Talk:Feldenkrais Method

Issues with Gorski citation

A David Gorski quote is used to support a skeptical perspective regarding the Feldenkrais Method. The citation leads to a 2009 opinion piece by Gorski criticising CAM services offered at the MD Anderson Cancer Centre, specifically Feldenkrais, Reflexology and Accupuncture. In the article, Gorski links to a Feldenkrais post by MD Anderson site; it goes to a 404 error page.

The tone of the post is subjective opinion and sarcasm. It is not a rational analysis. For example: Gorski quotes the Feldenkrais Foundation site and implies that he does not understand the words. Sarcastically seeking clarity he links to an item in the Skeptics Dictionary (SD) that is highly subjective with inherent logic errors. The SD item quotes a story by a person who had difficulty walking after an accident, and after a 3 day Feldenkrais workshop is able to walk more easily than before the accident. She describes the exercise method used. However the author places this quote in the middle of a critique of faith healing.

It appears that Gorski based his comment about FM having similarities to faith healing on that author’s opinion. This discredits the Gorski quote.

If the Gorski source is to be retained, a more useful (rational and accurate) quote would be (as of 2009) “I couldn't find any evidence that the Feldenkrais method has been "confirmed by by research in neuroscience," at least not any neuroscience published in the peer-reviewed literature indexed on PubMed. True, I did find 34 references, but a lot of them were in the CAM literature, and none of them were in any neuroscience journals that I could find.” D1doherty (talk) 15:38, 24 September 2023 (UTC)

Good source (independent, reputable), and fine for what it says. For straying into Neuroscience stronger WP:MEDRS would be needed. Bon courage (talk) 15:42, 24 September 2023 (UTC)

Gorski is reliable for his own opinions, but you're right that pulling a single quote from the article is a due weight violation. Either summarize the opinion blog post in its entirety or don't use it at all. Horse Eye's Back (talk) 16:00, 24 September 2023 (UTC)

I would go further and say that the true Skeptic in the quoted article was actually the Feldenkrais teacher, who showed the student his workings! The "Skeptic" failed to see this, and Gorski uncritically accepted the "Skeptic's" conclusions. freakypete (talk) 22:12, 12 May 2024 (UTC)

Since Wikipedia is based on reliable sources and not on your opinion, this does not matter. --Hob Gadling (talk) 06:06, 13 May 2024 (UTC)

Missing systematic reviews

I'm aware evidence quality matters. Below I offer three systematic reviews, and/or meta-analyses and would balance and improve the definition and efficacy sections. We seem to be excluding sources because they study alternative medicine, kinesiology, or public health when they otherwise conform to methods and standards of evidence quality.

Proposed Additions

A 2015 systematic review in Evidence-Based Complementary and Alternative Medicine found that Feldenkrais has "broad application in populations interested in improving awareness, health, and ease of function". Meta-analysis showed significant improvements in both balance and functional reach. The authors noted, "as a body of evidence, effects seem to be generic, supporting the proposal that [Feldenkrais] works on a learning paradigm rather than disease-based mechanisms. Further research is required; however, in the meantime, clinicians and professionals may promote the use of [Feldenkrais] in populations interested in efficient physical performance and self-efficacy."

A 2020 review of recent literature in Kinesiology Review studied the effectiveness of Feldenkrais for "improving balance, mobility, and coordination and its effectiveness for management of chronic pain." The authors found that "research clearly supports the effectiveness of the [Feldenkrais Method] for improvement of balance and chronic pain management."

A 2022 systematic review and meta-analysis in The International Journal of Environmental Research and Public Health sought to "identify the populations and conditions for which the FM can be used in physiotherapy and to determine the intervention modalities." It found:

1. Elderly people: "Significantly improved gait, balance, mobility and quality of life."
2. Cervical, dorsal, or shoulder pain: "Significantly improved pain, functional balance, and perceived exertion on subjects with cervical, dorsal, or shoulder pain."
3. Chronic low back pain: "Improvements in pain, disability, quality of life and interoceptive awareness."
4. Multiple sclerosis: "Improvement in functional capacity in subjects."
5. Parkinson’s disease: "Significant effects on quality of life and functional tests."

It concluded: "Evidence shows that FM has therapeutic effects comparable to other physiotherapy techniques in patients with spine pain. In addition, improvements in mobility and balance were seen in the elderly and people with neurodegenerative diseases." Ocaasi ^{t | c} 13:43, 3 July 2024 (UTC)

References

Evidence quality does matter. For example, we tend not to use stuff from predatory publishers (like MDPI/IJERP), or from journals that have been stripped of their impact factors due to functioning as paper mills (like both Evidence-Based Complementary and Alternative Medicine and IJERP). MrOllie (talk) 13:17, 4 July 2024 (UTC)

Thank you @MrOllie. I still feel there's a shifting of the goalposts. CAM can't use its own sources, or mere RCTs, so researchers publish recent systematic reviews and meta-analyses. Then the journals they publish in are deemed predatory, even if those distinctions are themselves controversial and not universal. These are still indexed journals by PubMed, Scopus, and Web of Science. There is a downgrading by Clarivate, but Impact Factor is itself very disputed. It seems like there's nothing CAM can do to have its worth represented. This is an old concern of mine, dating back to 2009 (!) but I feel like it's raising its head again here. Ocaasi ^{t | c} 17:55, 4 July 2024 (UTC)

It is not a 'shifting of the goalposts' to note that CAM advocates can't seem to get their stuff published in reputable journals. The goalposts' are where they always have been - CAM advocates just can't get past them. MrOllie (talk) 17:58, 4 July 2024 (UTC)

Notifying you of this discussion about the 2nd source, at RSN:

Wikipedia:Reliable_sources/Noticeboard#Inclusion_of_medical_evidence_review_at_Feldenkrais_Method

Cheers, Ocaasi ^{t | c} 17:16, 7 July 2024 (UTC)

Definition: Somatics

I've updated the definition with seven varied sources, from journals, to books, to articles, to websites that broadly locate, or categorize, FM within the field of Somatics. These sources are not superseded by one Australian systematic review, as WP:MEDRS applies to medical claims not definitions, categorizations, types, or kinds of movement practices, some of which, like Yoga and Tai chi, date back thousands of years. FM, by its own definition, and that of many others, is a somatic practice. If there's a dispute in the sources, we describe the debate, we don't ignore it. Ocaasi ^{t | c} 19:01, 4 July 2024 (UTC)

Efficacy Contradiction

This article contains two sentences that can't both be right:

1) "There is no medical evidence that the Feldenkrais method improves health outcomes..." (2015)

2) "There is limited evidence that workplace-based use of the Feldenkrais Method may help aid rehabilitation of people with upper limb complaints." (2019)

Either (2) is inaccurate, insufficient, or unreputable; or (1) can't be stated as a plain fact (especially in the lede). Ocaasi ^{t | c} 14:42, 5 July 2024 (UTC)

For context, what (2) says is "The Feldenkrais group showed a significant decrease in neck/shoulder complaints, compared with the physiotherapy and control groups...The authors postulated that this could be because Feldenkrais has a stronger focus on participants’ perceptions and experiences than physiotherapy, and that Feldenkrais has some features in common with relaxation and biofeedback techniques, which have been found to be effective at reducing pain...Feldenkrais should be implemented with caution, as only one study supported [this intervention]...more research needs to be conducted on these interventions." Ocaasi ^{t | c} 14:47, 5 July 2024 (UTC)

Efficacy Contradiction Part 2: The lede

We now have two superseding studies after the Australian 2015 systematic review which found "no evidence". Now we have n=2 of "yes/some evidence". How do we summarize this mix in the lede?

1. "There is no medical evidence that the Feldenkrais method improves health outcomes..." (2015)
2. "It is concluded that FM proved to be effective [for LBP], but not in all people with musculoskeletal disorders..." (Elsevier, 2017)
3. "There is limited evidence that workplace-based use of the Feldenkrais Method may help aid rehabilitation of people with upper limb complaints." (Springer, 2019)

Ocaasi ^{t | c} 19:30, 6 July 2024 (UTC)

Usual solution is to summarise by saying "no good evidence". Bon courage (talk) 05:21, 8 July 2024 (UTC)

RSN thread on Kinesiology Review

Please note, I've posted about the Kinesiology Review at RS/N. Feel free to share comments there:

Wikipedia:Reliable_sources/Noticeboard#Inclusion_of_medical_evidence_review_at_Feldenkrais_Method

Cheers, Ocaasi ^{t | c} 17:15, 7 July 2024 (UTC)

IQWIG report

While responding to the above-mentioned RSN query, I came across this 2022 report on the effectiveness of Feldenkrais Method by the German Institute for Quality and Efficiency in Health Care, which is not currently cited in the wikipedia article. Worth considering. Abecedare (talk) 23:58, 7 July 2024 (UTC)

Great find! It concludes:

• "For patients with Parkinson's disease, there is a hint of greater benefit of the Feldenkrais method in comparison with the passive strategy of an educational programme in the form of lectures. This benefit consists of improved mobility and health-related quality of life at the end of treatment."
• "In the comparison with active strategies, the available evidence for patients with chronic low back pain is inconsistent. Compared with an educational programme involving trunk stabilization exercises, there is a hint of greater benefit of the Feldenkrais method with regard to improved mobility and health-related quality of life at the end of the 5-week treatment period."
• "In comparison with back school, there is a hint of greater benefit of the Feldenkrais method with regard to pain reduction, but also a hint of lesser benefit of this method with regard to health-related quality of life after 3 months. However, no differences in effects were found directly at the end of therapy."
• "There is no hint of either long-term benefit of the Feldenkrais method or for its benefit in other therapeutic indications."
• "The question about the benefit of the Feldenkrais method in comparison with active strategies such as extensive physiotherapy generally remains open. Overall, little evidence is available. From an ethical perspective, the absence of evidence from RCTs is problematic for informed decision making but does not constitute evidence of an absent benefit."
• "Further research is needed, particularly regarding long-term effects of the Feldenkrais method, its application in various therapeutic indications, and in comparison with further active comparator therapies typically used in practice, e.g. physiotherapy." Ocaasi ^{t | c} 01:45, 8 July 2024 (UTC)