Parkinson's Disease & the Feldenkrais Method
In Parkinson's disease, the natural rhythm and flow of perception, sensation, and movement become disrupted. The intention to move and the ability to start or complete an action become disconnected. Everyday automatic behaviors — walking, speaking, swallowing, even facial expression — become difficult or, at times, inaccessible.
Parkinson's is a disease of the nervous system that affects the way the brain controls the body's movements. A specific brain region responsible for controlling muscle movement gradually degenerates, and this is accompanied by a drop in dopamine production. Dopamine is a chemical messenger — part of the wider family of neurotransmitters that allow communication between neurons in the nervous system. This lack of dopamine makes it difficult for people with Parkinson's to control their muscles and movement.
In his book Musicophilia, Oliver Sacks describes how the smooth, graceful flow of movement — the "kinetic melody" — becomes a "kinetic stutter." This kinetic stutter in Parkinson's is linked to the shortage of dopamine, which normally carries information across synapses to the brain regions that coordinate movement. When this communication is disrupted, tremor, slowness of movement, rigidity, and instability can result, and balance and coordination gradually decline.
Parkinson's originates in the brain — but neuroscientists have shown that other, unaffected brain regions (including the visual and auditory systems, as well as sensory and motor pathways in the peripheral nervous system) can compensate for functions lost in the areas damaged by Parkinson's, and can ultimately improve movement control. This means the nervous system has a real capacity to reorganize itself, to some degree, to work around some of the limitations Parkinson's imposes. This capacity of the brain is called neuroplasticity.
What's possible
In 2010, the New England Journal of Medicine published video of a 58-year-old patient with a 10-year history of Parkinson's who "froze" every time he tried to walk — yet could cycle comfortably. The moment he got off the bicycle, he froze again and lost the ability to walk.
The Mark Morris Dance Company in New York has offered dance classes to people with Parkinson's since 2001. They report that many students showed no symptoms of their disease during class — moving fluidly and in harmony with other students. Many retained the ability to move with the feelings, qualities, and rhythms they learned in class, and found they could walk, speak, and express themselves better afterward.
There are many documented cases of patients who were able to overcome their symptoms while climbing stairs, cycling, playing piano, skiing, singing, or acting. Neuroscientists and clinicians have recognized that these remarkable exceptions open up new possibilities, and have developed strategies through music, dance, exercise and movement — including the Feldenkrais Method — to help people with Parkinson's live a more active life.
Some researchers theorize that rhythm and musical phrasing, dance steps and choreography, the sound-rhythm of pedaling, the visual rhythm of a staircase, or repeating lines on a pavement, all give people with Parkinson's enough visual, kinesthetic, and auditory information to hold the pulse of an activity. A clearly defined rhythm, tempo, and a wider dynamic range can help sustain an action through time and space — particularly useful for walking. Vivid kinesthetic experiences, visual imagery, metaphor, and theatrical participation can also help people express feelings and meaning around actions, supporting communication as well. Whatever the underlying mechanism, the nervous system finds creative ways to work around some Parkinson's symptoms, at least temporarily.
The Feldenkrais Method
The Feldenkrais Method works on the brain and behavior through a learning process — through movement exploration, trial, and problem-solving. Students develop their ability to attend to internal (proprioceptive) as well as external, environmental information. Children learn to lift their heads, crawl, roll over, sit, stand, and speak through this same process. Rather than "correcting" or "showing" the student how to do something, the practitioner offers different options that help the student solve a problem for themselves. These options are carefully designed movement sequences, adaptable to each student's specific needs — the student decides what feels like it's working best for them. It is a self-organizing learning process, rather than a prescription from a generic exercise program.
The Feldenkrais Method offers people with Parkinson's a way to discover and apply movement patterns that can improve their functional abilities — and this looks different for every student. The practitioner's goal is to create the best possible conditions for learning.
Possible directions within a session
- Focus — directing attention to the physical requirements of an action. If you tend to freeze, focus on how you shift your weight, how you free the other leg, how you take a single step.
- Grounding — focusing on the soles of the feet to build awareness of weight distribution and the surface you're standing on, perceiving the feet and ankles as balance sensors.
- Balance — testing and improving balance in a safe environment; learning how to avoid falls, how to protect yourself, how to fall gently if you do, and how to get back up.
- Walking — exploring rhythm, range, tempo, and the rhythmic relationship between hips and arms, developing rhythmic phrases that help you walk and keep walking forward.
- Action imagery — using vivid visual and kinesthetic imagery to cue and initiate a desired movement; using play and theatre to amplify the feelings that motivate a wider range of movement.
- Swallowing — noticing how the larynx lowers when you yawn and rises when you swallow; observing how the tongue begins deep in the throat, and how this affects breathing, swallowing, and speech.
- Vocal expression — using the voice to create vibrations that awaken the lips, skull, jaw, face, and expression.
- Developing core awareness — building the strength and adaptability of the core, spine, and legs for support; learning how the pelvis and hips serve as the center of support, balance, and strength.
Many people with Parkinson's feel frustrated by standard, generic prescriptions for their condition — exercise therapy, fall prevention, gait training — and want to find other ways to be helped. The Feldenkrais Method empowers the student to take responsibility for themselves and to take their own steps in learning, according to their own needs.
source article - David Zemach-Bersin and Mark Hirschfield of the Feldenkrais Institute of New York
