Poised for Parkinson's: Retention of benefits 6-7 months after Alexander technique synchronous online group course

Wednesday, November 9, 2022

12:31 PM – 12:36 PM

Location: Station 6

Presenting Author(s)

Monika M. Gross, BFA, mAmSAT, mATI, RSME

Executive Director
The Poise Project
Candler, North Carolina, United States

Non-presenting Author(s)

CC

Celeste L. Condie

Research assistant
University of Idaho
Moscow, Idaho, United States
JG

Jared Grieb, n/a

Undergraduate Assistant
University of Idaho
Moscow, Idaho, United States
Rajal G. Cohen, Ph.D., M.AmSAT

Associate Professor
University of Idaho
Moscow, Idaho, United States

Research Objectives: To test retention of symptom-management success for people living with Parkinson's (PWP) after participation in an online Alexander technique (AT) group course that showed benefits post-course [1]. AT is a cognitive embodiment training combining inhibition, body schema, and goal awareness to enhance daily activity. In-person one-to-one and group AT training has shown benefits retained at 1-12 months [2-9].

Design: Feasibility study. Pre-course, post-course, and 6-7 month follow-up data collection.

Setting: Participants' homes via Zoom.

Participants: Three courses recruited participants from North and South Carolina. Care partners (CP) were included to increase follow-through. 16 PWP (H&Y Stages 1-3)/14 CP began course; 14 PWP/12 CP completed course. Funding allowed only 8 PWP/6 CP for survey/interviews and only 6 PWP for functional assessments follow up.

Interventions: Classes met for 105 minutes via Zoom 2x/week x 9 weeks. Coursework included functional anatomy and self-management strategies taught through verbal instruction, physical demonstration, visual aids, and activities. Embodiment-enhancing approaches were embedded in everyday movement, including gait, sit-to-stand, and functional IADLs. Review handouts and session recordings were provided.

Main Outcome Measures: Functional reach, one-leg stance, TUG, and 7-item Physical Performance Test (PPT), administered via Zoom in-home with care partner assistance. Symptom-management self-report. Anonymous evaluations. Audio interviews.

Results: At 6-7 months, simulated eating, book-lift, jacket, penny-pickup, right-leg balance, TUG, 50-foot walk, and forward reach were better than pre-course. Simulated eating, book-lift, and forward reach maintained post-course improvements. Penny-pickup, right-leg balance, and TUG were better than post-course. Numerically, all scores were closer to post-course than pre-course (PPT: 2.69 pre; 2.85 post; 2.81 follow-up. BriefBEST: 1.92 pre; 2.13 post; 2.08 follow-up), though N is too small for significance. PWP and CP both reported symptom-management improvement from pre-course in shuffling, festination, balance, falls, pain, fine motor, handwriting, mumbling, apathy, depression, and physical control. Both agreed pain management even better at follow-up than post-course. CP reported continued vocal volume improvement.

Conclusions: Alexander technique shows strong potential for long-term symptom-management retention for PWP with increased benefits after 6-7 months in some areas. Large RCTs are justified.

Author(s) Disclosures: None.

Learning Objectives:

To understand the general approach of Alexander technique as a self-management tool to improve symptom management for people living with Parkinson’s disease, and to experience in classroom training interactively.
To learn specific benefits that were retained at six months following an Alexander technique based group intervention for people living with Parkinson's and their care partners.
To learn some objective and subjective measures used to demonstrate improved functioning and perceived symptom management following group training in Alexander technique.