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Body schema acuity training and Feldenkrais? movements compared to core stabilization biofeedback and motor control exercises| Comparative effects on chronic non-specific low back pain in an outpatient clinical setting| A randomized controlled comparative efficacy study

<p> Back problems continue to be a leading cause for disability in all of medicine and are the number one symptom disorder for consulting integrative medicine practitioners. Feldenkrais&reg; practitioners aim to clarify new functional interrelationships towards an improved <i>neuroplasticity-based </i> change in the cognitive construct of one&rsquo;s own background body schema. These phenomena have been found to clinically correlate to chronic pain through concurrent distortions in the reorganization of usual sensory-motor cortical representations in the brain &ndash; being further associated with altered body perception (Wand, et al. 2016). The <i>Feldenkrais Method </i>&reg; (FM) is a comprehensive approach being manifested through manual sensory contact (FI&reg;) techniques and movement experiences (ATM&reg;) and has been anecdotally purported to improve symptoms and functions in Chronic Non-specific Low Back Pain (CNSLBP). However, there is little scientific evidence to support superior treatment efficacy.</p><p> A Randomized Controlled Trial compared a novel <i>Virtual Reality Bones&trade; / Feldenkrais&reg; Movement</i> (VRB<sup>3</sup>/FM) intervention against more conventional protocols for <i>Core Stabilization Biofeedback / Motor Control Exercises</i> (CSB/MCE). The (VRB<sup> 3</sup>)&trade; treatment component consisted of full-scale skeletal models, kinematic avatars, skeletal density imagery, temporal bone-vestibular system relationships, and haptic self-touch techniques being aimed to re-conceptualize participant&rsquo;s prior notions and beliefs regarding body schema and low back pain (LBP). N=30 participating patients with CNSLBP were assigned to either the experimental group (VRB<sup>3</sup>/FM @ N=15) or the control group (CSB/MCE @ N=15). Known confounding biopsychosocial variables were controlled via stratified-random assignment on the FABQ. Treatment Outcome measures included VAS-PAIN, RMDQ, PSFS, and Timed Position Endurances Tests &ndash; including Flexion / Extension Ratios at baseline, 2-weeks, 4-weeks and 8-weeks. Statistical Analysis was conducted using Wilcoxon Rank Sum and paired, two-tailed t-test. Results showed that the VRB<sup>3</sup>/FM group demonstrated greater improvement in all treatment outcome measures as compared to the matched CSB/MCE control group.</p><p> This is the first RCT study to demonstrate that a <i>Feldenkrais Method</i>&reg; based approach being combined with <i>Virtual Reality Bones</i>&trade; can be more efficacious for the treatment of CNSLBP than the current and accepted physical medicine standard of isolated Core Stabilization Biofeedback / Training and Motor Control Exercises. Future multi-site RCT studies with larger sample sizes are therefore recommended.</p>

Identiferoai:union.ndltd.org:PROQUEST/oai:pqdtoai.proquest.com:10251703
Date18 March 2017
CreatorsSobie, Timothy J.
PublisherSaybrook University
Source SetsProQuest.com
LanguageEnglish
Detected LanguageEnglish
Typethesis

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