Comparison of the effects of the Feldenkrais method versus core stability exercise in the management of chronic low back pain: a randomised control trial

Abstract

Objective:

To investigate the effect of the Feldenkrais method versus core stability exercises on pain, disability, quality of life and interoceptive awareness in patients with chronic non-specific low back pain.

Design:

A single-blinded, randomised, controlled trial.

Setting:

Outpatient, sports medicine clinic of Mazandaran medical university.

Participants:

Sixty patients with chronic non-specific low back pain randomised equally into the Feldenkrais method versus core stability exercises groups.

Intervention:

Intervention group received Feldenkrais method consisting of training theoretical content and supervised exercise therapy two sessions per week for five weeks. Control group received educational programme and home-based core stability exercises for five weeks.

Outcome measures:

All patients were examined by World Health Organization’s Quality of life Questionnaire, McGill Pain Questionnaire, Oswestry Disability Questionnaire and Multidimensional Assessment of Interoceptive Awareness Questionnaire. All outcomes were measured at baseline and the end of the intervention

Results:

There were statistically significant differences between groups for quality of life (P = 0.006, from 45.51 to 60.49), interoceptive awareness (P > 0.001, from 2.74 to 4.06) and disability (P = 0.021, from 27.17 to 14.5) in favour of the Feldenkrais method. McGill pain score significantly decreased in both the Feldenkrais (from 15.33 to 3.63) and control groups (from 13.17 to 4.17), but there were no between-groups differences (P = 0.16).

Conclusion:

Feldenkrais method intervention gave increased benefits in improving quality of life, improving interoceptive awareness and reducing disability index.

Keywords

Feldenkrais method low back pain core stability exercises quality of life interoceptive awareness

Get full access to this article

View all access options for this article.

References

Cedraschi

Nordin

Haldeman

, et al. The Global Spine Care initiative: a narrative review of psychological and social issues in back pain in low-and middle-income communities. Eur Spine J 2018; 27(6): 828–837.

Foster

Anema

Cherkin

, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet 2018; 391(10137): 2368–1383.

Stochkendahl

Kjaer

Hartvigsen

, et al. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J 2018; 27(1): 60–75.

Qaseem

Wilt

McLean

, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2017; 166(7): 514–530.

Shipton

. Physical therapy approaches in the treatment of low back pain. Pain Ther 2018; 7(2): 127–137.

Lundblad

Elert

Gerdle

. Randomized controlled trial of physiotherapy and Feldenkrais interventions in female workers with neck-shoulder complaints. J Occup Rehabil 1999; 9(3): 179–194.

Smith

Kolt

McConville

. The effect of the Feldenkrais method on pain and anxiety in people experiencing chronic low back pain. NZ J Physiother 2001; 29: 6–14.

Vrantsidis

Hill

Moore

, et al. Getting Grounded Gracefully©: effectiveness and acceptability of Feldenkrais in improving balance. J Aging Phys Act 2009; 17(1): 57–76.

Ullmann

Williams

Hussey

, et al. Effects of Feldenkrais exercises on balance, mobility, balance confidence, and gait performance in community-dwelling adults age 65 and older. J Altern Complement Med. 2010; 16(1): 97–105.

10.

Connors

Galea

Said

. Feldenkrais method balance classes improve balance in older adults: a controlled trial. Evid Based Complement Alternat Med 2009; 2011: 37.

11.

Pugh

Williams

. Feldenkrais method empowers adults with chronic back pain. Holist Nurs Pract 2014; 28(3): 171–183.

12.

Paolucci

Zangrando

Iosa

, et al. Improved interoceptive awareness in chronic low back pain: a comparison of Back school versus Feldenkrais method. Disabil Rehabil 2017; 39(10): 994–1001.

13.

Mohan

Paungmali

Sitilertpisan

, et al. Feldenkrais method on neck and low back pain to the type of exercises and outcome measurement tools: a systematic review. Polish Annals of Medicine 2017; 24(1): 77–83.

14.

Plastaras

Schran

Kim

, et al. Manipulative therapy (Feldenkrais, massage, chiropractic manipulation) for neck pain. Curr Rheumatol Rep 2013; 15(7): 339.

15.

Mattes

. Attentional focus in motor learning, the Feldenkrais method, and mindful movement. Percept Mot Skills 2016; 123(1): 258–276.

16.

Noormohammadpour

Mansournia

Asadi-Lari

, et al. A subtle threat to urban populations in developing countries: low back pain and its related risk factors. Spine 2016; 41(7): 618–627.

17.

Haefeli

Elfering

. Pain assessment. Eur Spine J 2006; 15(1): S17–S24.

18.

Nejat

Montazeri

Holakouie Naieni

, et al. The World Health Organization quality of Life (WHOQOL-BREF) questionnaire: translation and validation study of the Iranian version. J Sch Publ Health Inst Publ Health Res 2006; 4(4): 1–12.

19.

Khosravi

Sedighi

Moradi Aalamdari

, et al. Translation, validation, and reliability of McGill Pain questionnaire in patients with cancer. Tehran Univ Med J 2013; 71(1): 53–58.

20.

Haas

Nyiendo

. Diagnostic utility of the McGill Pain Questionnaire and the Oswestry Disability Questionnaire for classification of low back pain syndromes. J Manipulative Physiol Ther 1992; 15(2): 90–98.

21.

Baradaran

Ebrahimzadeh

Birjandinejad

, et al. Cross-cultural adaptation, validation, and reliability testing of the modified oswestry disability questionnaire in Persian population with low back pain. Asian Spine J 2016; 10(2): 215–219.

22.

Mousavi

Parnianpour

Mehdian

, et al. The Oswestry disability index, the Roland-Morris disability questionnaire, and the Quebec back pain disability scale: translation and validation studies of the Iranian versions. Spine 2006; 31(14): E454–E459.

23.

Mehling

Price

Daubenmier

, et al. The multidimensional assessment of interoceptive awareness (MAIA). PloS One 2012; 7(11): e48230.

24.

Abbasi

Ghorbani

Hatami

, et al. Validity and reliability of multidimensiontal assessment of interoceptive awareness (MAIA) in Iranian students. Journal of Sabzevar University of Medical 2018; 25(1 #M00315).

25.

Moghadam

Ghaffari

Noormohammadpour

, et al. Comparison of the recruitment of transverse abdominis through drawing-in and bracing in different core stability training positions. J Exerc Rehabil 2019; 15(6): 819.

26.

Mehling

Daubenmier

Price

, et al. Self-reported interoceptive awareness in primary care patients with past or current low back pain. J Pain Res 2013; 6: 403.

27.

Öhman

Åström

Malmgren-Olsson

E-B

. Feldenkrais^® therapy as group treatment for chronic pain–a qualitative evaluation. J Bodyw Mov Ther 2011; 15(2): 153–161.

28.

Plastaras

Schran

Kim

, et al. Complementary and alternative treatment for neck pain: chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais. Phys Med Rehabil Clin 2011; 22(3): 521–537.

29.

Brown

Kegerreis

. Electromyographic activity of trunk musculature during a Feldenkrais awareness through movement lesson. Isokinet Exerc Sci 1991; 1(4): 216–221.

30.

Kiesel

Uhl

Underwood

, et al. Rehabilitative ultrasound measurement of select trunk muscle activation during induced pain. Man Ther 2008; 13(2): 132–138.

31.

Oliveira

Maher

Pinto

, et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J 2018; 27(11): 2791–2803.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

3.33 MB