and help you achieve your goals.

Here are 4 of the major changes we have made in the last 12 months:

Clinical Pilates Update 1 – Adding in Jaw (TMJ) assessment and treatment into our process

The TMJ (tempero-madibular joint) can often be a source of pain directly in the side of the head and can cause headaches.

Temporomandibular Joint

Temporomandibular Joint structure

We knew that this joint can be a source of pain, we did not have a good systematic way of assessing and treating the area.

Over the last 18 months, Mark Latimer (who worked at our Doncaster East practice for 12 months), taught all the staff his method managing TMJ.

This was the beginning.  Although the basics were there, we had to make the process simple and easy to follow.

Over several training sessions between the MD Health staff, we worked on improving the process.  We assessed each other, tried different treatment techniques and then narrowed down the main causes of pain in the TMJ.

Updated TMJ Assessment – The outcome:

The result was a simple assessment process that looks at 3 main aspects:

  • The capsule of the joint – which can become stiff as a result of either direct trauma to the area or a change in biomechanics, due to dental or orthodontic work
  • The 3 major ligament structures in the area
  • The 5 major muscle groups in the area – which can be overactive when there is irritation in the joint, as a normal protective response.

We can now quickly and easily, assess the area and add appropriate treatments is anyone’s Clinical Exercise and Pilates program:

Temporomandibular Joint Assessment

Temporomandibular Joint Assessment

Clinical Pilates Update 2 – Complete build and re-design of our Full Body Assessment software

This has been Michael’s pet project and major technical goal over the last 15 year (or so).  The Full Body Assessment process (and software) has been the main system we use for:

  • Assessing all the major joints
  • Doing our treatment planning
  • Recording all of our treatments and exercises.

Although it still stands out as the big difference between MD Health and other Clinical Pilates services, it has always run as an excel spreadsheet format.  This has meant that making a change to the process (adding a new assessment area, test, diagnosis or treatment) has been a very difficult and manual process.

As a result, to make an improvement/change to the system, it could take up to 18-24 months.  This previously involved adding the test/diagnosis/treatment, then slowly doing their 12 month re-assessments with until it becomes the standard.  This is too slow for change and improvement to occur.  So, from November 2020 Michael and our Senior Software Developer, Noel Tenis, have worked behind the scenes to build our own Full Body Assessment software.  We launched the software on the 23rd September 2021.

Updated Full Body Assessment Software

Updated Full Body Assessment Software

The result has been fantastic.  Now, to make a change to the software, takes a few minutes (or maybe a few hours), instead of 18-24 months.  Some of the direct benefits have been:

  • The easy and simple addition of TMJ assessment and treatment (as described above)
  • Removal of unnecessary tests and simplification of the assessment of the hip
  • The improvement and simplification of the assessment of kids and teenagers (whose needs are different)
  • Much faster and easier treatment planning for the clinical staff
  • Easier review of files. If something is not working, we can scan the previous sessions and assessments, determine where things potentially did not work and adjust the plan for a new direction

Clinical Pilates Update 2 – Re-write and simplification of our HIIT (High Intensity Interval Training) program

Although a lot of our clients want to work on their fitness, our HIIT program has been difficult to implement because:

  • To get someone set up on the program, it could take up to 3 session (or more).
  • There was no direct relationship between the assessment process (YMCA sub-maximal VO2 Max testing) and the program itself
  • It required the use of heart rate monitoring.  In addition, heart rate can be very unreliable to assess fitness levels due to large variations between people. Heart rate is also affected by heart conditions and many medications

As a result, we have spent a large amount of time re-writing the program and making it simpler and much more client friendly

Updated HIIT form

Updated HIIT form

Updated HIIT – The outcome:

  • The testing is a lot simpler, using perceived exertion being main measure, instead of Heart rate.  The outcome is that fitness assessment is a lot easier and can determine your fitness level for your age and gender very quickly.  Plus, you don’t need the heart rate monitor
  • We can very easily determine the work level (output in watts) at each main energy level (aerobic threshold, anaerobic threshold and alactic threshold). This directly translates to your program.  So, after your assessment, we can directly practice your ideal program the session afterwards (not 2 sessions afterwards)
  • When using a heart rate monitor, it is more tailored to you as an individual.  Heart rate prediction formulas (such as 220 minus your age) are extremely unreliable.  The have an error of about 40 beat per minute too high or too low.  Therefore, they can be off by 80 beats for an individual.  In this new approach we can determine your specific heart rate at a given workload (eg at the aerobic threshold).  This is then used for your program, a much more accurate and tailored way.

Clinical Pilates Update 4 – Specific kids and teenage assessment – Not the same as small adults

We have known for a while that assessing kids in the same way as adults was not the best way.  Their needs are different.  The issues children present with are also different.

After workshopping this problem with all the clinical staff, we adapted the assessment program for children.  The new assessment process involves the following:

  • Looking at the major joints movements with specific tests only:   Assessing all the structures we assess in adult joints is just not necessary for children. A limited joint assessment to clear the major joints of injury is more appropriate.  However, if we do find a problem, we can go into more detail as required
  • It’s more important to assess their ability to participate in activity: We can measure children’s speed, agility and balance.  These are the more important factors of their ability to participate in sport and general activity. This is also a better guide in what to do during their sessions with us.
  • Treating children under 12 differently to teenagers: With teenagers, strength testing is also important (compared to children under 12). To fit everything we need to do, we will do the full assessment with teenagers on initially, then an activity based tests on their first session.  With children under 12, because the assessment does not have to look at strength, we can do the activity based tests during their initial assessment

Special kids testing in assessment:

Kids Assessment

Kids Assessment

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