***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Study Design . Two abdominal muscle patterns were tested in the same group of individuals , and their effects were compared in relation to sacroiliac joint laxity . One pattern was contraction of the transversus abdominis , independently of the other abdominals ; the other was a bracing action that used all the lateral abdominal muscles . Objectives . To demonstrate the biomechanical effect of the exercise for the transversus abdominis known to be effective in low back pain . Summary of Background Data . Drawing in the abdominal wall is a specific exercise for the transversus abdominis muscle ( in cocontraction with the multifidus ) , which is used in the treatment of back pain . Clinical effectiveness has been demonstrated to be a reduction of 3-year recurrence from 75 % to 35 % . To the authors ’ best knowledge , there is not yet in vivo proof of the biomechanical effect of this specific exercise . This study of a biomechanical model on the mechanics of the sacroiliac joint , however , predicted a significant effect of transversus abdominis muscle force . Methods . Thirteen healthy individuals who could perform the test patterns were included .  Sacroiliac joint laxity values were recorded with study participants in the prone position during the two abdominal muscle patterns . The values were recorded by means of Doppler imaging of vibrations . Simultaneous electromyographic recordings and ultrasound imaging were used to verify the two muscle patterns . Results . The range of sacroiliac joint laxity values observed in this study was comparable with levels found in earlier studies of healthy individuals . These values decreased significantly in all individuals during both muscle patterns ( P < 0.001 ) . The independent transversus abdominis contraction decreased sacroiliac joint laxity ( or rather increased sacroiliac joint stiffness ) to a significantly greater degree than the general abdominal exercise pattern ( P < 0.0260 ) . Conclusions . Contraction of the transversus abdominis significantly decreases the laxity of the sacroiliac joint . This decrease in laxity is larger than that caused by a bracing action using all the lateral abdominal muscles . These findings are in line with the authors ’ biomechanical model predictions and support the use of independent transversus abdominis contractions for the treatment of low back pain Stability ball training ( SBT ) is believed to improve spinal stability ( SS ) and could reduce the risk of back pain in sedentary individuals . The purpose of this study was to examine the effects of SBT on SS .  Twenty sedentary individuals were r and omly assigned to either an experimental group that performed SBT twice per week for 10 weeks or to a control group . Differences between groups were assessed by analysis of variance ( ANOVA ) with repeated measures . The experimental group improved significantly ( p < 0.05 ) on the static back-endurance test from pretest ( 149.3 ± 72.3 seconds ) to posttest ( 194.6 ± 56.7 seconds ) and the side bridge test from pretest ( 45.4 ± 39.4 seconds ) to posttest ( 71.3 ± 59.7 seconds ) . Back endurance for the control group did not change from pretest ( 123.4 ± 64.9 seconds ) to posttest ( 87.5 ± 40.2 seconds ) , nor did the results of the side bridge test change for this group from pretest ( 41.8 ± 26.4 seconds ) to posttest ( 51.6 ± 35.9 seconds ) . These findings illustrate that SBT may provide improvements in SS within this population . Practitioners might use SBT exercises where the position of the spine is maintained during the early phases of back-pain prevention programs . This type of programming might be beneficial to individuals who spend a good deal of time sitting ( i.e. , in corporate fitness programs ) or for individuals who are prone to back pain and have been cleared to exercise . Also , the side bridge and static back endurance assessment s may be good choices for measuring SS in field setting Methods of exercise such as Pilates and taiji quan , which have been shown to have beneficial effects on physical and mental characteristics , have been studied more often in sample s of older participants . The purpose of this investigation was to examine the effects of a semester of either Pilates or taiji quan training on perceived self-efficacy , sleep quality and mood , as well as strength and balance in college-age individuals .  Self-efficacy was found to be improved in the Pilates and taiji quan groups and there was a trend towards improvement in sleep quality . Mood was found to be improved significantly in the Pilates group while the taiji group showed a trend towards improvement . There were no changes or group differences in the strength or balance measures .  Pilates and taiji quan are effective exercise modes to improve mental parameters in college-age individuals STUDY DESIGN R and omized pretest-posttest control group design . OBJECTIVES To determine the intratester and intertester reliability of a modified isometric stability test and to use this test to evaluate the effects of practice following a 4-week stabilization exercise program with weekly reinstruction . BACKGROUND Although " stabilization " exercise programs are commonplace in the clinic , the reliability to a tool capable of measuring changes in the ability to perform increasingly difficult stabilization exercises has not , to our knowledge , been reported . In addition , it is not clear if practice improves the ability to perform stabilization exercises . METHODS AND MEASURES A convenience sample of 44 asymptomatic subjects was pretested using a pressure transducer placed beneath the lumbar spine to detect motion ( + /- 4 mm Hg ) . A series of 7 exercises was attempted , which required increasing levels of muscular control of the lumbar spine for stability . Subjects received a pass or fail for each exercise level based on the pressure gauge readings and the absence of movement compensations . Subjects were assigned r and omly to exercise and nonexercise groups , and posttest measurements were taken after 4 weeks . The control group did not receive additional instruction . RESULTS The weighted kappa coefficient of 0.61 for intratester and 0.62 for intertester represents good agreement . The median level of exercise attainment increased for the exercise group but not for the nonexercise group . CONCLUSION These results suggest that the modified isometric stability test was reliable and that a 4-week lumbar stabilization exercise program , with weekly intervals of reinstruction and testing , improves the ability to perform progressively difficult lumbar stabilization exercises OBJECTIVE To evaluate the influence of pain on vertical ground-reaction force ( VGRF ) in patients with low back problems and the effect of the Pilates method on the gait of these patients . DESIGN A single-blind r and omized controlled trial . PARTICIPANTS 28 individuals assigned to a control group ( n = 11 ) and a low-back group ( n = 17 ) , the latter of which was subdivided into a Pilates group ( n = 8) and a no-Pilates group ( n = 9 ) . INTERVENTION The Pilates group undertook 15 sessions of Pilates . MAIN OUTCOME MEASURES The VGRF parameters were recorded during preferred and faster walking speeds . The data were collected before and after the intervention . RESULTS The weight-acceptance rate and push-off rate were significantly less in the right lower limb of low-back group than of the control group at preferred speed . Improvements were seen in the Pilates group postintervention , with increased middle-support force for the left lower limb at faster walking speed and decreased pain ; this did not occur in the no-Pilates group . CONCLUSIONS These results suggest that patients with low back pain use strategies to attenuate the amount of force imposed on their body . The Pilates method can improve weight discharge in gait and reduce pain compared with no intervention OBJECTIVE To determine whether the abdominal hollowing technique is more effective for lumbar spine stabilization than a full abdominal muscle cocontraction . DESIGN Within-subject , repeated- measures analysis of variance was used to examine the effect of combining each of 4 loading conditions with either the hollow or brace condition on the dependent variables of stability and compression . A simulation was also conducted to assess the outcome of a person activating just the transversus abdominis during the hollow . SETTING Laboratory . PARTICIPANTS Eight healthy men ( age range , 20 - 33y ) . INTERVENTIONS  Electromyography and spine kinematics were recorded during an abdominal brace and a hollow while supporting either a bilateral or asymmetric weight in the h and s. MAIN OUTCOME MEASURES Spine stability index and lumbar compression were calculated . RESULTS In the simulation " ideal case , " the brace technique improved stability by 32 % , with a 15 % increase in lumbar compression . The transversus abdominis contributed .14 % of stability to the brace pattern with a less than 0.1 % decrease in compression . CONCLUSIONS Whatever the benefit underlying low-load transversus abdominis activation training , it is unlikely to be mechanical . There seems to be no mechanical rationale for using an abdominal hollow , or the transversus abdominis , to enhance stability . Bracing creates patterns that better enhance stability Study Design . A r and omized , controlled trial , test‐retest design , with a 3‐ , 6‐ , and 30‐month postal question naire follow‐up . Objective . To determine the efficacy of a specific exercise intervention in the treatment of patients with chronic low back pain and a radiologic diagnosis of spondylolysis or spondylolisthesis . Summary of Background Data . A recent focus in the physiotherapy management of patients with back pain has been the specific training of muscles surrounding the spine ( deep abdominal muscles and lumbar multifidus ) , considered to provide dynamic stability and fine control to the lumbar spine . In no study have research ers evaluated the efficacy of this intervention in a population with chronic low back pain where the anatomic stability of the spine was compromised . Methods . Forty‐four patients with this condition were assigned r and omly to two treatment groups . The first group underwent a 10‐week specific exercise treatment program involving the specific training of the deep abdominal muscles , with co‐activation of the lumbar multifidus proximal to the pars defects . The activation of these muscles was incorporated into previously aggravating static postures and functional tasks . The control group underwent treatment as directed by their treating practitioner . Results . After intervention , the specific exercise group showed a statistically significant reduction in pain intensity and functional disability levels , which was maintained at a 30‐month follow‐up . The control group showed no significant change in these parameters after intervention or at follow‐up . Summary . A " specific exercise " treatment approach appears more effective than other commonly prescribed conservative treatment programs in patients with chronically symptomatic spondylolysis or spondylolisthesis STUDY DESIGN A r and omized controlled trial , prestest-posttest design , with a 3- , 6- , and 12-month follow-up . OBJECTIVES To investigate the efficacy of a therapeutic exercise approach in a population with chronic low back pain ( LBP ) . BACKGROUND Therapeutic approaches developed from the Pilates method are becoming increasingly popular ; however , there have been no reports on their efficacy . METHODS AND MEASURES Thirty-nine physically active subjects between 20 and 55 years old with chronic LBP were r and omly assigned to 1 of 2 groups . The specific-exercise-training group participated in a 4-week program consisting of training on specialized ( Pilates ) exercise equipment , while the control group received the usual care , defined as consultation with a physician and other specialists and healthcare professionals , as necessary . Treatment sessions were design ed to train the activation of specific muscles thought to stabilize the lumbar-pelvic region . Functional disability outcomes were measured with The Rol and Morris Disability Question naire ( RMQ/RMDQ-HK ) and average pain intensity using a 101-point numerical rating scale . RESULTS There was a significantly lower level of functional disability ( P = .023 ) and average pain intensity ( P = .002 ) in the specific-exercise-training group than in the control group following the treatment intervention period . The posttest adjusted mean in functional disability level in the specific-exercise-training group was 2.0 ( 95 % CI , 1.3 to 2.7 ) RMQ/RMDQ-HK points compared to a posttest adjusted mean in the control group of 3.2 ( 95 % CI , 2.5 to 4.0 ) RMQ/RMDQ-HK points . The posttest adjusted mean in pain intensity in the specific-exercise-training group was 18.3 ( 95 % CI , 11.8 to 24.8 ) , as compared to 33.9 ( 95 % CI , 26.9 to 41.0 ) in the control group . Improved disability scores in the specific-exercise-training group were maintained for up to 12 months following treatment intervention . CONCLUSIONS The individuals in the specific-exercise-training group reported a significant decrease in LBP and disability , which was maintained over a 12-month follow-up period . Treatment with a modified Pilates-based approach was more efficacious than usual care in a population with chronic , unresolved LBP Mirrors are often used in an instructional environment where precise movements must be learned ( e.g. , martial arts , Pilates , dance ) . The potential for mirrors in the learning environment of a Pilates class , to affect the subsequent performance of a Pilates star movement when mirrors are not present , was examined . Twenty subjects learned the Pilates star movement  over seven weeks , either with ( n=11 ) or without ( n=9 ) , mirrors present in the Pilates studio .  Performance of the star without mirrors present  was assessed quantitatively before and after the training , by video analysis of the degree of lateral straightness of the subject 's body at the start , middle , and end of the star movement . Performance of the star movement without a mirror present improved similarly for both the group that learned with , and the group that learned without , mirrors present ( p<0.05 ) . These results indicate that the inclusion of mirrors in a learning environment , to provide immediate visual feedback during learning , does not necessarily enhance the subsequent performance of a skill when mirrors are not present Study Design . Intrasubject controls with r 
    Output:
    
Conclusion : There is a scientific basis for the effectiveness of Pilates exercise , with limited evidence to support it as a rehabilitative intervention