Clinical Rehabilitation 2002; 16: 705-718
Stallibrass C, Sissons P, Chalmers C
School of Integrated Medicine, University of Westminster, London, UK
This study demonstrated that Alexander Technique lessons led to an increased ability of people with Parkinson’s disease to carry out everyday activities.
Ninety-three people with Parkinson’s disease were randomly allocated to one of three groups: 24 one-to-one Alexander Technique lessons given by STAT-trained and registered teachers; 24 massage sessions given by trained therapeutic massage practitioners; or, no additional intervention. The massage arm was included because, in addition to any massage-specific benefits, it would provide an equivalent amount of touch and individual attention to the Alexander lessons and so would control for any non-specific effects of the lessons. All the participants continued to receive usual medical care, including their usual medication for Parkinson’s disease. The main aim of the study was to determine whether Alexander lessons would reduce motor and postural disability in individuals with Parkinson's.
The study showed that Alexander lessons led to a significantly increased ability to carry out everyday activities compared with usual medical care (there was no significant change in the massage group). This benefit remained when the participants were followed up 6 months later. An additional finding, which deserves further study, was a significantly lower rate of change of Parkinson’s disease medication in the Alexander group than for either of the other groups (medication dose generally increases with time in this progressive disease). Participants also reported subjective improvements in balance, posture and walking, as well as increased coping ability and reduced stress.
As a result of these findings, the UK National Institute for Health and Clinical Excellence (NICE) recommends that Alexander Technique lessons may be offered to benefit people with Parkinson’s by ‘helping them to make lifestyle adjustments that affect both the physical nature of the condition and the person’s attitudes to having Parkinson’s disease’.
To determine whether the Alexander Technique, alongside normal treatment, is of benefit to people suffering disability from idiopathic Parkinson's disease. Design: A randomized controlled trial with three groups, one receiving lessons in the Alexander Technique, another receiving massage and one with no additional treatment. Measures were taken pre- and post-intervention, and at follow-up, six months later.
The Polyclinic at the University of Westminster, Central London.
Ninety-three subjects with clinically confirmed idiopathic Parkinson's disease.
The Alexander Technique group received 24 lessons in the Alexander Technique and the massage group received 24 sessions of massage. Main outcome measures: The main outcome measures were the Self-assessment Parkinson's Disease Disability Scale (SPDDS) at best and at worst times of day. Secondary measures included the Beck Depression Inventory and an Attitudes to Self Scale.
The Alexander Technique group improved compared with the no additional treatment group, pre-intervention to post-intervention, both on the SPDDS at best, p = 0.04 (confidence interval (CI) -6.4 to 0.0) and on the SPDDS at worst, p = 0.01 (CI -11.5 to -1.8). The comparative improvement was maintained at six-month follow-up: on the SPDDS at best, p = 0.04 (CI -7.7 to 0.0) and on the SPDDS at worst, p = 0.01 (CI -11.8 to -0.9). The Alexander Technique group were comparatively less depressed post-intervention, p = 0.03 (CI -3.8 to 0.0) on the Beck Depression Inventory, and at six-month follow-up had improved on the Attitudes to Self Scale, p = 0.04 (CI -13.9 to 0.0).
There is evidence that lessons in the Alexander Technique are likely to lead to sustained benefit for people with Parkinson's disease.
The final, definitive version of this paper has been published in Clinical Rehabilitation 2002; 16: 705-718 by SAGE Publications Ltd, All rights reserved. © Arnold 2002
Contact for correspondence: Chloe Stallibrass, Flat 18, Manor Mansions, Belsize Grove, London NW3 4NB, UK. Email: [email protected]