title: Can the Alexander Technique improve balance and mobility in older adults with visual impairments? A randomized controlled trial.
abstract: OBJECTIVE
  To investigate the impact of Alexander Technique lessons on balance and mobility in older adults with visual impairments.
  
  
  METHODS
  Randomized assessor blinded controlled trial with intervention and usual care control groups.
  
  
  METHODS
  Participants' homes.
  
  
  METHODS
  A total of 120 community-dwellers aged 50+ with visual impairments.
  
  
  METHODS
  Twelve weeks of Alexander lessons and usual care.
  
  
  METHODS
  Short Physical Performance Battery items were primary outcomes at 3 months and secondary outcomes at 12 months. Additional secondary outcomes were postural sway, maximal balance range and falls over 12 months.
  
  
  RESULTS
  Between-group differences in primary outcomes were not significant. The intervention group reduced postural sway on a firm surface with 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 a greater intervention effect among past multiple-fallers (2+) than non-multiple fallers for gait speed (P = 0.02) and step length (P < 0.01) at 3 months and chair stand at 12 months (P < 0.01). There was a non-significant reduction in falls rate (IRR = 0.64, 95%CI 0.34 to 1.15, P = 0.13) and injurious falls (IRR = 0.61, 95% CI 0.28 to 1.30, P = 0.20) in the intervention group compared to the control group.
  
  
  CONCLUSIONS
  The intervention did not have a significant impact on the primary outcomes but benefits for the intervention group in postural sway, trends towards fewer falls and injurious falls and improved mobility among past multiple-fallers suggest further investigation of the Alexander Technique is warranted.
authors.affiliation: Injury Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Gleeson
authors.affiliation: Musculoskeletal Division, The George Institute for Global Health, The University of Sydney, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.affiliation: Statistical Division, The George Institute for Global health, The University of Sydney, Australia.
authors.forename: Serigne
authors.initials: S
authors.lastname: Lo
authors.affiliation: Injury Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia lkeay@georgeinstitute.org.au.
authors.forename: Lisa
authors.initials: L
authors.lastname: Keay
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D009517:New South Wales; D004856:Postural Balance / Q000502:physiology*; D014786:Vision Disorders / Q000150:complications / Q000534:rehabilitation*; D016138:Walking / Q000502:physiology*
keywords: Alexander Technique; Visual impairment; balance; mobility