Comments on "the Feldenkrais Method: a dynamic approach to changing motor behavior"

An Overview of the Bodily Awareness Representation and Interoception: Insights and Progress in the Field of Neurorehabilitation Research

In the last two decades, the scientific literature on so-called body representations has been increasing, and the notion of body awareness (BA) is particularly interesting for neurorehabilitation. In this article, we present results derived from recent studies on this representation, considering the different definitions and explicative models proposed as well as the empirical settings used to test it, providing an extensive overview of these issues. This article discusses the challenge of understanding how we integrate the sensory experiences of proprioception (knowing where our body is in space) and interoception (sensing internal bodily sensations, like hunger of thirst) with our perception of self. This is a difficult problem to analyze because our awareness of our body is inherently linked to our perspective, since the body is the means through which we interact with the world. Presenting the different viewpoints offered by recent theories on this concern, we highlighted that the neurorehabilitation and psychiatric settings offer two important fields useful for the study of BA because in them it is possible to analyze bodily representations by inducing/observing a controlled discrepancy between dysfunctional content and sensory inputs.

Motor performance in violin bowing: Effects of attentional focus on acoustical, physiological and physical parameters of a sound-producing action

Violin bowing is a specialised sound-producing action, which may be affected by psychological performance techniques. In sport, attentional focus impacts motor performance, but limited evidence for this exists in music. We investigated effects of attentional focus on acoustical, physiological, and physical parameters of violin bowing in experienced and novice violinists. Attentional focus significantly affected spectral centroid, bow contact point consistency, shoulder muscle activity, and novices' violin sway. Performance was most improved when focusing on tactile sensations through the bow (somatic focus), compared to sound (external focus) or arm movement (internal focus). Implications for motor performance theory and pedagogy are discussed.

Attentional Focus in Motor Learning, the Feldenkrais Method, and Mindful Movement

The present paper discusses attentional focus in motor learning and performance from the point of view of mindful movement practices, taking as a starting point the Feldenkrais method. It is argued that earlier criticism of the Feldenkrais method (and thereby implicitly of mindful movement practices more generally) because of allegedly inappropriate attentional focus turns out to be unfounded in light of recent developments in the study of motor learning and performance. Conversely, the examples of the Feldenkrais method and Ki-Aikido are used to illustrate how both Western and Eastern (martial arts derived) mindful movement practices might benefit sports psychology.

Improved interoceptive awareness in chronic low back pain: a comparison of Back school versus Feldenkrais method

PURPOSE

To determine the efficacy of the Feldenkrais method for relieving pain in patients with chronic low back pain (CLBP) and the improvement of interoceptive awareness.

METHOD

This study was designed as a single-blind randomized controlled trial. Fifty-three patients with a diagnosis of CLBP for at least 3 months were randomly allocated to the Feldenkrais (mean age 61.21 ± 11.53 years) or Back School group (mean age 60.70 ± 11.72 years). Pain was assessed using the visual analog scale (VAS) and McGill Pain Questionnaire (MPQ), disability was evaluated with the Waddel Disability Index, quality of life was measured with the Short Form-36 Health Survey (SF-36), and mind-body interactions were studied using the Multidimensional Assessment of Interoceptive Awareness Questionnaire (MAIA). Data were collected at baseline, at the end of treatment, and at the 3-month follow-up.

RESULTS

The two groups were matched at baseline for all the computed parameters. At the end of treatment (Tend), there were no significant differences between groups regarding chronic pain reduction (p = 0.290); VAS and MAIA-N sub scores correlated at Tend (R = 0.296, p = 0.037). By the Friedman analysis, both groups experienced significant changes in pain (p < 0.001) and disability (p < 0.001) along the investigated period.

CONCLUSIONS

The Feldenkrais method has comparable efficacy as Back School in CLBP. Implications for rehabilitation The Feldenkrais method is a mind-body therapy that is based on awareness through movement lessons, which are verbally guided explorations of movement that are conducted by a physiotherapist who is experienced and trained in this method. It aims to increase self-awareness, expand a person's repertoire of movements, and to promote increased functioning in contexts in which the entire body cooperates in the execution of movements. Interoceptive awareness, which improves with rehabilitation, has a complex function in the perception of chronic pain and should be investigated further in future research. The efficacy of the Feldenkrais method is comparable with that of BS for nonspecific chronic low back pain. The physician can recommend a body-mind rehabilitation approach, such as the Feldenkrais method, or an educational and rehabilitation program, such as BS, to the patient, based on his individual needs. The 2 rehabilitation approaches are equally as effective in improving interoceptive awareness.

A review of thoracic outlet syndrome and the possible role of botulinum toxin in the treatment of this syndrome

The objective of this paper is to discuss the classification, diagnosis, pathophysiology and management of Thoracic outlet syndrome (TOS). Thoracic outlet syndrome (TOS) is a complex entity that is characterized by different neurovascular signs and symptoms involving the upper limb. TOS is defined as upper extremity symptoms due to compression of the neurovascular bundle in the area of the neck just above the first rib. Compression is thought to occur at one or more of the three anatomical compartments: the interscalene triangle, the costoclavicular space and the retropectoralis minor spaces. The clinical presentation can include both neurogenic and vascular symptoms. TOS can be difficult to diagnose because there is no standardized objective test that can be used and the clinician must rely on history and several positive findings on physical exam. The medial antebrachial cutaneous nerve conduction may be a sensitive way to detect pathology in the lower trunks of the brachial plexus which is promising for future research. Treatment options continue to be conservative and surgical. However, for those who have failed physical therapy there is research to suggest that botulinum toxin may help with symptom relief. However, given that there has been conflicting evidence, further research is required using randomized controlled trials.

Body awareness: construct and self-report measures

Objectives

Heightened body awareness can be adaptive and maladaptive. Improving body awareness has been suggested as an approach for treating patients with conditions such as chronic pain, obesity and post-traumatic stress disorder. We assessed the psychometric quality of selected self-report measures and examined their items for underlying definitions of the construct.

Data sources

PubMed, PsychINFO, HaPI, Embase, Digital Dissertations Database.

Review methods

Abstracts were screened; potentially relevant instruments were obtained and systematically reviewed. Instruments were excluded if they exclusively measured anxiety, covered emotions without related physical sensations, used observer ratings only, or were unobtainable. We restricted our study to the proprioceptive and interoceptive channels of body awareness. The psychometric properties of each scale were rated using a structured evaluation according to the method of McDowell. Following a working definition of the multi-dimensional construct, an inter-disciplinary team systematically examined the items of existing body awareness instruments, identified the dimensions queried and used an iterative qualitative process to refine the dimensions of the construct.

Results

From 1,825 abstracts, 39 instruments were screened. 12 were included for psychometric evaluation. Only two were rated as high standard for reliability, four for validity. Four domains of body awareness with 11 sub-domains emerged. Neither a single nor a compilation of several instruments covered all dimensions. Key domains that might potentially differentiate adaptive and maladaptive aspects of body awareness were missing in the reviewed instruments.

Conclusion

Existing self-report instruments do not address important domains of the construct of body awareness, are unable to discern between adaptive and maladaptive aspects of body awareness, or exhibit other psychometric limitations. Restricting the construct to its proprio- and interoceptive channels, we explore the current understanding of the multi-dimensional construct and suggest next steps for further research.

Thoracic outlet syndrome: a review

BACKGROUND

: Arterial and venous thoracic outlet syndrome (TOS) were recognized in the late 1800s and neurogenic TOS in the early 1900s. Diagnosis and treatment of the 2 vascular forms of TOS are generally accepted in all medical circles. On the other hand, neurogenic TOS is more difficult to diagnose because there is no standard objective test to confirm clinical impressions.

REVIEW SUMMARY

: The clinical features of arterial, venous, and neurogenic TOS are described. Because neurogenic TOS is by far the most common type, the pathology, pathophysiology, diagnostic tests, differential and associate diagnoses, and treatment are detailed and discussed. The controversial area of objective and subjective diagnostic criteria is addressed.

CONCLUSION

: Arterial and venous TOS are usually not difficult to recognize and the diagnosis can be confirmed by angiography. The diagnosis of neurogenic TOS is more challenging because its symptoms of nerve compression are not unique. The clinical diagnosis relies on documenting several positive findings on physical examination. To date there is still no reliable objective test to confirm the diagnosis, but measurements of the medial antebrachial cutaneous nerve appear promising.

Feldenkrais Method, Alexander Technique, and Yoga—Body Awareness Therapy in the Performing Arts

The three disciplines described are practiced by many individuals for a myriad of reasons. Depending upon ability and depth of study, teachers of all three disciplines may have specific competencies with which to analyse, instruct, and interact with students/clients. In the author's experience, persons who seek out these practices and incorporate them into their daily lives and expressions of physical activity often are motivated to maintain or establish an optimal state of well-being and function. Physicians and therapists who work with performing artists are in a position to encourage such positive direction in patients, provide information on local resources, and consider the practices as collaborative and adjunctive to medical care.

Use of complementary and alternative medicine for the treatment of children with cerebral palsy

The use of complementary and alternative medicine for the treatment of patients with cerebral palsy is more prevalent than one might anticipate. Using the classification of complementary and alternative medicine developed by the National Center for Complementary and Alternative Medicine, this article reviews the different treatments that are used by patients with this condition.

Complementary and alternative therapies for cerebral palsy

The optimal practice of medicine includes integrating individual clinical expertise with the best available clinical evidence from systematic research. This article reviews nine treatment modalities used for children who have cerebral palsy (CP), including hyperbaric oxygen, the Adeli Suit, patterning, electrical stimulation, conductive education, equine-assisted therapy, craniosacral therapy, Feldenkrais therapy, and acupuncture. Unfortunately, these modalities have different degrees of published evidence to support or refute their effectiveness. Uncontrolled and controlled trials of hippotherapy have shown beneficial effects on body structures and functioning. Studies of acupuncture are promising, but more studies are required before specific recommendations can be made. Most studies of patterning have been negative and its use cannot be recommended. However, for the other interventions, such as hyperbaric oxygen, more evidence is required before recommendations can be made. The individual with CP and his or her family have a right to full disclosure of all possible treatment options and whatever knowledge currently is available regarding these therapies.

Studies in motor behavior: 75 years of research in motor development, learning, and control

Research focused on human motor development, learning, and control has been a prominent feature in the Research Quarterly for Exercise and Sport (RQES) since it was first published in 1930. The purpose of this article is to provide an overview of the papers in the RQES that demonstrate the journal's contributions to the study of motor development, learning, and control. The landmark study by Henry and Rogers (1960), the C. H. McCloy lectures, and theoretical and review papers in motor behavior are highlighted. The RQES has served as a significant outlet for research in development, learning, and control throughout its 75-year history. The convergence of the theories, research methods and analytical tools lead to the proposition that these three areas have evolved into afield best described as motor behavior.