Feldenkrais awareness though movement intervention for fibromyalgia syndrome: A proof-of-concept study.

INTRODUCTION: The Feldenkrais Method® is a form of awareness through movement (ATM) aimed at improving spatial and kinesthetic awareness through verbally guided movements, in order to learn more effective actions. METHOD: The present study, a proof-of-concept, observational, non-controlled prospective study, aims at exploring the effectiveness of ATM for fibromyalgia syndrome (FM), measuring the effect by means of multi-dimensional questionnaires, administered at baseline and after 4 months of ATM activity. RESULTS: One hundred twenty-eight FM patients (mean age 54 years old, 2% males) participated in the study. A statistically significant improvement was found in FM-specific measures (Polysymptomatic Distress Scale, PDS) (p = 0.003) and the Pain Catastrophization Scale (PCS) (p = 0.020); coherently, the Revised Fibromyalgia Impact Questionnaire (FIQR) showed a trend in improvement after the intervention, although this improvement was not statistically significant. The logistic regression analysis found a correlation between PDS, fatigue and anxiety measures; PCS, years from diagnosis and anxiety. CONCLUSION: ATM could improve FM-specific measures and pain-related catastrophizing. Further studies are needed to identify FM subgroups in order to find personalized targets that can be used to guide treatments.

Movement disorders: is the Feldenkrais method effective? IQWiG Reports - Commission

The Feldenkrais method is presumably preferred by social groups who generally strive to use non-drug and non-surgical interventions for preventing and treating diseases. Since chronic pain is more common in advanced age, older people are likely to be more interested in this method. This health technology assessment (HTA) report investigates the use of the Feldenkrais method as a therapeutic intervention, i.e. only in people with movement disorders, rather than for preventive purposes or in persons with mobility impairments which are not defined in more detail. Demand is nurtured, in part, by the Feldenkrais method being expected to favourably affect private and social life due to greater self-perceived physical mobility. Since the Feldenkrais method's trademark protection is viewed positively, these groups may harbour erroneous assumptions with regard to the benefits to be expected. From an ethical perspective, this tends to be viewed critically because users who do not reap any benefit may have incurred costs to be paid out of pocket (the relevance of this aspect differs between social groups) and not utilized effective therapies. A total of 6 randomized controlled trials (RCTs), all with a high risk of bias, were identified for 5 therapeutic indications, and hints of (greater) benefit were determined for 2 therapeutic indications. For patients with Parkinson's disease, there is a hint of greater benefit of the Feldenkrais method in comparison with the passive strategy of an educational programme in the form of lectures. This benefit consists of improved mobility and health-related quality of life at the end of treatment. In the comparison with active strategies, the available evidence for patients with chronic low back pain is inconsistent. Compared with an educational programme involving trunk stabilization exercises, there is a hint of greater benefit of the Feldenkrais method with regard to improved mobility and health-related quality of life at the end of the 5-week treatment period. In comparison with back school, there is a hint of greater benefit of the Feldenkrais method with regard to pain reduction, but also a hint of lesser benefit of this method with regard to health-related quality of life after 3 months. However, no differences in effects were found directly at the end of therapy. There is no hint of either long-term benefit of the Feldenkrais method or for its benefit in other therapeutic indications. It was also impossible to derive any hint of harm from the Feldenkrais method, with the studies failing to provide data on deaths and adverse events. The question about the benefit of the Feldenkrais method in comparison with active strategies such as extensive physiotherapy generally remains open. The determined evidence is based on group interventions in the "Awareness Through Movement" (ATM) format rather than one-on-one interventions in the "Functional Integration" format (only 4 sessions investigated in 1 study). The intervention costs equal €10 to €20 per person and group session or €60 to €90 per one-on-one session. These costs are typically to be paid out of pocket by patients, a fact which is of differing relevance for different social groups. No studies on health economic aspects are available. If greater benefit were to be confirmed for certain therapeutic indications, some problematic issues might arise from an ethical or organizational perspective, particularly in view of limited access to the method. Since liability issues are conceivable in case of demonstrable physical injuries, the use of the Feldenkrais method as a therapeutic intervention would require corresponding basic medical qualifications of Feldenkrais teachers, possibly with state accreditation. From a social and organizational perspective, use of the Feldenkrais method requires some patient collaboration (to ensure continuity of the intervention) and potentially leads to lower utilization of medically trained healthcare providers. If the costs of the Feldenkrais method were to be covered by statutory health insurance for therapeutic indications with established benefit, the service would need to be offered nationwide by appropriately trained personnel. Additional resources would likely be needed. Overall, little evidence is available. From an ethical perspective, the absence of evidence from RCTs is problematic for informed decision making but does not constitute evidence of an absent benefit. Only 2 small, ongoing RCTs of questionable relevance were identified, and therefore, the availability of evidence is not expected to change in the short term. Due to the limited availability of data, further research is needed, particularly regarding long-term effects of the Feldenkrais method, its application in various therapeutic indications, and in comparison with further active comparator therapies typically used in practice, e.g. physiotherapy.

Feldenkrais Method

An educational system designed to use movement and perception to foster individualized improvement in function.

Un sistema educativo diseñado para utilizar el movimiento y la percepción para fomentar la mejora individualizada en la función.

Abordagem pedagógica que usa o movimento corporal e a percepção de si para promover a melhoria individualizada da função e coordenação motoras.

Effects of the Feldenkrais Method as a Physiotherapy Tool: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The Feldenkrais Method (FM) is based on the learning of alternative movement patterns, carried out in an active and conscious way, which may have therapeutic effects. The objective of this systematic review is to identify the populations and conditions for which the FM can be used in physiotherapy and to determine the intervention modalities. Research in PubMed, Cochrane and PEDro databases was performed. The PEDro scale was employed to assess the methodological quality. Meta-analyses (MA) were performed whenever populations and outcome measures were comparable in at least two studies. Sixteen studies were included. In elderly people, in three of the four selected trials, the FM group significantly improved gait, balance, mobility and quality of life. The MA showed significant differences between interventions in the Timed-Up-and-Go test [Cohen's d = -1.14, 95% CI (-1.78, -0.49), p = 0.0006]. FM significantly improved pain, functional balance, and perceived exertion in three trials performed on subjects with cervical, dorsal, or shoulder pain. FM demonstrated improvements in pain, disability, quality of life and interoceptive awareness in the three trials performed in subjects with chronic low back pain. In multiple sclerosis, an improvement in functional capacity was observed in the two selected studies. The MA showed no significant differences between groups in the Function (p = 0.97) and Control (p = 0.82) dimensions of the Multiple Sclerosis Self-Efficacy Scale. In Parkinson's disease, two studies showed significant effects on quality of life and functional tests. In conclusion, evidence shows that FM has therapeutic effects comparable to other physiotherapy techniques in patients with spine pain. In addition, improvements in mobility and balance were seen in the elderly and people with neurodegenerative diseases.

Prevalence, specific and non-specific determinants of complementary medicine use in Switzerland: Data from the 2017 Swiss Health Survey.

OBJECTIVES: To determine the prevalence of use of complementary medicine (CM) in Switzerland in 2017, its development since the 2012 Swiss Health Survey, and to examine specific and non-specific sociodemographic, lifestyle and health-related determinants of CM use as compared to determinants of conventional health care use. MATERIALS AND METHODS: We used data of 18,832 participants from the cross-sectional Swiss Health Survey conducted by the Swiss Federal Statistical Office in 2017 and compared these data with those from 2012. We defined four CM categories: (1) traditional Chinese medicine, including acupuncture; (2) homeopathy; (3) herbal medicine; (4) other CM therapies (shiatsu, reflexology, osteopathy, Ayurveda, naturopathy, kinesiology, Feldenkrais, autogenic training, neural therapy, bioresonance therapy, anthroposophic medicine). Independent determinants of CM use and of conventional health care use were assessed using multivariate weighted logistic regression models. RESULTS: Prevalence of CM use significantly increased between 2012 and 2017 from 24.7% (95% CI: 23.9-25.4%) to 28.9% (95% CI: 28.1-29.7%), respectively, p<0.001). We identified the following independent specific determinants of CM use: gender, nationality, age, lifestyle and BMI. Female gender and nationality were the most specific determinants of CM use. Current smoking, being overweight and obesity were determinants of non-use of CM, while regular consumption of fruits and/or vegetables and regular physical activity were determinants of CM use. CONCLUSION: Prevalence of CM use significantly increased in Switzerland from 2012 to 2017. Gender, nationality, age, lifestyle and BMI were independent specific determinants of CM use as compared to conventional health care use. Healthier lifestyle was associated with CM use, which may have potentially significant implications for public health and preventive medicine initiatives. The nationality of CM users underlines the role of culture in driving the choice to use CM but also raises the question of whether all populations have equal access to CM within a same country.

Complexity Regulation Competencies: A Naturalistic Framework.

This article presents a framework to describe how professional experts regulate complex adaptive systems (CAS), a skill found across bio-psychological, ecological, technical, and social contexts. The regulation aim is to facilitate and constrain the self-organization of a CAS; regulators engage in dynamic decision making while the system evolves. While many naive regulators are overtaxed when they encounter nonlinear and multi-causal dynamics, less is known about how experts perform. I argue that a rich set of competencies can make expert performance distinctive. The basic sensitivities for CAS that shape the general philosophy of practice and a role identity as process facilitators provide some foundation. Turning this into an applied skill set, however, additionally requires (a) the creation of mediating interfaces with a 'target' CAS, (b) interaction skills for exploring and stimulating the CAS, (c) the use of domain knowledge about the system's nature and structure for conceptualizing its state as well as dynamics, (d) the use of analogical reasoning, categories, heuristics, and models to make 'if-then' inferences from systemic problem constellations to holistic strategies, and (e) synoptic and meta-regulative capabilities that allow supervising the mix of deployed resources relative to the demands of ongoing task. These CAS regulation tools mesh in variable ways and can mutually amplify each other, i.e. synergize. Illustrations for the framework come from two somatic therapies (aka bodywork), the Shiatsu and Feldenkrais methods, in which therapists use manual techniques as a regulatory means to help their clients.

Complementary and integrative health interventions in post-stroke rehabilitation: a systematic PRISMA review.

AIM: Researchers have reported measurable improvements in emotional and physical health among adults post-stroke after participating in complementary and integrative health techniques. The aim of this manuscript was to systematically review the effectiveness of active complementary and integrative health interventions as a treatment modality for adults post-stroke. METHOD: For this review, active interventions were defined as those that required participants to be in control of initiating their own body movement. Five active complementary and integrative health techniques were reviewed and included: Feldenkrais Method, qigong, Pilates, Tai Chi, and yoga. A key word search was conducted in Medline, Cochrane Library, EBSCO, Google Scholar, and PubMed. Inclusion criteria for studies were (1) randomized controlled trials on the effects of active complementary and integrative health interventions, (2) all participants had to be post-stroke, and (3) studies appeared in English in a peer-reviewed journal. RESULTS: Articles in this review included one Qigong, five Pilates, nine Tai Chi, and five yoga studies. All 20 manuscripts reported improvements for participants. Participants in Pilates experienced improvements in quality of life. Improvements in functional balance, standing and dynamic balance, reaction time, maximum excursion, and quality of life were reported in the Pilates studies. Participants in the TC studies experienced a range of positive results including center of gravity, increased reaction time, improved aerobic endurance, fewer falls, sway length and velocity, functional reach, dynamic gait, walking speed, and static and dynamic balance. Improvements after participation in the yoga manuscripts consisted of reduced depression, decreased state and trait anxiety, improved balance, reduction in fear of falling, and enhanced quality of life. CONCLUSION: Based on the small number of randomized controlled trials, this systematic review reported the effectiveness of four active mind-body interventions for individuals post-stroke. The strongest evidence was for the use of Tai Chi, followed by Pilates and yoga.Implications for rehabilitationClinicians should consider the benefits of qigong, Pilates, Tai Chi, and yoga to best meet individual patient needs and goals.Clinicians who offer qigong, Pilates, Tai Chi, and/or yoga should be qualified to instruct the specific active complementary and integrative health technique or refer patients to those who are qualified.Locate qigong, Pilates, Tai Chi, and yoga classes that are appropriate for people post-stroke in the community to help integrate patients into a program after treatment.

Dance Intervention Using the Feldenkrais Method Improves Motor, and Non-Motor Symptoms and Gait in Parkinson's Disease: A 12-Month Study.

OBJECTIVE: The aim of this study was to assess the effects of dancing (using the Feldenkrais method) on motor and non-motor symptoms, quality of life (QoL), and objective parameters of gait at the time of intervention and at the end of the 1-year study period. METHODS: This was a single-arm study in which 12 subjects with Parkinson's disease (PD) received dance intervention during a 6-month period. Objective motor scales, gait analysis, and questionnaires on non-motor symptoms were evaluated at baseline and at 3, 6, and 12 months. RESULTS: Dance intervention decreased motor scale (Unified Parkinson's Disease Rating Scale and Tinetti scale) scores and improved gait disturbance (gait velocity and step length) without increasing levodopa equivalent dose. Furthermore, dancing decreased non-motor scale (Non-Motor Symptoms Scale and Montgomery-Asberg Depression Rating Scale) scores and improved QoL. CONCLUSION: Our findings suggest that dance intervention can be a complementary management method for PD patients.

Dance Intervention Using the Feldenkrais Method Improves Motor, and Non-Motor Symptoms and Gait in Parkinson’s Disease: A 12-Month Study

Objective@#The aim of this study was to assess the effects of dancing (using the Feldenkrais method) on motor and non-motor symptoms, quality of life (QoL), and objective parameters of gait at the time of intervention and at the end of the 1-year study period. @*Methods@#This was a single-arm study in which 12 subjects with Parkinson’s disease (PD) received dance intervention during a 6-month period. Objective motor scales, gait analysis, and questionnaires on non-motor symptoms were evaluated at baseline and at 3, 6, and 12 months. @*Results@#Dance intervention decreased motor scale (Unified Parkinson’s Disease Rating Scale and Tinetti scale) scores and improved gait disturbance (gait velocity and step length) without increasing levodopa equivalent dose. Furthermore, dancing decreased non-motor scale (Non-Motor Symptoms Scale and Montgomery-Asberg Depression Rating Scale) scores and improved QoL. @*Conclusion@#Our findings suggest that dance intervention can be a complementary management method for PD patients.

The Empowering Effect of Embodied Awareness Practice on Body Structural Map and Sensorimotor Activity: The Case of Feldenkrais Method.

While outcomes of embodied awareness practices in terms of improved posture and flexibility, movement efficiency, and well-being are often reported, systematic investigations of such training effects and of the actual nature, extent, and neurofunctional correlates of learning mechanisms thought to lie at the core of such practices are very limited. The present study focused on the Feldenkrais method (FM), one of the most established embodied awareness practices, and aimed at investigating the neurofunctional outcomes of the somatic learning process at the core of the method by testing the modulations induced by a standardized FM protocol on the complexity of practicers' body structural map and on the activity of their sensorimotor network during different movement-related tasks (i.e., gestures observation, execution, and imagery). Twenty-five participants were randomly divided into an experimental group-which completed a 28-session FM protocol based on guided group practice-and a control group, and underwent pre-/post-training psychometric and electrophysiological assessment. Data analysis highlighted, at the end of the FM protocol, a significant increase of EEG markers of cortical activation (task-related mu desynchronization) in precentral regions during action observation and in central regions during action execution and imagery. Also, posterior regions of the sensorimotor network showed systematic activation during all the action-related tasks.

Study protocol of a randomized intervention study to explore effects of a pure physical training and a mind-body exercise on cognitive executive function in independent living adults age 65-85.

BACKGROUND: Decline in cognitive function associated with aging is one of the greatest concerns of older adults and often leads to a significant burden for individuals, families, and the health care system. Executive functions are most susceptible to age-related decline. Despite the well-known benefits of regular exercise on cognitive health, older adults tend to be less physically active than other age groups. Thus, there is a need to identify strategies that attract older adults and can enhance cognitive vitality. AIMS: This article describes the protocol of a study designed to evaluate whether two interventions, a pure physical exercise and a mind-body exercise, can improve cognitive executive function in independent-living older adults. In addition, the study will explore barriers/facilitators related to adherence. METHODS: After baseline assessment, participants will be randomly assigned to one of three groups (strength training, Awareness Through Movement®, or a control group). Participants of the two active groups will attend the interventions for 12 weeks. The control group continues with the usual everyday life. Assessments will include three measures of executive function of the NIH Toolbox, and are administered at baseline, post-intervention and at 3-month follow-up. The primary outcomes are the changes in cognitive executive function performances. Secondary outcomes include adherence, self-efficacy for exercise, symptoms of depression, mindfulness and enjoyment. Attendance will be used as a measure of adherence. DISCUSSION AND CONCLUSION: If successful, the interventions could provide low-cost strategies for older adults to maintain cognitive vitality and has the potential to impact current exercise guidelines.

Movement-Based Therapies in Rehabilitation.

Movement therapy refers to a broad range of Eastern and Western mindful movement-based practices used to treat the mind, body, and spirit concurrently. Forms of movement practice are universal across human culture and exist in ancient history. Research demonstrates forms of movement therapy, such as dance, existed in the common ancestor shared by humans and chimpanzees, approximately 6 million years ago. Movement-based therapies innately promote health and wellness by encouraging proactive participation in one's own health, creating community support and accountability, and so building a foundation for successful, permanent, positive change.

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

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.

Workplace-Based Rehabilitation of Upper Limb Conditions: A Systematic Review.

Purpose The objective of this systematic review was to identify, collate and analyse the current available evidence on the effectiveness of workplace-based rehabilitative interventions in workers with upper limb conditions on work performance, pain, absenteeism, productivity and other outcomes. Methods We searched Medline, Cochrane Library, Scopus, Web of Science, Academic Search Premier, Africa-Wide Information, CINAHL, OTSeeker and PEDro with search terms in four broad areas: upper limb, intervention, workplace and clinical trial (no date limits). Studies including neck pain only or musculoskeletal pain in other areas were not included. Results Initial search located 1071 articles, of which 80 were full text reviewed. Twenty-eight articles were included, reporting on various outcomes relating to a total of seventeen studies. Nine studies were of high methodological quality, seven of medium quality, and one of low quality. Studies were sorted into intervention categories: Ergonomic controls (n = 3), ergonomic training and workstation adjustments (n = 4), exercise and resistance training (n = 6), clinic-based versus workplace-based work hardening (n = 1), nurse case manager training (n = 1), physiotherapy versus Feldenkrais (n = 1), and ambulant myofeedback training (n = 1). The largest body of evidence supported workplace exercise programs, with positive effects for ergonomic training and workstation adjustments, and mixed effects for ergonomic controls. Ambulant myofeedback training had no effect. The remaining three categories had positive effects in the single study on each intervention. Conclusion While there is substantial evidence for workplace exercise programs, other workplace-based interventions require further high quality research. Systematic review registration PROSPERO CRD42017059708.

Chronic low back pain and postural rehabilitation exercise: a literature review.

Chronic low back represents one of the major causes of disability worldwide. Our narrative review has the purpose of highlighting the evidence supporting the different rehabilitative techniques described for its management. In total, 26 studies were found suitable to be included in the review (14 articles about pilates, six about McKenzie (MK), one article about Feldenkrais, three about Global Postural Rehabilitation (GPR) and two about Proprioceptive Neuromuscular Facilitation). The effect of exercise therapy was examined for each single study through changes in the main clinical outcomes (pain, disability,) quality of life (QoL) and psychological aspects and the targeted aspects of physical function (muscle strength, mobility, muscular activity and flexibility). All the techniques are effective for the study groups with respect to the control groups in reducing pain and disability and improving the QoL and maintaining benefits at follow-up; pilates, Back School, MK and Feldenkrais methods reduce pain and are more efficient than a pharmacological or instrumental approach in reducing disability and improving all psychological aspects also. GPR shows long lasting results for the last outcome. To date, it is difficult to affirm the superiority of one approach over another. Further high quality research is needed to confirm the effect of these techniques, together with the use of more appropriate evaluation measures.

Feldenkrais 'Functional Integration' Increases Body Contact Surface in the Supine Position: A Randomized-Controlled Experimental Study.

Feldenkrais 'Functional Integration' (FI) is a widely used type of body work with a focus on the continuous integration of body sensations and awareness with movement. The method is, amongst others, known for improving balance in aging populations, but also for its ability to relax muscles. With participants treated in the supine position FI is potentially changing the surface area of the body in contact with the surface on which a participant is lying. So far, no prior study has assessed this claim. We evaluated objectively and subjectively if a treatment with FI would induce changes in pressure and contact surface of the body on the mat. Thirty volunteers received an individual treatment with FI, in a randomized order on both sides of the body. Pressure and contact surface was documented with the Xsensor-Measurement-System. Subjective sensations were assessed with a self-report scale. Due to two parallel assessments alpha-level was adjusted to α = 0.025. We found that pressure and contact surface of the body on the mat significantly changed after the treatment (factor time: p < 0.0001, η p 2 = 0.90). We also found that pressure and contact surface increased significantly on the left side for the group that started with the left side first (time × group p = 0.016; η p 2 = 0.62), but less so on the right side for the group that started with the right side first (time × group: p = 0.056) although there was still a substantial effect size ( η p 2 = 0.54). The subjective reports confirmed the physical measurements. In conclusion our results demonstrate for the first time that the treatment with the Feldenkrais method changes muscle tone leading to a more relaxed supine position with respect to pressure and contact surface on the mat.

The Feldenkrais Method improves functioning and body balance in people with intellectual disability in supported employment: A randomized clinical trial.

Loss of functioning and age-related health problems tend to appear earlier in individuals with intellectual disability (ID) than in their non-disabled peers. The Feldenkrais method (FM) is a movement-based form of learning that enhances body balance and physical functioning. We carried out an intervention based on Awareness Through Movement, a form of the FM. Thirty-two middle-aged (48.94±6.01years old) adults with ID who were in supported employment were recruited and randomly assigned to the experimental group (EG) or control group (CG). The EG received 30 Awareness Through Movement classes while the CG did not receive any movement-based intervention. Physical functioning (body balance, gait speed and chair stands) was assessed with the Short Physical Performance Battery (SPPB) and balance by stabilometry. After 30 FM classes, individuals in the EG had significantly improved their chair stand test score (p<0.005) and SPPB total score (p<0.005), and reduced their sway area (p<0.05) in the stabilometric test. These results indicate that the FM could be a good tool for the prevention of loss of functioning and body balance in middle-aged individuals with ID.

Feldenkrais Movement Lessons Improve Older Adults' Awareness, Comfort, and Function.

This prospective controlled intervention study assessed Feldenkrais Moving Forward movement lessons for older adults. Participants (N = 87 returning from original sample of 124; median age = 76 years) were assigned to movement (n = 51) or waitlist control (n = 36) groups. The movement groups took twelve 60-min lessons across either 6 or 12 weeks, to compare lesson density. Pretests and posttests included Base of Support, Timed Up and Go, Tandem Stance, Functional Reach, modified OPTIMAL, and questions about individual priorities and outcomes. Results included significant correlations between lessons attended and both improved Functional Reach and improved OPTIMAL score. A significantly higher proportion of the movement (vs. control) group reported positive changes at the posttest in both prioritized and newly identified activities. These results show that Feldenkrais lessons are helpful to older adults for promoting balance, mobility, and confidence.

Ejercicio físico como tratamiento en el manejo de lumbalgia / Exercise as a treatment for low back pain management

RESUMEN La lumbalgia es un padecimiento que conlleva grandes repercusiones económicas, sociales y se ha convertido en una de las primeras causas de incapacidad laboral a nivel global. Cuando ocurre el dolor en la parte baja de la espalda se genera la incertidumbre sobre los factores de riesgo o causas que pueden desencadenar la lumbalgia, sin embargo; su diagnóstico no es sencillo y cerca del 90 % de los casos generalmente no presentan algún tipo de lesión demostrable, por lo que el problema se cataloga como una lumbalgia inespecífica. El tratamiento incluye movimiento de la persona, ya que el reposo debilita y atrofia la musculatura de la espalda, además; dentro de los métodos de ejercicios recomendados se encuentran los ejercicios localizados en musculatura del tronco y abdomen principalmente, resistencia muscular, estabilidad espinal, Pilates, ejercicios de Williams y Mckenzie, técnicas de Feldenkrais y Alexander, entre otros.(AU)

ABSTRACT Low back pain is an illness with various economic and social repercussions since it is one on the most causes of work absence worldwide. When the patient feels pain in the back, there is an uncertainty regarding a possible risk or cause for low back pain; however, diagnosis is not easy, and around 90 % of the cases do not present physical evidence, therefore, the problem is classified as a non-specific low back pain. Treatment includes body movement, because rest weakens the back muscles and causes atrophy; the recommended exercise methods include exercises for the trunk and abdomen muscles mainly, muscular resistance, spinal stability, Pilates, Williams and Mckenzie exercises, Feldenkrais and Alexander techniques, among others.(AU)