Effects of Alexander-Based Corrective Techniques on Forward Flexed Posture, Risk of Fall, and Fear of Falling in Idiopathic Parkinson’s Disease

Abstract

Background: Patients with idiopathic Parkinson’s disease (PD) have a flexed posture and are at an increased risk of falls. In addition, fear of falling (FOF) is among the main complaints of PD patients. To reduce the risk of falling, complex non-drug interventions are required, involving balance-challenging exercises with proper strength, along with posture alignment through corrective exercise interventions (Alexander techniques), which are often utilized to manage patients with PD and thoracic hyperkyphosis. Objectives: To investigate the effects of Alexander-based corrective techniques (ABCT) on forward flexed posture (thoracic hyperkyphosis and forward head posture), risk of falling, and FOF among idiopathic PD patients. Methods: In this interventional study, 26 male and female patients were randomly assigned to the experimental (n, 13) and control groups (n, 13). The subjects participated in a postural realignment program, consisting of 60-minute sessions over 8 weeks (3 sessions per week). Pre- and posttest evaluations were also carried out. Results: The results of paired t test regarding the effects of ABCT on the thoracic kyphosis angle (TKA), craniovertebral angle (CVA), falls efficacy scale-international (FES-I) score, freezing of gait (FOG), and functional reach test (FRT) score revealed a significant difference between the pre- and posttest stages in the control group (P = 0.05). In addition, the t test results showed a significant difference in the mean changes of TKA, FES-I score, FOG, and FRT score between the groups in the pre- and postintervention stages. The Pearson’s correlation test showed that TKA had a significant positive correlation with FES-I and FOG in the groups. On the other hand, the results of Pearson’s correlation test showed a significant negative correlation between TKA and FRT. Finally, the Pearson’s correlation coefficient showed a significant positive correlation between CVA and FES-I, but not FRT in the groups. Conclusions: The findings of this study indicated that 8 weeks (24 sessions) of ABCT in the experimental group caused considerable improvements in TKA, CVA, FOF, FOG, and risk of fall in patients with PD.