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Parkinson's disease (PD) is a neurodegenerative disorder characterized by tremors, rigidity, and postural instability. These symptoms significantly impact balance and increase the risk of falls, which subsequently lead to a heightened fear of falling and a diminished quality of life. Alexander Technique and the Feldenkrais Method have shown effects in improving overall well-being.
The study is randomized clinical trial will be carried at General hospital. 46 participants meeting the inclusion criteria will be included in this study. Participants will be randomly assigned into 2 groups, Group A and Group B participants will receive Alexander techniques and Feldenkrais method, respectively. All the groups will receive interventions for three days a week for 8 weeks.
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as tremors, rigidity, bradykinesia, and postural instability. These symptoms significantly impact balance and increase the risk of falls, which subsequently lead to a heightened fear of falling and a diminished quality of life. Alexander Technique and the Feldenkrais Method have shown promise in improving motor function and overall well-being. The primary objective of this study is to compare the effects of the Alexander Technique and the Feldenkrais Method on balance, fear of falling, and quality of life in patients with Parkinson's disease.
This randomized clinical trial will be carried at General hospital after the approval of permission letter. Total number of 46 participants meeting the inclusion criteria will be included in this study through a non-probability convenient sampling technique. Participants will be randomly assigned into 2 groups using computer generated randomization method. Group A and Group B participants will receive Alexander techniques and Feldenkrais method, respectively. All the groups will receive interventions for three days a week for 8 weeks. Total treatment time will be 40 minutes. The outcome measuring scales used will be Berg balance scale and time-up and go to measure balance, fall efficacy scale-international to measure fear of fall, and the Parkinson's disease questionnaire (PDQ-39) to measure quality of life. The data will be collected at baseline and after 8 weeks of therapy, to measure the outcome measures.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| alexander | Experimental | Group A will receive therapy according to Alexander techniques for every alternate day (3 days per week) for 8 weeks. Total 40 minutes of session. |
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| feldenkrais | Experimental | Group B will receive therapy according to Feldenkrais method for every alternate day (3 days per week) for 8 weeks. Total 40 minutes of session |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Alexander technique | Other | 24 sessions for 8 weeks, per week 3 sessions will be given |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Berg balance scale | It is a 14-item list with each item consisting of a five-point ordinal scale ranging from 0 to 4, with 0 indicating the lowest level of function and 4 the highest level of function and takes approximately 20 minutes to complete. It does not include the assessment of gait. A score of 56 indicates functional balance. A score of <45 indicates individuals may be at greater risk of falling. A score of ≤49 indicates a risk of falls in individuals with stroke. | 8 weeks |
| Time up and go (TUG) | The patient starts in a seated position. The patient stands up upon therapist's command: walks 3 meters, turns around, walks back to the chair and sits down. The time stops when the patient is seated. An older adult who takes ≥12 seconds to complete the TUG is at risk for falling. In Parkinson's, the patient is at high risk of fall if he takes more than 11.5 seconds. | 8 weeks |
| Fall efficacy scale-international (FES-I) | It is a 16-item questionnaire, with a score ranging from minimum 16 (no concern about falling) to maximum 64 (severe concern about falling). | 8 weeks |
| Quality of life questionnaire for Parkinson's PDQ-39 | PDQ-39 comprises 39 questions from 8 dimensions which include mobility, activities of daily of living, emotional well-being, stigma, social support, cognition, communication, and bodily discomfort. | 8 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sabiha Arshad, M.Phill | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| General hospital | Lahore | Punjab Province | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Teixeira-Machado L, de Araújo FM, Menezes MA, Cunha FA, Menezes T, Ferreira CdS, et al. Feldenkrais method and functionality in Parkinson's disease: a randomized controlled clinical trial. International Journal on Disability and Human Development. 2017;16(1):59-66. | ||
| Background | Sedaghati P, Goudarzian M, Daneshmandi H, Ardjmand A. Effects of Alexander-based corrective techniques on forward flexed posture, risk of fall, and fear of falling in idiopathic Parkinson's disease. Archives of Neuroscience. 2018;5(2). | ||
| 35248289 | Background | Hafezi M, Rahemi Z, Ajorpaz NM, Izadi FS. The effect of the Alexander Technique on pain intensity in patients with chronic low back pain: A randomized controlled trial. J Bodyw Mov Ther. 2022 Jan;29:54-59. doi: 10.1016/j.jbmt.2021.09.025. Epub 2021 Oct 9. | |
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| Feldenkrais method |
| Other |
The method is divided into eight lessons according to 'Awareness Through Movement'. Each lesson will be given three times for one week. |
|
| Background |
| Kang SH, Kim J, Kim I, Moon YA, Park S, Koh SB. Dance Intervention Using the Feldenkrais Method Improves Motor, and Non-Motor Symptoms and Gait in Parkinson's Disease: A 12-Month Study. J Mov Disord. 2022 Jan;15(1):53-57. doi: 10.14802/jmd.21086. Epub 2021 Nov 3. |
| Background | Gross M, Condie C, Grieb J, Cohen R. Poised for Parkinson's: Retention of benefits 6-7 months after Alexander technique synchronous online group course. Archives of Physical Medicine and Rehabilitation. 2022;103(12):e150. |
| Background | Babaei H, Alizadeh MH, Minoonezhad H, Movahed A, Maher R. Effectiveness of the Alexander Technique on quality of life in young men with upper crossed syndrome. Physical Treatments-Specific Physical Therapy Journal. 2024;14(2):125-36. |
| 36360614 | Background | Berland R, Marques-Sule E, Marin-Mateo JL, Moreno-Segura N, Lopez-Ridaura A, Sentandreu-Mano T. Effects of the Feldenkrais Method as a Physiotherapy Tool: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health. 2022 Oct 22;19(21):13734. doi: 10.3390/ijerph192113734. |
| Background | Pour Kamali T, Yazdkhasti F, Oreyzi HR, Chitsaz A. A Comparison of Effectiveness of Dohsa-hou and the Alexander Technique on Happiness, Social Adjustment, Hope, Mental Health, and Quality of Life in Patients with Parkinson's Disease. Japanese Psychological Research. 2018;60(2):87-98. |
| 32226825 | Background | Cohen RG, Baer JL, Ravichandra R, Kral D, McGowan C, Cacciatore TW. Lighten Up! Postural Instructions Affect Static and Dynamic Balance in Healthy Older Adults. Innov Aging. 2020 Mar 24;4(2):igz056. doi: 10.1093/geroni/igz056. eCollection 2020. |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |