Sensory motor learning in patients with chronic low back pain: a prospective pilot study using optoelectronic movement analysis

United States Guild Certified Feldenkrais Teachers®: a survey of characteristics and practice patterns

Background

Feldenkrais Method® teachers help students improve function and quality of life through verbally and manually guided lessons. The reasons people seek Feldenkrais® lessons are poorly understood. Similarly, little is known about practice characteristics and patterns. To address these knowledge gaps, we conducted an extensive survey of United States Guild Certified Feldenkrais Teachers®.

Methods

We invited all Feldenkrais Teachers to participate in this survey delivered in web-based or print formats. We obtained overall and question-specific response rates, descriptive statistics, chi-square tests of response bias, and performed qualitative thematic review of comments.

Results

Overall response rate was 30.5% (392/1287). Ninety percent of responders had college degrees in diverse fields; 12.5% had credentials outside health care, 36.9% held conventional health care licenses, and 23.1% had complementary and alternative medicine credentials. Mean age was 55.7 years; most teachers were women (83%). California (n = 100) and New York (n = 34) had the most teachers. Forty-five percent of teachers earned ≤ 20% of their gross income from their practices, while 26% earned > 80%. Most saw < 10 students/week for individual lessons and < 10 students/week for group lessons. Students were mostly women (71.1%) and 45–64 years old. The primary reason students sought Feldenkrais lessons was pain. A quarter of students self-referred, a fifth were referred by conventional health care providers, and two-thirds paid for services directly. Themes from comments included: beliefs that Feldenkrais training had important personal and professional benefits for teachers; recognition of the challenges of operating small businesses and succinctly describing the Feldenkrais Method; the variety of practice approaches; and a deep commitment to the Feldenkrais Method.

Conclusions

Most Feldenkrais Teachers were well educated, often held additional credentials, were located in the West, were women, were older than 50 years, and had part-time practices. Most students were women, were adults, came from various referral sources, and paid directly for services. Teachers and students utilized the Feldenkrais Method in diverse settings and applications. These findings may foster practice development by Feldenkrais Teachers, improve communication between health care consumers and providers and assist decision-making, and stimulate more research concerning the Feldenkrais Method.

The discriminating properties of an optoelectronic movement analysis method in patients with parkinsonism

Several partly overlapping diseases have Parkinsonism as a symptom and tools that may differentiate between these disorders would be helpful. The authors evaluated the discriminating properties of the objective automated posturo-locomotor-manual (PLM) L-DOPA test in regard to health, and the movement disorders Parkinson's disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP). A PLM test-retest procedure was performed in healthy controls (n = 37) and results were compared with PLM L-DOPA tests performed by 132 patients with Parkinsonism in intermediate to advanced stages (56 PD, 53 MSA, 23 PSP). The movement time (MT) for the standardized movement and its different components was measured. The discriminating abilities of individual, or combinations of, test variables were determined by forward stepwise multiple logistic regression and evaluated with receiver-operating characteristic (ROC) analysis. Each PLM variable separated healthy persons from patients with Parkinsonism before administration of L-DOPA (area under the curve (AUC) = 0.94-0.99, p < .001 for any separate variable). A combination of (MToff - MTon)/MToff and MTon had the highest ability to separate patients with PD from patients with atypical Parkinsonism (area under the curve = 0.91, p < .001). The PLM test discriminates between healthy controls and patients with Parkinsonism, and between patients with Parkinson's disease and patients with atypical Parkinsonism.

Motor performance in chronic low back pain: is there an influence of pain-related cognitions? A pilot study

Background

Methods

Results

Conclusion

A new automated implementation of the Posturo-Locomotion-Manual (PLM) method for movement analysis in patients with parkinson's disease

OBJECTIVE

The Posturo-Locomotion-Manual (PLM) test, which uses an optoelectronic laboratory system, has here been further developed into an automated, more user-friendly, standardized tool for movement analysis named the QbTestMotus. This paper compares the accuracy of QbTestMotus to the PLM test, in particular the automated data analysis.

METHODS

Both QbTestMotus and the PLM recorded data simultaneously from the same 61 patients. The correlation coefficients of movement time (MT), postural time (P), locomotion time (L), and manual time (M) were calculated between the systems. The absolute differences between the result parameters for each patient were also studied. Finally, the differences in MT between the systems were compared with the positive responses in the levodopa (L-dopa) challenges as measured in the PLM test for 11 patients.

RESULTS

The comparisons in all the 61 patients showed high correlation coefficients for all four parameters. The absolute differences between the parameters were small and had small standard deviations, and the decreases in MT because of L-dopa in the positive L-dopa responders were much larger than the absolute difference between the systems.

CONCLUSION

The PLM test and QbTestMotus are equivalent along all parameters, thus indicating that the test quality is equivalent between the PLM test and the automated QbTestMotus system.

A preliminary survey of the practice patterns of United States Guild Certified Feldenkrais PractitionersCM

Background

The Feldenkrais Method^® of somatic education purports to guide people of varying ages and abilities to improve function. Many people choose this method to aid with recovery from injury, manage chronic conditions, or enhance performance even though limited research supporting its safety and effectiveness exists to guide decisions about use and referral. Very little information about practitioner characteristics and practice patterns is publicly available to assist researchers in the design of appropriate safety and effectiveness studies. The purpose of this study was to obtain an initial overview of the characteristics of United States Guild Certified Feldenkrais Practitioners^CM.

Methods

Of 1300 certified Feldenkrais^® practitioners at the time of the study, there were 1193 practitioners with email accounts who were sent invitations to complete a web-based survey. The survey inquired about practice locations, additional credentials, service patterns and workloads during the previous 3 months. Response rate and descriptive statistics were calculated.

Results

The survey had a 32.3% (385/1193) response rate. The top states in which responders practiced were California (n = 92) and New York (n = 44). Most responders did not hold other credentials as traditional health care providers or as complementary and alternative medicine providers. Among those who did, the most common credentials were physical therapist (n = 83) and massage therapist (n = 38). Just over a third of traditional health care providers only provided Feldenkrais lessons, compared to 59.3% of complementary and alternative providers. On average, responders saw 7.6 ± 8.1 (median = 5) clients per week for individual lessons, 8.4 ± 11.5 (median = 5) clients per week for group lessons, and 2.9 ± 3.9 (median = 2) new clients per month for individual lessons.

Conclusions

This preliminary survey of United States Guild Certified Feldenkrais Practitioners indicated that most practiced in the west and northeast, did not hold additional credentials, and had part-time practices. Those who were traditional health care providers were more likely than complementary and alternative medicine providers in other areas to combine their services. These results provide a foundation for further analyses of Feldenkrais practitioner characteristics and practice patterns that can aid the design of safety and effectiveness studies, and enhance use and referral decision-making.

OPTOELECTRONIC MOVEMENT ANALYSIS TO MEASURE MOTOR PERFORMANCE IN PATIENTS WITH CHRONIC LOW BACK PAIN: TEST OF RELIABILITY

OBJECTIVE

To assess test-retest reliability of the Posturo-Locomotion-Manual(PLM) test in patients with chronic low back pain.

DESIGN

A controlled study in which the PLM test was used repeatedly on patients with chronic low back pain and persons without back pain.

SUBJECTS

Twelve patients with treatment-resistant chronic low back pain, selected by 2 orthopaedic spine surgeons and 12 age- and sex-matched individuals with no back pain history.

METHODS

An optoelectronic camera and a computer were used to quantify the performance during a simple test in which subjects picked up an object from the floor and transported it up to a shelf, thereby forcing the body through postural, locomotor and manual movements. The outcome measures were: movement time, simultaneity index and phase times for postural, locomotion and arm movement phases. Statistical analyses regarding intra-individual agreement between the measurements (reliability analysis) and changes over time were carried out.

RESULTS

The effect of test movement habituation was minimized when the lowest mean value of any of 3 consecutive measures (tri-average) was used. In the control group, variation between test occasions was small. In the group of patients with chronic low back pain there was a random measurement error before intervention (sensory motor learning). After intervention the PLM test had the same precision in both groups.

CONCLUSION

When the tri-average measure is used, the influence of test movement habituation is minimized and the optoelectronic PLM test is found to be reliable and responsive. It proved to be a useful tool to quantify dynamic performance in freely moving patients with chronic low back pain.