Lengthening the hamstring muscles without stretching using "awareness through movement"

A scoping review on the body awareness rehabilitation after stroke: are we aware of what we are unaware?

Body awareness (BA) is a complex multi-dimensional construct that refers to the subject's ability to consciously perceive and integrate sensory and proprioceptive information related to the position, movement, and balance of one's own body and body parts. Since it involves multiple brain regions and include different functional networks, it is very often affected by cerebrovascular damage such as stroke. Deficits in the ability to monitor our actions and predict their consequences or recognize our body parts and distinguish them from those of others may emerge after stroke. In this study, we decided to explore whether specific treatments targeting BA are discussed in current literature, and whether BA is considered as an outcome in neurorehabilitation processes for stroke patients. To achieve our goal, a scoping review on this often-underreported problem was performed. After analyzing the existing literature, emerged BA in stroke patients is rarely assessed or rehabilitated through specific stimulation or rehabilitation protocol. Additionally, treatment outcomes related to BA are often considered only from a "physical" perspective such as improvements in walking, balance, or the movement of specific body parts, rather than from a proprioceptive standpoint. Further research is needed to facilitate developing early and effective intervention strategies for the recovery of BA after stroke.

Central mechanisms of muscle tone regulation: implications for pain and performance

Muscle tone represents a foundational property of the motor system with the potential to impact musculoskeletal pain and motor performance. Muscle tone is involuntary, dynamically adaptive, interconnected across the body, sensitive to postural demands, and distinct from voluntary control. Research has historically focused on pathological tone, peripheral regulation, and contributions from passive tissues, without consideration of the neural regulation of active tone and its consequences, particularly for neurologically healthy individuals. Indeed, simplistic models based on the stretch reflex, which neglect the central regulation of tone, are still perpetuated today. Recent advances regarding tone are dispersed across different literatures, including animal physiology, pain science, motor control, neurology, and child development. This paper brings together diverse areas of research to construct a conceptual model of the neuroscience underlying active muscle tone. It highlights how multiple tonic drive networks tune the excitability of complex spinal feedback circuits in concert with various sources of sensory feedback and in relation to postural demands, gravity, and arousal levels. The paper also reveals how tonic muscle activity and excitability are disrupted in people with musculoskeletal pain and how tone disorders can lead to marked pain and motor impairment. The paper presents evidence that integrative somatic methods address the central regulation of tone and discusses potential mechanisms and implications for tone rehabilitation to improve pain and performance.

Physical and psychological effects of neuromuscular integrative activity vs Pilates on sedentary females

The aim of this study was to compare the effects of Neuromuscular Integrative Action (NIA) and Pilates exercises on physical fitness and psychological effects in sedentary women. The groups were randomly divided into Pilates (n = 22) and NIA (n = 21) groups using the closed envelope method. 43 sedentary women aged 20-45 years were included in the study. The 6 Minute Walking Test (6MWT), the Sit and Reach Test, and the Static Plank Test durations were used for the physical fitness level assessment at baseline and at the end of trainings. In addition, the Rosenberg Self-Esteem Scale, the Beck Anxiety Inventory, and the SF-36 were used to evaluate the psycho-somatic symptoms and health-related quality of life of the participants. Both groups received 60-min exercise sessions 2 days a week for 8 weeks. After treatment, within comparisons revealed that there was a significant improvement in BMI (P = 0.008), 6MWT (P = 0.0001), Sit and Reach Test (P = 0.016), Static Plank Test (p = 0.000), and SF-36 (p = 0.017) values in the NIA group. Additionally, BMI (P = 0.038), 6-min Walk Test (p = 0.0001), Sit and Reach test (p = 0.001), Static Plank test (0.000), Functional Reach distance (p = 0.06), Beck Depression Scale, and SF-36 (p = 0.006) scores improved in comparisons made within the Pilates group after treatment. Between group comparisons showed similar result for all variables in both Pilates and NIA groups. Based on the results of this study, NIA may be an alternative to Pilates for improving the physical fitness level and psychological effects in healthy women.

Feldenkrais awareness though movement intervention for fibromyalgia syndrome: A proof-of-concept study

INTRODUCTION

The Feldenkrais Method® is a form of awareness through movement (ATM) aimed at improving spatial and kinesthetic awareness through verbally guided movements, in order to learn more effective actions.

METHOD

The present study, a proof-of-concept, observational, non-controlled prospective study, aims at exploring the effectiveness of ATM for fibromyalgia syndrome (FM), measuring the effect by means of multi-dimensional questionnaires, administered at baseline and after 4 months of ATM activity.

RESULTS

One hundred twenty-eight FM patients (mean age 54 years old, 2% males) participated in the study. A statistically significant improvement was found in FM-specific measures (Polysymptomatic Distress Scale, PDS) (p = 0.003) and the Pain Catastrophization Scale (PCS) (p = 0.020); coherently, the Revised Fibromyalgia Impact Questionnaire (FIQR) showed a trend in improvement after the intervention, although this improvement was not statistically significant. The logistic regression analysis found a correlation between PDS, fatigue and anxiety measures; PCS, years from diagnosis and anxiety.

CONCLUSION

ATM could improve FM-specific measures and pain-related catastrophizing. Further studies are needed to identify FM subgroups in order to find personalized targets that can be used to guide treatments.

The Empowering Effect of Embodied Awareness Practice on Body Structural Map and Sensorimotor Activity: The Case of Feldenkrais Method

While outcomes of embodied awareness practices in terms of improved posture and flexibility, movement efficiency, and well-being are often reported, systematic investigations of such training effects and of the actual nature, extent, and neurofunctional correlates of learning mechanisms thought to lie at the core of such practices are very limited. The present study focused on the Feldenkrais method (FM), one of the most established embodied awareness practices, and aimed at investigating the neurofunctional outcomes of the somatic learning process at the core of the method by testing the modulations induced by a standardized FM protocol on the complexity of practicers’ body structural map and on the activity of their sensorimotor network during different movement-related tasks (i.e., gestures observation, execution, and imagery). Twenty-five participants were randomly divided into an experimental group—which completed a 28-session FM protocol based on guided group practice—and a control group, and underwent pre-/post-training psychometric and electrophysiological assessment. Data analysis highlighted, at the end of the FM protocol, a significant increase of EEG markers of cortical activation (task-related mu desynchronization) in precentral regions during action observation and in central regions during action execution and imagery. Also, posterior regions of the sensorimotor network showed systematic activation during all the action-related tasks.

Mindful movement and skilled attention

Bodily movement has long been employed as a foundation for cultivating mental skills such as attention, self-control or mindfulness, with recent studies documenting the positive impacts of mindful movement training, such as yoga and tai chi. A parallel “mind-body connection” has also been observed in many developmental disorders. We elaborate a spectrum of mindfulness by considering ADHD, in which deficient motor control correlates with impaired (disinhibited) behavioral control contributing to defining features of excessive distractibility and impulsivity. These data provide evidence for an important axis of variation for wellbeing, in which skillful cognitive control covaries with a capacity for skillful movement. We review empirical and theoretical literature on attention, cognitive control, mind wandering, mindfulness and skill learning, endorsing a model of skilled attention in which motor plans, attention, and executive goals are seen as mutually co-defining aspects of skilled behavior that are linked by reciprocal inhibitory and excitatory connections. Thus, any movement training should engage “higher-order” inhibition and selection and develop a repertoire of rehearsed procedures that coordinate goals, attention and motor plans. However, we propose that mindful movement practice may improve the functional quality of rehearsed procedures, cultivating a transferrable skill of attention. We adopt Langer’s spectrum of mindful learning that spans from “mindlessness” to engagement with the details of the present task and contrast this with the mental attitudes cultivated in standard mindfulness meditation. We particularly follow Feldenkrais’ suggestion that mindful learning of skills for organizing the body in movement might transfer to other forms of mental activity. The results of mindful movement training should be observed in multiple complementary measures, and may have tremendous potential benefit for individuals with ADHD and other populations.

The effectiveness of the feldenkrais method: a systematic review of the evidence

The Feldenkrais Method (FM) has broad application in populations interested in improving awareness, health, and ease of function. This review aimed to update the evidence for the benefits of FM, and for which populations. A best practice systematic review protocol was devised. Included studies were appraised using the Cochrane risk of bias approach and trial findings analysed individually and collectively where possible. Twenty RCTs were included (an additional 14 to an earlier systematic review). The population, outcome, and findings were highly heterogeneous. However, meta-analyses were able to be performed with 7 studies, finding in favour of the FM for improving balance in ageing populations (e.g., timed up and go test MD -1.14 sec, 95% CI -1.78, -0.49; and functional reach test MD 6.08 cm, 95% CI 3.41, 8.74). Single studies reported significant positive effects for reduced perceived effort and increased comfort, body image perception, and dexterity. Risk of bias was high, thus tempering some results. Considered as a body of evidence, effects seem to be generic, supporting the proposal that FM works on a learning paradigm rather than disease-based mechanisms. Further research is required; however, in the meantime, clinicians and professionals may promote the use of FM in populations interested in efficient physical performance and self-efficacy.

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.

Feldenkrais method balance classes improve balance in older adults: a controlled trial

The objective of this study was to investigate the effects of Feldenkrais Method balance classes on balance and mobility in older adults. This was a prospective non-randomized controlled study with pre/post measures. The setting for this study was the general community. A convenience sample of 26 community-dwelling older adults (median age 75 years) attending Feldenkrais Method balance classes formed the Intervention group. Thirty-seven volunteers were recruited for the Control group (median age 76.5 years). A series of Feldenkrais Method balance classes (the 33312Getting Grounded Gracefully33313 series), two classes per week for 10 weeks, were conducted. Main outcome measures were Activities-Specific Balance Confidence (ABC) questionnaire, Four Square Step Test (FSST), self-selected gait speed (using GAITRite instrumented gait mat). At re-testing, the Intervention group showed significant improvement on all of the measures (ABC, P = .016, FSST, P = .001, gait speed, P < .001). The Control group improved significantly on one measure (FSST, P < .001). Compared to the Control group, the Intervention group made a significant improvement in their ABC score (P = .005), gait speed (P = .017) and FSST time (P = .022). These findings suggest that Feldenkrais Method balance classes may improve mobility and balance in older adults.

Effect of awareness through movement on the head posture of bruxist children

The aim of this study was to evaluate the effectiveness of physiotherapy to improve the head posture and reduce the signs of bruxism in a group of bruxist children. A single-blind randomized clinical trial was performed. All the subjects were 3- to 6-year old, had complete primary dentition, dental and skeletal class I occlusion and were classified as bruxist according to the minimal criteria of the ICSD for bruxism. For each child, a clinical, photographic and radiographic evaluation of the head and cervical posture were realized with standardized techniques. The children were randomized in an experimental (n = 13) and a control (n = 13) group. A physiotherapeutic intervention was applied to the children of the experimental group once a week, until 10 sessions were completed. Afterwards, the cephalogram and the clinical and photographic evaluation of the head posture were measured again. The data were analysed with the t-test and Mann-Whitney test. The subjects of the experimental group showed statistically significant improvement in the natural head posture. The physiotherapeutic intervention showed to be efficient to improve the head posture at the moment of measurement in the studied children. The relationship between bruxism and head posture, if exists, seems to be worthwhile to examine.

Feldenkrais Method balance classes are based on principles of motor learning and postural control retraining: a qualitative research study

BACKGROUND

Feldenkrais Method balance classes have been found to be effective in improving balance in recent studies, but there has been little research into possible mechanisms behind the effectiveness of these classes. Indeed, there has been little research into the content of any balance training classes.

OBJECTIVES

To analyse the content of a series of Feldenkrais Method balance classes to gain an understanding of how the results in these studies may have been achieved and the principles through which the method may be effective.

DESIGN

Qualitative research approach (content analysis).

METHOD

Feldenkrais Method Awareness Through Movement lessons were transcribed and the contents were analysed. An intercoder reliability study was undertaken.

RESULTS

The content analysis revealed that the classes used motor skill acquisition elements of internal feedback, repetition and variability of practice using an exploratory learning approach. Postural control skills of intersegmental coordination of ankle/hip/trunk synergies were practised, with control of the centre of mass over the base of support explored in anterior/posterior, medio/lateral, diagonal, rotational and circular directions. Key findings were the extensive involvement of trunk flexibility and control in the balance activities, and also the intensive attention to internal feedback which was linked to body awareness training.

CONCLUSION

The Awareness Through Movement lessons contained many elements consistent with current theories of motor skill acquisition and postural control, providing a sound theoretical basis for the effectiveness of the Feldenkrais approach in improving balance. The methodology used in this study may provide a useful model for similar investigations into other balance training approaches.

Increasing muscle extensibility: a matter of increasing length or modifying sensation?

Various theories have been proposed to explain increases in muscle extensibility observed after intermittent stretching. Most of these theories advocate a mechanical increase in length of the stretched muscle. More recently, a sensory theory has been proposed suggesting instead that increases in muscle extensibility are due to a modification of sensation only. Studies that evaluated the biomechanical effect of stretching showed that muscle length does increase during stretch application due to the viscoelastic properties of muscle. However, this length increase is transient, its magnitude and duration being dependent upon the duration and type of stretching applied. Most of these studies suggest that increases in muscle extensibility observed after a single stretching session and after short-term (3- to 8-week) stretching programs are due to modified sensation. The biomechanical effects of long-term (>8 weeks) and chronic stretching programs have not yet been evaluated. The purposes of this article are to review each of these proposed theories and to discuss the implications for research and clinical practice.