The Effectiveness of the Feldenkrais Method: A Systematic Review of the Evidence

Summary & key facts

This systematic review looked at 20 randomized trials of the Feldenkrais Method (FM). Pooled results from 7 trials showed small but measurable balance improvements in older adults (for example, timed up and go was 1.14 seconds faster and functional reach improved by 6.08 cm). The studies and outcomes were very mixed and many trials had a high risk of bias, so the results are promising but not certain. The authors say FM appears to work as a general learning-based approach to movement and that more rigorous research is needed.

Key facts:

• The review included 20 randomized controlled trials (an additional 14 compared with an earlier review).
• Meta-analysis used 7 studies and found improved balance in older adults: timed up and go mean difference −1.14 seconds (95% CI −1.78 to −0.49).
• Meta-analysis also found improved functional reach: mean difference 6.08 cm (95% CI 3.41 to 8.74).
• The review found the included studies were highly heterogeneous — they covered different populations, outcomes, and methods.
• The reviewers judged the risk of bias in many trials to be high, which reduces confidence in the results.
• Single, individual trials reported positive effects for reduced perceived effort, increased comfort, improved body image perception, and better hand dexterity.
• The Feldenkrais Method is delivered as either individual manual lessons (functional integration) or group verbally guided classes (awareness through movement), and both forms were included in the review.
• The authors searched multiple databases (AMED, Embase, MEDLINE, Cochrane, PsycINFO, PubMed, Google Scholar) up to July 2014 and considered all languages and unpublished reports when possible.

Abstract

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.

Topics

Balance, Gait, and Falls Prevention Foot and Ankle Surgery Musculoskeletal pain and rehabilitation

Categories

Health Professions Health Sciences Physical Therapy, Sports Therapy and Rehabilitation

Tags

Alternative medicine Applied psychology Biology Environmental health Evidence-based practice Law Medicine MEDLINE Paleontology Pathology Physical medicine and rehabilitation Physical therapy Political science Population Protocol (science) Psychology Randomized controlled trial Surgery Systematic review Test (biology)