APPLICATION OF THE FELDENKRAIS METHOD IN PATIENTS WITH MULTIPLE SCLEROSIS

Abstract

The numerous symptoms, the chronic and often progressive flow of multiple sclerosis that worsens the physical activity and quality of life of the patients and increases the risk of their disability, mandates a long-term multidisciplinary rehabilitation to achieve optimal health. The Feldenkrais method is an educational system that uses balanced movement, breathing and neuromuscular relaxation to help people get to know themselves, improve their functions and achieve psychosomatic balance. The improvement of individual function develops through the expansion of the motor heritage, perfecting the dynamic relationship in the organism with respect to gravity and the environment. The study aims to follow the effect of applying the Feldenkrais method as part of neurorehabilitation in patients with a primary progressive form of multiple sclerosis. Material and methods: To fulfill the purpose of the study, 6 patients (mean age 49.6±5.4) with primary progressive form of multiple sclerosis were examined in a period of 1 month. In an average of 10% of patients, the disease progresses slowly and gradually from the beginning. The first symptoms of multiple sclerosis in everyone appear after the age of 40 and more often they manifest with progressive myelopathy. The Feldenkrais method is not limited to explaining movement exclusively in terms of anatomy, biomechanics and kinesiology, and it is necessary to understand the "organization" of movement by investigating its intentional or contextual nature. One must learn how to organize active movement in an environment to meet different criteria for active movement. Testing and evaluation methods: To analyze the effect of applying the Feldenkrais method as part of neurorehabilitation in patients with a primary progressive form of multiple sclerosis, the following are used: transfer test (transition from occipital lying to left/right lateral lying, from occipital lying to standing) and a balance test according to the Berg Balance Scale (Berg Balance Scale) – assessment of static and dynamic balance. All parameters of the tests were evaluated on the 1st, 10th day and 1st month after starting the application of the Feldenkrais method. Results: All the results of the study show the effect of applying the Feldenkrais method as part of neurorehabilitation in patients with primary progressive form of multiple sclerosis. The effect on functional possibilities in patients with primary progressive form of multiple sclerosis, assessed by (TUG) - test of movement and transfer and balance test (Berg Balance Scale), is significant during the whole trial and is most pronounced on the 1 month from the beginning of applying the Feldenkrais method as part of the overall neurorehabilitation. Conclusion: Since the Feldenkrais method works on awareness, how to achieve it and how to use it, each person learns to regulate himself, finding his own strategies for change. The combination of awareness and flexibility is very powerful in combating the effects of this disease. Using muscles to move rather than support against gravity improves range of motion and helps to have more energy. Then, learning to initiate the movement from the large muscles located in the center of the body allows for a better distribution of work, allowing energy and strength to be conserved, which are two major concerns for patients with multiple sclerosis. Future more comprehensive research is needed on the techniques of the method and their use and also to familiarize and adequately educate both health professionals and patients with multiple sclerosis.