terça-feira, 23 de junho de 2015

Alexander Technique

How it works

Alexander Technique teachers can quickly diagnose movement issues affecting each individual and demonstrate how Alexander skills can address and alleviate the problem. For maximum benefit Alexander Technique is taught over a series of 24 lessons. However a short course of six lessons teaches the basics and introductory group sessions are a great way to find out about the principles of Alexander Technique.
Changing the way we think, our posture and movement, through the process of the Alexander Technique, falls into the scientific domain of neuroscience, brain plasticity and behaviour change. We can improve the way we function, and the quality of our movements by using the Alexander Technique. This has been confirmed through neuroscience research as well as clinical trials.
Alexander Technique works to improve balance, proprioception and co-ordination. It does this by gradually modifying posture and coordination, thereby improving the muscle tone, responsiveness and flexibility of the spine. The Alexander Technique teaches you how to consciously make subtle changes to the central nervous system’s postural responsiveness to changing task requirements.
Early research on the mechanism of the Alexander Technique was published in medical journals between the 1940s and the 1970s.
Tim Cacciatore, Ph.D., Alexander Technique teacher, and neuroscientist is currently a Senior Research Associate at the University College London Institute of Neurology in England. Cacciatore’s research continues to produce evidence verifying the Alexander Technique’s positive influence on the “Central Set”.
Tim says the central set is a centralised preparatory state within the nervous system related to higher level task related intentions and expectations.
Modifying the Central Set helps to shape the automatic postural responses. The Alexander Technique improves postural coordination and tonic muscular activity using conscious high-level processes that modify the central set.
Alexander Technique teachers provide manual guidance and verbal instruction to alter counterproductive sensorimotor behaviour. Alexander Technique teachers are trained to detect and facilitate subtle changes in postural tonicity to improve overall function in human movement and biomechanical behaviour, reducing wear and tear impact on the body.
Patients who have tried the Alexander Technique as a part of clinical trials have found it responsive to their needs as individuals. They have found this affirming. We guarantee a person-centered approach to pain management.

Clinical Safety

No adverse events have been reported during the course of any of the published trials. Alexander Technique is regarded as a low-risk intervention. It is a non-invasive modality and informed consent is implicit in the teaching and learning approach. Research subjects have enjoyed the Alexander Technique experience.

The Trials

Alexander Technique has performed impressively under the scrutiny and rigours of the randomised controlled clinical trial. Key scientific trials strongly support the use of the Alexander Technique in healthcare.
Alexander Technique – producing strong results in randomized controlled trials
The Alexander Technique has produced outstanding results in 3 randomized controlled trials (RCT). An RCT is important because it demonstrates that the effect of the intervention on people has not happened by chance. The results strongly support the proposition that the Alexander Technique reduces chronic back pain and associated depression and quality of life indicators.
Woodman J.P, Moor N.R. Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review. International Journal of Clinical Practice, January 2012, 66,1, 98-112.
Alexander Technique looks promising in Pain Management clinics
In 1999 the Westmorland General Hospital pain management clinic conducted a trial on the impact of The Alexander Technique on chronic mechanical lower back pain. The effectiveness of The Alexander Technique was compared with provision of a support group and with the usual medical care. After 10 weeks Alexander Technique patients produced lower pain scores on standardized testing measures. There was a statistically significant benefit for those patients who had Alexander Technique lessons. It is of great significance that the benefit was sustained for those people 6 months after the intervention.
Vickers et al. The Impact of the Alexander Technique on Chronic Mechanical Lower Back Pain. Westmorland General Hospital, Kendal, UK (unpublished report 1999): 1-19.
Alexander Technique reduces disability and depression associated with Parkinson’s disease
In 2002 promising results were published on a trial examining the impact of Alexander Technique on management of the disability and depression associated with Idiopathic Parkinson’s Disease. This trial compared Alexander Technique, massage and usual medical care. The patients who received the Alexander Technique intervention showed a significant reduction in both disability and depression scores. Quality of life scores improved significantly better for the Alexander Technique group. It is of great interest that these patients also required a lower rate of medication increase. This suggests Alexander Technique played a role in controlling the expression of disabling symptoms. At six months and three years later, the effects were sustained.
Stallibrass C, Sissons P, Chalmers C. Randomized Controlled Trial of the Alexander Technique for Ideopathic Parkinsons’ Disease. Clinical Rehabilitation 2002, 16(7):695-708.
The Alexander Technique for people with chronic back pain
The Alexander Technique Exercise and Massage Trial (ATEAM trial) was published in the British Medical Journal in 2008. It is of clinical significance that in this study the Alexander Technique was shown to outperform spinal manipulation, massage, exercise and general practitioner management in the reduction of disability and pain associated with chronic lower back pain. It is also a very significant study because of the large sample size (579) people from various general practitioner practices across Western England. The Alexander Technique led to an 86% reduction in days in pain per month and a 42% reduction in disability scores. The people who undertook Alexander Technique lessons went from 21 out of 28 days in pain to a mere three out of 28 days in pain.
Little P, et al. (2008). Randomised Controlled Trial of Alexander Technique Lessons, Exercise, and Massage (ATEAM) for Chronic and Recurrent Back Pain. British Medical Journal, 337:a884.
Alexander Technique cutting healthcare costs and medication
Pain costs Australians around $34 billion a year in healthcare costs and loss of workforce participation, in addition to the effect on quality of daily life.
A study called the Service Evaluation of the Alexander Technique (SEAT) 2012 examined the value of including the Alexander Technique in pain clinic services. They did this because of the strong results in the ATEAM trial. The group of patients completing a series of Alexander Technique sessions cost the health service 50% less than those receiving standard care. This included a significant reduction in the use of prescription pharmaceuticals for pain management.
McClean S & Wye, L. Taking Charge, Choosing a New Direction: A Service Evaluation of Alexander Technique Lessons for Pain Clinic Patients (SEAT): an Approach to Pain Management. Project Report (2012) UWE Bristol, Bristol.
How does Alexander Technique perform in comparison to supervised physiotherapy exercises?
There is a new trial underway in the UK (the ASPEN trial). This trial will examine exactly how many Alexander Technique lessons are required to produce a significant and lasting effect for patients in pain. It will compare Alexander Technique with supervised physiotherapy excersises. (International Standard Registered Controlled Trial ISRCT51496752)
Thinking broadly or broader applications
There are many other documented outcomes that have been recorded in non-controlled and non-randomised studies. They suggest that further research should be undertaken on the application of Alexander Technique in Australia in A) the pain management context, B) Occupational Injury Prevention and Rehabilitation, and C) Aged care and falls prevention. There is strong indication that Alexander Technique is a tool fit for responding to these costly areas.

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