benefits of the feldenkrais method
Awareness Through Movement Improves Quality of Life in People with Multiple Sclerosis
J Neurol Phys Ther. 27(4): 170, 2003.
Stephens JL, Cates P, Jentes E, Perich A, Silverstein J, Staab E, du Shuttle D, Hatcher C, Shmunes J, Slaninka C 2003
PURPOSE/HYPOTHESIS: To assess quality of life changes associated with a successful balance intervention in a group of people with MS.
NUMBER OF SUBJECTS: 12 people with MS mean age 54 yrs, mean Kurtzke EDSS level 4.75
MATERIALS/METHODS: Subjects were randomly assigned to 2 groups: Awareness Through Movement intervention (ATM) and control group (EDU). The ATM group participated in 8 Awareness Through Movement sessions while the EDU group participated in 4 educational sessions over 2 months. Balance and mobility measures were performed before and after the intervention period. These results were published in Neurology Report 2001; 25(2): 39-49.
To assess quality of life the MSQLI was administered before and after the intervention. The MSQLI has 10 sub-scales including: Modified Fatigue Impact (MFIS), Pain Effects, Perceived Deficits (PDQ), and Modified Social Support Survey (MSSS).All scales are valid for people with MS with reliability scores ranging from .78 to .97. Data analysis used Kruskal - Walis ANOVA for group comparisons and Spearman rs for correlations.
RESULTS: There were 3 significant group differences: 1) increase in pain effects in the ATM group (p< 0.03); 2) decrease in perceived difficulty recalling recent events (PDQ-RM) in the ATM group (p< 0.035); and 3) improvement in perceived availability of others for companionship (MSSS-POS) in the ATM group (p< 0.035). Improvement on the PDQ-RM was highly correlated with decreased Fatigue Impact. Improvement in MSSS-POS was highly correlated with decrease in cognitive fatigue impact and a decrease in total PDQ, retrospective memory and planning and organization subscale scores.
CONCLUSIONS: The larger picture that emerges is that an intervention that was successful in improving balance and mobility had other spin-off benefits that were physical, psychological and social improving quality of life. ATM is intended to improve people's awareness and understanding of their bodies and to help individuals create alternative strategies for setting and achieving goals in their life. This spin-off impact may be present in other kinds of interventions but it has not been measured or documented.
CLINICAL RELEVANCE: In an environment where patients and payers increasingly demand significant functional outcomes and measurable improvements in quality of life, it is important to document not only the physical outcomes but also the outcomes that reflect quality of life.
Use of awareness through movement improves balance and balance confidence in people with multiple sclerosis: a randomized controlled study.
Neurology Report, 25(2), 39-49.
Stephens, J., DuShuttle, D., Hatcher, C., Shmunes, J. & Slaninka, C. (2001).
This study examined the effectiveness of a structured, group motor learning process, Awareness Through Movement (ATM), on balance, balance confidence, and self-efficacy. Twelve people with multiple sclerosis were randomly assigned to either ATM or control groups. The ATM group participated in 8 classes, 2 to 4 hours each while the control group participated in educational sessions, over 10 weeks. Six outcome measures were used: the Basic Balance Master modified Clinical Test of Sensory Interaction in Balance (mCTSIB) and Limits of Stability tests; the Activities-specific Balance Confidence Scale; prospective falls; Equiscale; and the Multiple Sclerosis Self-Efficacy Scale.
The ATM group exhibited significantly improved mCTSIB scores indicating an average center of pressure position closer to theoretical center, had significantly fewer abnormal mCTSIB tests, and demonstrated improved balance confidence compared to controls. There was a trend toward improvement in all other measures in the ATM group compared to controls. These results suggest that this type of motor learning intervention can be effective in improving a variety of physical and psychological parameters related to balance and postural control.