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Can Feldenkrais exercises ameliorate subclinical depressive symptoms in older adults? A pilot study
Abstract
Subclinical depressive symptoms are common among older patients in primary care practices. This study examined the effects of a five-week Feldenkrais intervention on depressive symptoms (CES-D), perceived stress (PSS-10) and health-related quality of life (HRQoL) in independent living older adults. Participants (N=47) were randomly assigned to two groups: a Feldenkrais intervention (FG, n = 25) and a control group (waitlist) (CG, n = 22). HRQoL, CES-D and PSS-10 were assessed at baseline and after 5 weeks. Results of the mixed models indicated a significant Group X Time interaction for the CES-D (p=.009). No other significant Group X Time interactions were present. The effect size of the Feldenkrais intervention was .32, whereas the effect size for the control group was -.33 for symptoms of depression.
... The interest in Feldenkrais has increased in recent years. Randomized controlled trials showed promising effects on balance, movement efficiency (Hillier & Worley, 2015;Ullmann et al., 2010), mood (Ullmann & Williams, 2011) and perception of pain (Webb et al., 2013). An exploratory study suggested that the Feldenkrais Method also affects cortical activity (Verrel et al., 2015). ...
Poor cognitive health a major concern of aging individuals, can compromise independent
living. More than 16 million people in the United States are affected by cognitive
impairment. We have studied the effects of the Feldenkrais Method� on cognitive function.
In this case series with three participants cognitive function was assessed with the Trail Making
Test A and B at baseline and after the Feldenkrais intervention. All participants improved performance
on Trail Making Test A and B after completing the Feldenkrais intervention indicating
that Feldenkrais lessons may offset age-related decline in cognitive function. The results of
this case series warrant larger scale studies on cognitive outcomes of Feldenkrais interventions
in clinical and non-clinical populations.
... Gentle mind-body exercises in a noncompetitive environment are an alternative option for older adults. Although we have less knowledge about the effects of mind-body exercises, mind-body exercises show promising results for the improvement of health and well-being of older adults and warrant further investigation (Batson & Barker, 2008;Chang, Nien, Tsai, & Etnier, 2010;Greendale, Huang, Karlamangla, Seeger, & Crawford, 2009;Liu & Frank, 2010;Rogers, Larkey, & Keller, 2009;Ullmann & Williams, 2011;Vrantsidis et al., 2009). ...
Background
Decline in cognitive function associated with aging is one of the greatest concerns of older adults and often leads to a significant burden for individuals, families, and the health care system. Executive functions are most susceptible to age-related decline. Despite the well-known benefits of regular exercise on cognitive health, older adults tend to be less physically active than other age groups. Thus, there is a need to identify strategies that attract older adults and can enhance cognitive vitality.AimsThis article describes the protocol of a study designed to evaluate whether two interventions, a pure physical exercise and a mind–body exercise, can improve cognitive executive function in independent-living older adults. In addition, the study will explore barriers/facilitators related to adherence.Methods
After baseline assessment, participants will be randomly assigned to one of three groups (strength training, Awareness Through Movement®, or a control group). Participants of the two active groups will attend the interventions for 12 weeks. The control group continues with the usual everyday life. Assessments will include three measures of executive function of the NIH Toolbox, and are administered at baseline, post-intervention and at 3-month follow-up. The primary outcomes are the changes in cognitive executive function performances. Secondary outcomes include adherence, self-efficacy for exercise, symptoms of depression, mindfulness and enjoyment. Attendance will be used as a measure of adherence.Discussion and conclusionIf successful, the interventions could provide low-cost strategies for older adults to maintain cognitive vitality and has the potential to impact current exercise guidelines.
We use functional magnetic resonance imaging to investigate short-term neural effects of a brief sensorimotor intervention adapted from the Feldenkrais method, a movement-based learning method. Twenty-one participants (10 men, 19-30 years) took part in the study. Participants were in a supine position in the scanner with extended legs while an experienced Feldenkrais practitioner used a planar board to touch and apply minimal force to different parts of the sole and toes of their left foot under two experimental conditions. In the local condition, the practitioner explored movement within foot and ankle. In the global condition, the practitioner focused on the connection and support from the foot to the rest of the body. Before (baseline) and after each intervention (post-local, post-global), we measured brain activity during intermittent pushing/releasing with the left leg and during resting state. Independent localizer tasks were used to identify regions of interest (ROI). Brain activity during left-foot pushing did not significantly differ between conditions in sensorimotor areas. Resting state activity (regional homogeneity, ReHo) increased from baseline to post-local in medial right motor cortex, and from baseline to post-global in the left supplementary/cingulate motor area. Contrasting post-global to post-local showed higher ReHo in right lateral motor cortex. ROI analyses showed significant increases in ReHo in pushing-related areas from baseline to both post-local and post-global, and this increase tended to be more pronounced post-local. The results of this exploratory study show that a short, non-intrusive sensorimotor intervention can have short-term effects on spontaneous cortical activity in functionally related brain regions. Increased resting state activity in higher-order motor areas supports the hypothesis that the global intervention engages action-related neural processes.
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.
: We report the first controlled study of Tai Chi effects on the P300 event-related potential, a neuroelectric index of human executive function. Tai Chi is a form of exercise and moving meditation. Exercise and meditation have been associated with enhanced executive function. This cross-sectional, controlled study utilized the P300 event-related potential (ERP) to compare executive network neural function between self-selected long-term Tai Chi, meditation, aerobic fitness, and sedentary groups. We hypothesized that because Tai Chi requires moderate aerobic and mental exertion, this group would show similar or better executive neural function compared to meditation and aerobic exercise groups. We predicted all health training groups would outperform sedentary controls.
: Fifty-four volunteers (Tai Chi, n=10; meditation, n=16; aerobic exercise, n=16; sedentary, n=12) were tested with the Rockport 1-mile walk (estimated VO
: Only Tai Chi and meditation plus exercise groups demonstrated larger P3b ERP switch trial amplitudes compared to sedentary controls.
: Our results suggest long-term Tai Chi practice, and meditation plus exercise may benefit the neural substrates of executive function.
This report is an evaluation of a pilot project in shared learning between nursing and medical undergraduate students conducted between January and March 1998. The project demonstrated real benefits in collaborative learning, including insight into roles and perspectives of other health professionals; opportunities for nursing and medical students to work with a wider range of members of primary health care teams whilst on placement; and opportunities for staff to meet and network. However, the pilot has confirmed previous reports as to the complexities of organizing and delivering a shared learning programme across differing curricula. Recommendations are made as to the key elements of creating best practice in coordinating shared learning between medical and nursing students in similar settings.
Objective. To investigate the effects of Feldenkrais Method classes on gait, balance, function, and pain in people with osteoarthritis. Design. Prospective study with pre-/postmeasures. Setting. Community. Participants. Convenience sample of 15 community-dwelling adults with osteoarthritis (mean age 67 years) attending Feldenkrais Method classes. Intervention. Series of Feldenkrais Method classes, two classes/week for 30 weeks.
Western Ontario and McMaster Universities osteoarthritis scale, Human Activity Profile, stair climbing test, 6-minute walk test, timed up-and-go test, Four Square Step Test (4SST), gait analysis, and assessment of quality of life (AQoL). Results. Participants improved on the 4SST and on some gait parameters. They also reported a greater ease of movement. Conclusions. A 30-week series of Feldenkrais classes held twice per week was feasible in the community setting. The lessons led to improvements in performance of the four square step test and changes in gait.
Objectives
To summarize and critically evaluate research on the effects of Tai Chi on cognitive function in older adults. DesignSystematic review with meta-analysis. SettingCommunity and residential care. ParticipantsIndividuals aged 60 and older (with the exception of one study) with and without cognitive impairment. MeasurementsCognitive ability using a variety of neuropsychological testing. ResultsTwenty eligible studies with a total of 2,553 participants were identified that met inclusion criteria for the systematic review; 11 of the 20 eligible studies were randomized controlled trials (RCTs), one was a prospective nonrandomized controlled study, four were prospective noncontrolled observational studies, and four were cross-sectional studies. Overall quality of RCTs was modest, with three of 11 trials categorized as high risk of bias. Meta-analyses of outcomes related to executive function in RCTs of cognitively healthy adults indicated a large effect size when Tai Chi participants were compared with nonintervention controls (Hedges' g = 0.90; P = .04) and a moderate effect size when compared with exercise controls (Hedges' g = 0.51; P = .003). Meta-analyses of outcomes related to global cognitive function in RCTs of cognitively impaired adults, ranging from mild cognitive impairment to dementia, showed smaller but statistically significant effects when Tai Chi was compared with nonintervention controls (Hedges' g = 0.35; P = .004) and other active interventions (Hedges' g = 0.30; P = .002). Findings from nonrandomized studies add further evidence that Tai Chi may positively affect these and other domains of cognitive function. Conclusion
Tai Chi shows potential to enhance cognitive function in older adults, particularly in the realm of executive functioning and in individuals without significant impairment. Larger and methodologically sound trials with longer follow-up periods are needed before more-definitive conclusions can be drawn.
ABSTRACT The 2001 Institute of Medicine report Crossing the Quality Chasm: A New Health System for the 21st Century recommended,that an interdisciplinary summit,be held to develop next steps for I reform of health professions education in order to enhance patient care quality and safety. In June 2002, the 10M convened this summit, which included 150 participants across disciplines and occupations. This follow-up report focuses on integrating a core set of competencies-patient- centered care, interdisciplinary teams, evidence-based practice, quality improvement and i informatics-into health professions education. The report's recommendations include a mix of approaches related to oversight processes, the training environment, research, public reporting, and leadership. The recommendations targeting oversight organizations include integrating core competencies into accreditation, and credentialing I processes across the professions. The goal is an outcome-based education system that better prepares clinicians to meet both the needs of patients and the requirements of a changing health system. Education for the health professions is in need of a major overhaul. Clinical education simply has not kept pace with or been responsive enough to shifting patient demographics and desires, changing health system expectations, evolving practice requirements and staffmg arrangements, new information, a focus on improving quality, or new technologies (Institute of Medicine, 2001): 1 HEALTH PROFESSIONS EDUCATION quality problems and in designing systemwide fixes (Baker et al., 1998; Buerhaus and Norman, 2001). . While clinicians are trained to use an array of cutting-edge technologies related to care delivery, they often are not provided a basic foundation in informatics (Gorman et al., 2000; Hoyenga, 2000). Training in this area