European Journal of Physical Education and Sport Science ISSN: 2501 - 1235 ISSN-L: 2501 - 1235 Available on-line at: www.oapub.org/edu 10.5281/zenodo.61314 Volume 2│Issue 2│2016 INVESTIGATION OF THE EFFECT OF THE PILATES MOVEMENT EDUCATION PROGRAM ON DEVELOPMENT OF FLEXIBILITY AND BALANCE OF THE CHILDREN AT SPECIAL EDUCATION AND REHABILITATION CENTER Ahmet Şirinkan Department of Recreation, Faculty of Sport Science, Atatürk Üniversity, Erzurum, Turkey Abstract: The aim of this study is to investigate the effect of the pilates movement education program on development of flexibility and balance of the children at special education and rehabilitation centre. 28 Students (18 male + 10 female) participated to this study. The age of the students was between 8 and 16 years. Two groups were created for the research. The first group was the experimental group and consisted of 14 (9 male + 5 female) students. Second group was control group and consisted of 14 (9 male + 5 female) students. It was considered the age, gender, and physical appearance and IQ levels of the students when creating the groups. The research data analysed by SPSS 16.0 software. Pre test and Post test comparisons, minimum and maximum values were tabulated. According to survey results, there is no significant improvement the flexibility of the control group and a significant improvement seen the flexibility (p<0,05) of the experimental group. There is also seen a significant improvement the balance (p<0,01) of both groups. As a result, it has been observed that pilates movement education program contributes to the physical characteristics and balance skills of the children with learning difficulties. Keywords: educable, pilates, flexibility, balance 1. Introduction Intellectual disabilities are multidimensional in that they affect all aspects of a person s life. Following are characteristics typically manifested in people with intellectual Copyright © The Author(s). All Rights Reserved Published by Open Access Publishing Group ©2015. 59 Ahmet Şirinkan INVESTIGATION OF THE EFFECT OF THE PILATES MOVEMENT EDUCATION PROGRAM ON DEVELOPMENT OF FLEXIBILITY AND BALANCE OF THE CHILDREN AT SPECIAL EDUCATION AND REHABILITATION CENTER disabilities. The area in which people with intellectual disabilities differ most from others is in cognitive behaviour. The greater the degree of intellectual disability, the lower the cognitive level at which the person functions. Another characteristics affecting learning are a limited ability to generalize information, short attention span, and inability to understand abstract concepts (Winnick, J. P. 2011). Even though intellectual disabled children have the same progress in the development stage with normally developing children, they follow them behind and cannot develop exactly as normal children. (Siedendop and friends, 1986) Krebs (1995) defined that the mild intellectual disabled children and children in borderline can race with peers with normal intelligence in terms of physical fitness and motor performans and also Krebs defined that the children in teachable level are about 4 years behind. Generally, the greater the intellectual disability, the greater the delay in attaining major development milestones. As a group, children with intellectual disabilities walk and talk later, are slightly shorter, and usually are more susceptible to physical problems and illnesses compared with other children. In comparative studies, children with intellectual disabilities consistently score lower than children without intellectual disabilities on measures of strength, endurance, agility, balance, running speed, flexibility, and reaction time (Winnick, J. P. 2011). Some researchers connect the loss of motor development of intellectual disabled children to insufficient physical activities. The physical fitness and motor development of intellectual disabled children caused by mostly insufficient training and not to give an opportunity to participate to the games has been claimed. It is expressed that the children who do not participate to the activities or are not accepted to the games by friends drop behind in terms of physical and motor fitness components and greatly have loos of skills. (Clark and Clark, 1978) Playing games over and over will help students learn specific steps that will increase their ability to motor plan and developed certain skills. For example, the students who are having difficulty releasing the ball when attempting to throw at a target or an opponent can practice the skill of throwing during the game and can be given individualized help if needed (Rouse, P. 2010). Materıal and Methods 28 Students (18 male + 10 female) participated to this study. The age of the students is between 8 16 years. Two groups were created for the research. The first group is European Journal of Physical Education and Sport Science - Volume 2 │ Issue 2 │ 2016 60 Ahmet Şirinkan INVESTIGATION OF THE EFFECT OF THE PILATES MOVEMENT EDUCATION PROGRAM ON DEVELOPMENT OF FLEXIBILITY AND BALANCE OF THE CHILDREN AT SPECIAL EDUCATION AND REHABILITATION CENTER experimental group and consist of 14 (9 male + 5 female) students. Second group is control group and consist of 14 (9 male + 5 female) students. It was considered the age, gender, and physical appearance and IQ levels of the students when creating the groups. The special movement training program which comprise with pilates materials was prepared for research. The materials which are used in research have been created with the kind of: 1. Pilates mats 2. Foam roll 8. Dumbbells (250 gr., 500 gr., 750 gr., 1000 gr.) 3. Peanut shape ball (90 cmx145 cm) 9. Resistanca bands 4. Pilates ball (40cm, 50 cm, 60 cm) 10. Pilates rollers 5. Balance ball (8 cmx16 cm) 11. Pilates ball with resistance 6. Weight ball (250 gr., 500 gr., 750 gr., 12. Pilates mini balls 1000 gr.) 13. Pilates soft balls. 7. Circle (40cm, 50 cm, 60 cm) While preparing the special movement training program, the study program was created with taking views of the special education department lecturers and the lecturer of coaching education department of sport science faculty. The research planned 12 weeks and two days per week. While prepared special movement training program was applied to experimental group, any program was not applied to control group. Two groups were created according to IQ status from the children of 14 people in experimental group. First group of 8 people (5 boys+3 girls) was created from the intellectual disabled children with medium grade IQ (IQ=35-40 to 50-55). Second group of 6 people (4 boys+ 2 girls) was created from the intellectual disabled children with low-grade IQ (IQ=50-55 to 70-75). The same movement program was applied to both groups. Pre-test (sit-reach, dynamic balance, static balance) was performed to experimental group before starting to the studies. After the 12 weeks study, same tests (sit-reach, dynamic balance, static balance) were performed as a post-test and compared with pre-test. Fındıngs According to survey results, there is no significant improvement in the flexibility of the control group and a significant improvement seen in the flexibility (p<0,05) of the European Journal of Physical Education and Sport Science - Volume 2 │ Issue 2 │ 2016 61 Ahmet Şirinkan INVESTIGATION OF THE EFFECT OF THE PILATES MOVEMENT EDUCATION PROGRAM ON DEVELOPMENT OF FLEXIBILITY AND BALANCE OF THE CHILDREN AT SPECIAL EDUCATION AND REHABILITATION CENTER experimental group. There is also seen a significant improvement in the balance (p<0,01) of both groups. As a result, it has been observed that pilates movement education program contributes to the physical characteristics and balance skills of the children with learning difficulties. Mental retardation level Intelligence test score Mild Mental Retardation IQ 50-55 to 70-75 Moderate Mental Retardation IQ 35-40 to 50-55 Severe Mental Retardation IQ 20-25 to 35-40 Profound Mental Retardation IQ below 20-25 Table 1: The age, gender, height, weight status of children who participated to the training program Groups Status M % Age experimental group 8-10 aged 4 25 Age control group 8-10 aged 4 25 Age experimental group 11-13 aged 6 37,5 Age control group 11-13 aged 6 37,5 Age experimental group 14-16 aged 6 37,5 Age control group 14-16 aged 6 37,5 Gender experimental group Male 9 56 Gender control group Male 9 56 Gender experimental group Female 7 44 Gender control group Female 7 44 Height experimental group 120-130 cm 5 31,25 Height control group 120-130 cm 5 31,25 Height experimental group 131-140cm 5 31,25 Height control group 131-140cm 5 31,25 Height experimental group 141-150cm 3 12.5 Height control group 141-150cm 3 12,5 Height experimental group 151cm and above 3 12.5 Height control group 151cm and above 3 12,5 Weight experimental group 30-40 kg 6 37,5 Weight control group 30-40 kg 6 37,5 Weight experimental group 41-50 kg 5 31,25 Weight control group 41-50 kg 5 31,25 Weight experimental group 51 kg and above 5 31,25 Weight control group 51 kg and above 5 31,25 European Journal of Physical Education and Sport Science - Volume 2 │ Issue 2 │ 2016 62 Ahmet Şirinkan INVESTIGATION OF THE EFFECT OF THE PILATES MOVEMENT EDUCATION PROGRAM ON DEVELOPMENT OF FLEXIBILITY AND BALANCE OF THE CHILDREN AT SPECIAL EDUCATION AND REHABILITATION CENTER Table 2: The Pilates special movement training program for students who participated to the training Weeks Basic Special movements movements Gains Used materials General Educational Muscles and Pilates mats, Foam roll, Week1. warming, games joints of the Resistanca bands, Pilates (2 exercises) opening and body to be rollers stretching ready to exercise General Educational Muscles and Peanut shape ball (90 Week2. warming, games with ball joints of the cmx145 cm), Pilates ball (2 exercises) opening and body to be (40cm, 50 cm, 60 cm), stretching ready to use Pilates mini balls, Pilates materials soft balls General Educational Muscles and Balance ball (8 cmx16 cm), Week3. warming, games with ball joints of the Weight ball (250 gr., 500 (2exercises) opening and and weights body to be gr., 750 gr., 1000 gr.) stretching ready to use materials General Educational Muscles and Circle (40cm, 50 cm, 60 Week4. warming, games with joints of the cm), Dumbbells (250 gr., (2exercises) opening and different sport body to be 500 gr., 750 gr., 1000 gr.), stretching materials ready to use Circle (40cm, 50 cm, 60 different cm), Dumbbells (250 gr., materials 500 gr., 750 gr., 1000 gr.) General Educational Ability to do Pilates mats, Foam roll, Week5. warming, games made on ground Resistanca bands, Pilates (2 exercises) opening and gym mat exercises rollers, Resistanca bands, individual and Pilates rollers stretching pairs General Educational Ability to do Pilates ball with Week6. warming, games made ground resistance, Pilates mini (2 exercises) opening and with weight exercises with balls, Pilates soft balls stretching balls on the gym weight balls mat individual and pairs General Educational Ability to do Pilates mats, Foam roll, Week7. warming, games related to flexibility and Resistanca bands, Pilates (2 exercises) opening and sport branches balance rollers and various sport European Journal of Physical Education and Sport Science - Volume 2 │ Issue 2 │ 2016 63 Ahmet Şirinkan INVESTIGATION OF THE EFFECT OF THE PILATES MOVEMENT EDUCATION PROGRAM ON DEVELOPMENT OF FLEXIBILITY AND BALANCE OF THE CHILDREN AT SPECIAL EDUCATION AND REHABILITATION CENTER stretching exercises balls individual and pairs General Competition Ability to do Penanut shape ball (90 Week8. warming, with educational ground cmx145 cm), Pilates ball (2 exercises) opening and games made on exercises with (40cm, 50 cm, 60 cm), stretching gym mat racing Pilates mini balls, Pilates individual and soft balls and various pairs sport balls General Educational Ability to do Balance ball (8 cmx16 cm), warming, games related to flexibility and Weight ball (250 gr., 500 Week9. opening and sport branches balance gr., 750 gr., 1000 gr.) and (2 exercises) stretching exercises various sport balls individual and pairs General Educational Ability to do Circle (40cm, 50 cm, 60 warming, games related to flexibility and cm , Dambıl Week10. opening and sport branches balance gr., 750 gr., 1000 gr.), (2 exercises) stretching exercises Circle (40cm, 50 cm, 60 individual and cm), Dumbbells (250 gr., pairs 500 gr., 750 gr., 1000 gr.) gr., and various sport balls General Competition Ability to do Pilates mats, Foam roll, Week11. warming, with educational ground Resistanca bands, Pilates (2 exercises) opening and games made on exercises with rollers, Resistanca bands, stretching gym mat racing Pilates rollers and various individual and sport balls pairs General Shows with Ability to do Pilates ball with warming, educational shows with resistance, Pilates mini Week12. opening and games made on ground balls, Pilates soft balls and (2 exercises) stretching gym mat exercises various sport balls individual and pairs Analysis The research data analysed by SPSS 16.0 software. Pre test, Post test comparisons, minimum and maximum values were tabulated. European Journal of Physical Education and Sport Science - Volume 2 │ Issue 2 │ 2016 64 Ahmet Şirinkan INVESTIGATION OF THE EFFECT OF THE PILATES MOVEMENT EDUCATION PROGRAM ON DEVELOPMENT OF FLEXIBILITY AND BALANCE OF THE CHILDREN AT SPECIAL EDUCATION AND REHABILITATION CENTER Table 3: The results of pre-test and post-test of experimental and control groups who participated to research Tests Pre and Post n Min. Max. Z Tests Flexibility tests of girls in experimental group Pre-test 5 6.07 Post-test 5 8.45 17.05 Pre-test 5 5,25 8,60 ,765 Post-test 5 5,00 8,45 Pre-test 9 8 Post-test 9 12 Pre-test 9 7 16 ,275 Post-test 9 7 15 Flamingo balance tests of girls in experimental Pre-test 5 18 40 ,000 group Post-test 5 29 60 Flamingo balance tests of girls in control group Pre-test 5 16 26 ,398 Post-test 5 15 28 Flamingo balance tests of boys in experimental Pre-test 9 25 45 ,000 group Post-test 9 35 60 Flamingo balance tests of boys in control group Pre-test 9 22 43 ,523 Post-test 9 24 45 Flexibility tests of girls in control group Flexibility tests of boys in experimental group Flexibility tests of boys in control group 8.15 ,000 15 ,000 18 Conclusıon and Evaluation According to research results, the special movement training program which is applied to children in experimental group contributed significant development to children s basic motor skills of balance and flexibility development (p< 0.01). Children in control group who were tested with the same age, gender, physical property and IQ degree and do not participate to any kind of exercise program did not have this development. It is expressed that ıntellectual disabled boys are more flexible and balanced than girls and moderate intellectual disabled children are more flexible than mild intellectual disable children. (Özer, D. 2010) Rarick and Dobbins (1972) have been expressed that in most intellectual disabled children have many problems of body mechanics and balance because of having loose musculature. In Kreb s research it is emphasized that intellectual disabled children have problem with walking and sitting skills because of their body proportions and European Journal of Physical Education and Sport Science - Volume 2 │ Issue 2 │ 2016 65 Ahmet Şirinkan INVESTIGATION OF THE EFFECT OF THE PILATES MOVEMENT EDUCATION PROGRAM ON DEVELOPMENT OF FLEXIBILITY AND BALANCE OF THE CHILDREN AT SPECIAL EDUCATION AND REHABILITATION CENTER looseness in musculature. It is seen that in most children who participated to our research have irregularities in body structure (overweight, excessive weakness, arm and leg structure etc.). The results of positive contribution in made Pilate s program to the body development (walk, run, balance, coordination, flexibility etc.) have been reached. In research Egan, C. Pilates for Children With Neuromuscular Disorders which is done to related to our research, pilates for children with neuromuscular disorders such as cerebral palsy or hypertonia differs from pilates for general rehab. Therapists working with this unique group must understand the social, emotional, behavioural and developmental implications of neurological damage, and how to harness Pilate s principles to counteract these effects. Children with neuromuscular challenges have difficulty modulating an appropriate balance of flexion and extension. While a healthy motor control system acts like a dimmer switch your body automatically knows what percentage to flex or extend an affected neuromuscular system is more like an on-off switch. For example, the knee is either straight or bent. In other research (Foley, M., K. 2009), it is common for people with MS to experience a decrease in flexibility and decline in motor control. You can improve your flexibility and range of motion, while strengthening your legs, by using the foot straps on the reformer to perform leg circles. You can also flex and extend your knees or ankles by pushing against the foot-bar or foot-board in a closed-chain exercise. The movements can be small in order to strengthen isolated leg muscles and improve motor control. Part of pilates s Endelman, K. Pilates.com. success which is done for a result of injury rehabilitation is based on the approach to the principles of pilates - core strength, an even musculature, etc. But another reason is that it provides a greater degree of flexibility than most conventional forms of physical therapy. This is true because pilates exercises can be modified for each person and still be extremely effective. You can go from basic movements to very advanced, depending on how a patient needs to progress or how badly they are injured. The pilates exercises (Burke, D. Pilates.com, 2016) which are done as a result of knee injuries for treatment shows that at the end of week 8, John demonstrated increased tolerance to all exercises with minimal complaint of knee pain. He was able to climb and descend stairs without discomfort and only experienced L knee pain with passive knee flexion to end range. Objective measures were improved as well. Bilateral quad strength was equal at 5/5 and visually, the L vastus medialis showed increased activity with isometric, closed chain and open chain activities. Additionally, increased European Journal of Physical Education and Sport Science - Volume 2 │ Issue 2 │ 2016 66 Ahmet Şirinkan INVESTIGATION OF THE EFFECT OF THE PILATES MOVEMENT EDUCATION PROGRAM ON DEVELOPMENT OF FLEXIBILITY AND BALANCE OF THE CHILDREN AT SPECIAL EDUCATION AND REHABILITATION CENTER awareness of hip stability was demonstrated with all exercises. After two months of pilates exercises focused on strengthening the muscles around the knee and stabilizing the hip, John was back to full function without limitations. In another research (Wintroub, B., Pilates.com. 2016), in a gym or other fitness facility, Aerobic Pilates fits perfectly. Begin the pilates class with jumpboard activities. First, teach the foot patterns with a red and a blue spring. This will warm up the feet, knees and hips while holding the neutral pelvic zone. Next, teach the proper hand patterns without weights, and then add 2 lb. weights once the patterns are coordinated with the footwork. Finally, add disco music to the foot patterns. From there the instructor can call out the patterns. To make the workout more difficult, simulate running up a hill by changing the springs to two red springs or more. Or, use a single blue spring to simulate running on the moon, which requires a huge amount of pelvic stability that will challenge anyone. Finish the workout by leaving the jumpboard up and doing stretching exercises like elephant, mermaid, knee stretch, Eve s stretch, etc. In pilates exercises which are done to Parkinson patients (Royer, L., Waldmann, K. Pilates.com. 2016), the ability to bring a client from a foreign to a familiar environment/gravity relationship, and to simulate functional, biomechanically correct movement with increased proprioceptive challenge can best be achieved with access to multiple pilates apparatus. One example: doing Footwork on the Reformer, progressing to a single-leg version, then eventually to the Standing/Single Leg Pump on the Chair. The addition of pilates mat repertoire and use of props such as foam rollers, balls, balance discs, etc, can be used (when successfully following this model of progression to develop an individualized program specific to the patient s activities and functional requirements. This also allows for a home exercise program to compliment the studio program, especially for clients who are unable to commit to a studio appointment more than once a week. As a result it is said that pilates exercises contributes positively to the indispensable muscle and joint development for basic motor control, motor skills and life if it is done to normal people, patients or disabled people. References 1. ”urke, D. . Pilates and Knee Injuries . It is taken on . . from www.pilates.com European Journal of Physical Education and Sport Science - Volume 2 │ Issue 2 │ 2016 67 Ahmet Şirinkan INVESTIGATION OF THE EFFECT OF THE PILATES MOVEMENT EDUCATION PROGRAM ON DEVELOPMENT OF FLEXIBILITY AND BALANCE OF THE CHILDREN AT SPECIAL EDUCATION AND REHABILITATION CENTER 2. Clarke, H. H., & Clarke, H. D., . Development and “dapted Physical Education . Second Edition., Prentice Hall INC. Englewoodb Cliffs, New Jersey. 3. Egan, K. . Pilates for Children with Neuromuscular Disorders . It is taken on 15.02.2016 from pilates com. 4. Endelman, K. . Pilates: Effective for Injury Rehabilitation . It is taken on 04.03.2016 from www.pilates.com 5. Foley, M., K., 6. Krebs, P.L. . Improving Mobility with Pilates . Disabled World. . Mental Retardation. “dapted Physical Education and Sport Ed:J.P. Winnick . Human Kintics ”ooks Champaigne, 7. 5zer, D. S. p, İllinois. . Physical Education and Sports for the Disabled , Nobel Release Distribution, Ankara. 8. Rarick, G., L., & Dobbins, D., A., . ”asic Component in the Motor Performance of Educable Mentally Retarded Children: Implications for Corriculum Development . U.S. Office of Education., Washington. 9. Rouse, P. . Inclusion in Physical Education. Fitness, motor, and social skills for students of all abilities . Human Kinetics, Printed in the United States of America. 10. Royer, L., Waldmann, K. . Pilates for People with Parkinson Disease . It is taken on 4.3.2016 from www.pilates.com 11. Siedentop, D., Mond, C. & Toggort, “. . Students with special needs. Physical Education Teaching and Curriculum Strategies for Grades 5- .May, Field Publishing Company Mountain View, 113-127 p., California. 12. Winnick, J. P. (20 . “dapted Physical Education and Sport . Fifth Edition, Human Kinetics, Printed in the United States of America. 13. Wintroub, ”. . “erobic Pilates and to Jumpboard . It is taken on 4.3.2016 from www.pilates.com Creative Commons licensing terms Authors will retain the copyright of their published articles agreeing that a Creative Commons Attribution 4.0 International License (CC BY 4.0) terms will be applied to their work. 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