title: Lighten Up: Specific Postural Instructions Affect Axial Rigidity and Step Initiation in Patients With Parkinson's Disease.
abstract: BACKGROUND
  Parkinson's disease (PD) is associated with stooped postural alignment, increased postural sway, and reduced mobility. The Alexander Technique (AT) is a mindfulness-based approach to improving posture and mobility by reducing muscular interference while maintaining upward intentions. Evidence suggests that AT can reduce disability associated with PD, but a mechanism for this effect has not yet been established.
  
  
  OBJECTIVE
  We investigated whether AT-based instructions reduce axial rigidity and increase upright postural alignment, and whether these instructions have different effects on postural alignment, axial rigidity, postural sway, and mobility than effort-based instructions regarding posture.
  
  
  METHODS
  Twenty subjects with PD practiced 2 sets of instructions and then attempted to implement both approaches (as well as a relaxed control condition) during quiet standing and step initiation. The "Lighten Up" instructions relied on AT principles of reducing excess tension while encouraging length. The "Pull Up" instructions relied on popular concepts of effortful posture correction. We measured kinematics, resistance to axial rotation, and ground reaction forces.
  
  
  RESULTS
  Both sets of experimental instructions led to increases in upright postural alignment relative to the control condition. Only the Lighten Up instructions led to reduced postural sway, reduced axial postural tone, greater modifiability of tone, and a smoother center of pressure trajectory during step initiation, possibly indicating greater movement efficiency.
  
  
  CONCLUSIONS
  Mindful movement approaches such as AT may benefit balance and mobility in subjects with PD by acutely facilitating increased upright postural alignment while decreasing rigidity.
authors: University of Idaho, Moscow, ID, USA rcohen@uidaho.edu.
authors: Rajal G
authors: RG
authors: Cohen
authors: Oregon Health & Science University, Beaverton, OR, USA.
authors: Victor S
authors: VS
authors: Gurfinkel
authors: Macalester College, St Paul, MN, USA.
authors: Elizabeth
authors: E
authors: Kwak
authors: University of Idaho, Moscow, ID, USA.
authors: Amelia C
authors: AC
authors: Warden
authors: Oregon Health & Science University, Beaverton, OR, USA Portland Veterans' Administration Medical Center, Portland, OR, USA.
authors: Fay B
authors: FB
authors: Horak
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D004856:Postural Balance; D011187:Posture; D016896:Treatment Outcome; D016138:Walking
keywords: Alexander Technique; Parkinson’s disease; gait initiation; mindfulness; postural alignment; postural sway; rigidity