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Lisa J Keay, Michael G Gleeson, Serigne Lo, Cathie Sherrington; Can the Alexander Technique improve balance and mobility in adults over 50 years of age with visual impairments? A single-blind randomized controlled trial. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4579.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the impact of the Alexander Technique on physical functioning in older adults with visual impairments
Randomized controlled trial involving 120 community-dwellers aged 50+ with visual impairments. Participants were randomized to 12 weeks of Alexander lessons or usual care. The primary outcomes were the Short Physical Performance Battery (SPPB) items at 3 months. Secondary outcomes were SPPB items at 12 months, postural sway and maximal balance range at 3 and 12 months and falls over 12 months.
Between-group differences for the SPPB were not significant at 3 months. However the intervention group performed significantly better than the control group in postural sway on a firm surface with the eyes open at 3 months after adjusting for baseline values (-29.59 mm, 95%CI -49.52 to -9.67, p < 0.01). Planned sub-group analyses indicated that the intervention had a greater effect among past multiple (2+) fallers than non-multiple fallers for 3 month gait speed (interaction term p = 0.01; between group difference in multiple fallers after adjustment for baseline values 0.19 m/s, 95%CI 0.03 to 0.36, p=0.02; non-multiple fallers -0.02 m/s, 95%CI -0.12 to 0.08, p=0.68) and number of steps in the 3 month 4-metre walk (p < 0.01; multiple fallers -2.20 steps, 95%CI -3.79 to -0.62, p < 0.01; non-multiple fallers; -0.32 steps, 95%CI -0.95 to 0.30, p = 0.31) and 12 month chair stand (p < 0.01; multiple fallers -5.4 seconds, 95%CI -8.78 to -2.02, p < 0.01; non-multiple fallers; 0.90 seconds, 95%CI -0.92 to 2.72, p = 0.33). There was a lower but non-significant reduction in rate of falls (IRR = 0.64, 95%CI 0.34 to 1.15, p = 0.13) and injurious falls (IRR =0.60, 95% CI 0.28 to 1.29, p = 0.193) in the intervention group compared to the control group.
This study did not find a significant impact of Alexander lessons on the primary outcomes. However benefits for the intervention group in postural sway, trends towards fewer falls and injurious falls and improvements in mobility among past multiple fallers suggest that further investigation of the Alexander Technique in this vulnerable population is warranted.
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