J of Musculoskeletal Pain, Vol. 9(4) 2001, pp. 25-35
Authors: Sally Aspegren Kendall, Lisa Ekselius, Björn Gerdle, Birgitta Sörén, Ann Bengtsson
Affiliations: Sally Aspegren Kendall, MD Björn Gerdle, MD, are Professors, and Birgitta Sörén is Lecturer in Physiotherapy, Department of Rehabilitation Medicine, Faculty of Health Sciences, SE-581 85 Linköping, Sweden. Lisa Ekselius, MD, is Assistant Professor, Department of Neuroscience, Psychiatry, University Hospital, SE-751 85 Uppsala. Sweden. Ann Bengtsson, MD, PhD, is Associate Professor, Department of Rheumatology, University Hospital, SE-581 85 Linköping, Sweden.
Address correspondence to: Sally A. Kendall, MD, Faculty of Health Sciences, INR, Department of Rehabilitation Medicine, SE-581 85 Linköping, Sweden [E-mail: mailto:email@example.com].
The study was supported by the Swedish Medical Research Council [L. Ekselius] and the Swedish Rheumatism Association [A. Bengtsson].
Submitted: January 15, 2001.
Revision Accepted: May 19, 2001.
Objectives: To evaluate the effect of the Feldenkrais intervention in fibromyalgia patients.
Methods: Twenty fibromyalgia patients started Feldenkrais intervention done as one individual and two group sessions weekly for 15 weeks. Nineteen started a group-based pain education program followed by a pool program. Test and self-report questionnaires were administered at the start, at six month follow up, and at the end of intervention.
Results: After the Feldenkrais intervention improvement in balance and trends to better lower extremity muscle function were shown, but the improvements were not maintained.
Conclusions: No sustained benefit of the Feldenkrais intervention compared to a pool program was seen. Methodological problems are discussed.
The core symptoms of fibromyalgia [FMS] are chronic widespread muscle pain at rest and after muscular exertion, the feeling of muscular stiffness, sleep disturbances, and fatigue. Its cause[s] is unknown and several pain mechanisms may be present (1,2). A number of studies have shown benefit from nonpharmacological therapies (3) but further systematic evaluation of the effectiveness of nonpharmacological treatment approaches in FMS is needed (4). Pool training [hydrotherapy) is recommended in Sweden (5) and has nearly become standard therapy. Another intervention that has attracted considerable interest in Sweden is Feldenkrais therapy (6).
The Feldenkrais method (7) is based on the theory of sensory awareness as a prerequisite for voluntary control of the pattern of movement. A central concept is self-image, viewed in terms of movement, sensation, feeling, and thought. The four components influence each other but changes [improvement] in actions and movement will only occur after changes in the brain and nervous system have taken place. Feldenkrais therapy aims to teach how to relearn the basic motor pattern used before the [painful] condition appeared and to give the student knowledge about how we move not merely experience that we move. Thus the external, physical changes towards which Feldenkrais therapy aims are the outward conscious manifestations of an internal change in the other components of self-image.
The Feldenkrais intervention has not been studied systematically in FMS although a randomized, controlled trial in women with neck-shoulder complaints (6) showed a decrease in complaints and occupational disability. We hypothesized that the Feldenkrais therapy would be beneficial in FMS management. The aims of the present study were to analyze the effects of a Feldenkrais Intervention in FMS compared with pool training [hydrotherapy] and to examine stable personality traits measured by the Karolinska Personality Scale [KSP].
© 2001 by The Haworth Press, Inc. All rights reserved.