A Holistic Practice Based on Embodied Neuroscience, Introspective Learning, & Effective Action
Body Schema Acuity Entrainment through Virtual Reality Bones™ and Feldenkrais® Movements
Core Stabilization Biofeedback Training and Motor Control Exercises:
Comparative Effects on Chronic Non-Specific Low Back Pain in an Outpatient Clinical Setting
A Dissertation Study and Randomized Controlled Trial
Timothy J. Sobie, PT, Ph.D., GCFP®
Background and purpose: 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® practitioners aim to clarify new functional interrelationships towards an improved neuroplasticity-based change in the cognitive construct of one’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 – being further associated with altered body perception (Wand, et al. 2016). The Feldenkrais Method® (FM) is a comprehensive approach being manifested through manual sensory contact (FI®) techniques and movement experiences (ATM®) 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.
Methods: A Randomized Controlled Trial compared a novel Body Schema Acuity Training / Feldenkrais® Movement (VRB3/FM) intervention against more conventional protocols for Core Stabilization Biofeedback / Motor Control Exercises (CSB/MCE). The (VRB3)™ treatment component (Virtual Reality Bones™) 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’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 (VRB3/FM @ N=15) or the control group (CSB/MCE @ N=15). Known confounding biopsychosocial variables (i.e. Fear-Avoidance Beliefs) were controlled via stratified-random assignment on the FABQ. Treatment Outcome measures included VAS-PAIN scales, RMDQ (disability scores), PSFS (function ratings), and Timed Position Endurances Tests – including Flexion / Extension Ratios at baseline, 2-weeks, 4-weeks and 8-weeks.
Results: Statistical Analysis was conducted using Wilcoxon Rank Sum and paired, two-tailed t-test. Results showed that the VRB3/FM group demonstrated greater improvement in all treatment outcome measures as compared to the matched CSB/MCE control group.
Conclusions: This is the first RCT study to demonstrate that a Feldenkrais Method® based approach being combined with Body Schema Acuity Training (using Virtual Reality Bones™ / VRB3)™ 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.
Source: Proquest Open Dissertations & Theses (see link for citation and further details)