Feldenkrais versus conventional exercises for the elderly

Dyadic Group Exercises for Persons with Memory Deficits and Care Partners: Mixed-Method Findings from the Paired Preventing Loss of Independence through Exercise (PLIÉ) Randomized Trial

Background: Non-pharmacological therapies for persons with dementia (PWD) are needed. Objective: To develop and test the Paired Preventing Loss of Independence through Exercise (PLIÉ) program, an integrative group movement program for PWD and care partners (CPs). Methods: Participants were randomized to immediate or delayed start to Paired PLIÉ in community-based classes (1 hour, 2 days/week, 12 weeks, 3 home visits). Co-primary outcomes included standard measures of cognition, physical function,and quality of life (PWD) and caregiver burden (CPs) assessed by blinded assessors, analyzed using linear mixed models to calculate effect sizes for outcome changes during Paired PLIÉ, controlling for randomization group. Anonymous satisfaction surveys included satisfaction ratings and thematic analysis of open-ended responses. Results: Thirty dyads enrolled, 24 (80%) completed. PWD (mean age 80; 55% female) experienced significant improvement in self-rated quality of life (Effect Size+0.23; p = 0.016) when participating in Paired PLIÉ, while CPs experienced a non-significant increase in burden (–0.23, p = 0.079). Changes in physical and cognitive function in PWD were not significant. All CPs returning the satisfaction survey (n = 20) reported being moderately-to-highly satisfied with the program. Thematic analyses identified physical (e.g., sit-to-stand, more energy), emotional (enjoyment), and social benefits (peer-to-peer interaction) for PWD and CPs; challenges were primarily related to getting to the in-person classes. Conclusion: Paired PLIÉ is a promising integrative group movement program that warrants further study. It is feasible and may improve self-rated quality of life in PWD. Although CPs may experience increased burden due to logistical challenges, most reported high satisfaction and physical, emotional, and social benefits.

The preparatory set: a novel approach to understanding stress, trauma, and the bodymind therapies

Basic to all motile life is a differential approach/avoid response to perceived features of environment. The stages of response are initial reflexive noticing and orienting to the stimulus, preparation, and execution of response. Preparation involves a coordination of many aspects of the organism: muscle tone, posture, breathing, autonomic functions, motivational/emotional state, attentional orientation, and expectations. The organism organizes itself in relation to the challenge. We propose to call this the "preparatory set" (PS). We suggest that the concept of the PS can offer a more nuanced and flexible perspective on the stress response than do current theories. We also hypothesize that the mechanisms of body-mind therapeutic and educational systems (BTES) can be understood through the PS framework. We suggest that the BTES, including meditative movement, meditation, somatic education, and the body-oriented psychotherapies, are approaches that use interventions on the PS to remedy stress and trauma. We discuss how the PS can be adaptive or maladaptive, how BTES interventions may restore adaptive PS, and how these concepts offer a broader and more flexible view of the phenomena of stress and trauma. We offer supportive evidence for our hypotheses, and suggest directions for future research. We believe that the PS framework will point to ways of improving the management of stress and trauma, and that it will suggest directions of research into the mechanisms of action of BTES.

Educational and therapeutic qualities of the Bones for Life method – Third Age University lectures

The advantages of the Bones for Life method (BFL) when working with the elderly cannot be overestimated. Bones for Life method may constitute an example of a modern practice of oneself, an example of empowerment which differs from the one offered by mass culture. Thanks to its philosophical underpinnings and consistency the BFL method is holistic in its approach i.e. it addresses the physical as well as the spiritual aspect of human nature thus avoiding treating instrumentally the psycho-physical unity of human beings. What is also significant in the BFL method is its ethical aspect as it combines therapeutic and educational qualities. Its constitutes an integral part of somatic education (a branch of knowledge still little known in Poland) and thus fosters personal development irrespective of the person’s age. Given the increase in demand for different forms of activity tailored for senior citizens perhaps we ought to take a closer look at methods well-known and practised elsewhere in the world.

Does the Feldenkrais Method make a difference? An investigation into the use of outcome measurement tools for evaluating changes in clients

Evidence-based practice confirms the need for outcome measures. Feldenkrais Method practitioners struggle to use such tools because of the broad range of applications of the Feldenkrais Method and the difficulty identifying suitable measurement tools. A pre/post-test design was used to investigate the use of three outcome measurement tools [Patient-specific Functional Scale (PSFS), Pain Outcome Profile (POP) and Short Form12v2 Health questionnaire (SF12v2)] for clients experiencing problems performing everyday functional tasks who attended Feldenkrais sessions. Eleven Feldenkrais practitioners submitted data on 48 clients. Changes were detected in the clients' ability to perform everyday tasks (PSFS improved 3.8 points, p < 0.001), levels of pain decreased (POP improved in current pain p = 0.001, physical index p < 0.001 and affective index p = 0.001) and quality of life improved significantly in six of the eight SF12v2 domains. These three tools have been found to be suitable for detecting changes in client function before and after a series of Feldenkrais sessions.

Getting Grounded Gracefully©: Effectiveness and Acceptability of Feldenkrais in Improving Balance

The Getting Grounded Gracefully© program, based on the Awareness Through Movement lessons of the Feldenkrais method, was designed to improve balance and function in older people. Fifty-five participants (mean age 75, 85% women) were randomized to an intervention (twice-weekly group classes over 8 wk) or a control group (continued with their usual activity) after being assessed at baseline and then reassessed 8 wk later. Significant improvement was identified for the intervention group relative to the control group using ANOVA between-groups repeated-measures analysis for the Modified Falls Efficacy Scale score (p= .003) and gait speed (p= .028), and a strong trend was evident in the timed up-and-go (p= .056). High class attendance (88%) and survey feedback indicate that the program was viewed positively by participants and might therefore be acceptable to other older people. Further investigation of the Getting Grounded Gracefully program is warranted.

Mood Alterations in Mindful Versus Aerobic Exercise Modes

The results of most recent studies have generally indicated an improvement in mood after participation in aerobic exercise. However, only a few researchers have compared mindful modes of exercise with aerobic exercise to examine the effect of 1 single session of exercise on mood. In the present study, the authors assessed state anxiety, depressive mood, and subjective well-being prior to and following 1 class of 1 of 4 exercise modes: yoga, Feldenkrais (awareness through movement), aerobic dance, and swimming; a computer class served as a control. Participants were 147 female general curriculum and physical education teachers (mean age = 40.15, SD = 0.2) voluntarily enrolled in a 1-year enrichment program at a physical education college. Analyses of variance for repeated measures revealed mood improvement following Feldenkrais, swimming, and yoga but not following aerobic dance and computer lessons. Mindful low-exertion activities as well as aerobic activities enhanced mood in 1 single session of exercise. The authors suggest that more studies assessing the mood-enhancing benefits of mindful activities such as Feldenkrais and yoga are needed.

The Feldenkrais Method: a dynamic approach to changing motor behavior

This tutorial describes the Feldenkrais Method and points to parallels with a dynamic systems theory (DST) approach to motor behavior Feldenkrais is an educational system designed to use movement and perception to foster individualized improvement in function. Moshe Feldenkrais, its originator, believed his method enhanced people's ability to discover flexible and adaptable behavior and that behaviors are self-organized. Similarly, DST explains that a human-environment system is continually adapting to changing conditions and assembling behaviors accordingly. Despite little research, Feldenkrais is being used with people of widely ranging ages and abilities in varied settings. We propose that DSTprovides an integrated foundation for research on the Feldenkrais Method, suggest research questions, and encourage researchers to test the fundamental tenets of Feldenkrais.

Long-term exercise and its effect on balance in older, osteoarthritic adults: results from the Fitness, Arthritis, and Seniors Trial (FAST)

OBJECTIVES

To examine the effects of 18-month aerobic walking and strength training programs on static postural stability among older adults with knee osteoarthritis.

DESIGN

Randomized, single-blind, clinical trial of therapeutic exercise.

SETTING

Both center-based (university) and home-based.

PARTICIPANTS

A cohort of 103 older adults (age = 60 years) with knee osteoarthritis who were participants in a large (n = 439) clinical trial and who were randomly assigned to undergo biomechanical testing.

INTERVENTION

An 18-month center- (3 months) and home-based (15 months) therapeutic exercise program. The subjects were randomized to one of three treatment arms: (1) aerobic walking; (2) health education control; or (3) weight training.

MEASUREMENTS

Force platform static balance measures of average length (Rm) of the center of pressure (COP), average velocity (Vel) of the COP, elliptical area (Ae) of the COP, and balance time (T). Measures were made under four conditions: eyes open, double- and single-leg stances and eyes closed, double- and single-leg stances.

RESULTS

In the eyes closed, double-leg stance condition, both the aerobic and weight training groups demonstrated significantly better sway measures relative to the health education group. The aerobic group also demonstrated better balance in the eyes open, single-leg stance condition.

CONCLUSIONS

Our results suggest that long-term weight training and aerobic walking programs significantly improve postural sway in older, osteoarthritic adults, thereby decreasing the likelihood of larger postural sway disturbances relative to a control group.

Implementing a Structured Exercise Program for Frail Nursing Home Residents with Dementia: Issues and Challenges

This pilot study evaluated (a) the feasibility of a group exercise program in an institutionalized population with dementia; (b) the effects of such a program on physical performance measures; and (c) the potential additional effects of vitamin D supplementation on gait and muscle strength. Nursing home residents (N= 25) with chronic dementia and mobility impairments attended a thrice weekly exercise class for 8 weeks. They were randomly assigned to receive either a vitamin D supplement or no supplement throughout the program. Between-group differences in the effectiveness of the exercise intervention were analyzed. Pre-to-post changes were also assessed for both groups combined. In postexercise comparisons of both groups, knee extensor torque at 0°/sec declined by 18.6% while performance of 1-RM for hip extension increased by 16.1%. Balance also improved. Although vitamin D levels increased significantly in the supplement group, the two groups did not differ in their response to the exercise intervention.

The effect of therapy on the mental health of the elderly

This research synthesis was undertaken to study the effects of treatment on the mental health of elderly people. Forty-one controlled studies were analyzed using meta-analytic techniques. Type of treatment along with subject, therapist, setting, and methodological characteristics of the studies were identified and their contributions to mental health outcomes measured. Results indicated that the mean outcome of the experimental group, treated with any type of treatment improved from the fiftieth percentile to the seventieth percentile relative to the mean of the untreated control groups. This research synthesis supports the belief that, in general, treatment is effective in enhancing the mental health of the elderly.