Mindful movement-based practices are popular complementary therapies in Parkinson’s disease (PD), defined as healing practices involving movement of the body while focusing on the mind. They are performed in addition to standard therapies with the goal of improving quality of life. Many of you probably have heard of yoga and tai chi, but there are many other movement therapies that are performed by people with PD that you may not have heard of. These include the Feldenkrais method, the Alexander technique, and the Nia technique, among others. These modalities are often referred to as mindful exercise techniques. I will dedicate today’s blog to a discussion of these three therapies – their similarities, and differences, as well as their use in PD.
Of note, I have highlighted a number of non-movement based complementary practices in prior blogs including:
To help me understand the mindful movement-based therapies for Parkinson’s disease, I turned to the expertise of Caroline Kohles, Senior Director at The Center for Health and Wellness at the Marlene Meyerson Jewish Community Center (JCC) in Manhattan. A health and wellness professional for more than 25 years, Caroline is co-founder of Nia New York™ and Nia Brain Body Fitness for PD. Nia is a holistic lifestyle and fitness practice, and Caroline teaches classes in this and other movement therapies at the JCC’s nationally and internationally recognized Edmond J. Safra Parkinson’s program, which Caroline helped design. The program is now in its twelfth year and runs in partnership first with The Fresco Institute at NYU Langone Medical Center and now with Northwell Health.
I asked Caroline about mindful movement-based practices for PD. She reached out to her staff who offered input for this article. Bill Connington, created the Alexander for PD curriculum for the JCC, and Sonja Johannson teaches the Feldenkrais Method and Nordic Walking to people living with PD.
Q: What is meant by mindfulness and what are mindful exercise techniques?
A: We know that there is evidence that exercise delays progression of PD, so people living with the disease want to stay as active as possible. People with PD however, often have difficulty with awareness of their movements. Mindful exercise techniques such as The Feldenkrais Method, The Alexander Technique, and Nia help students connect to their bodies and move with greater cognizance. In all of these modalities, participants learn how to be more aware of what’s happening in their bodies and in their movements, how to prevent physical misuse that can lead to injury and how to develop more positive, constructive ways of using their body and mind together.
Traditional fitness classes often focus more on the mechanics of fitness than on learning how to use the body artfully and efficiently. Mindful exercise is important because it teaches all of us how to listen to our bodies consciously in the moment, enabling us to move away from pain and towards greater function and pleasure.
Q: What are the similarities and differences between the Nia Technique, the Alexander Technique and The Feldenkrais Method?
A: The Nia Technique is a nontraditional, cardiovascular movement and lifestyle practice that uses easy-to-follow movements to create a full-body, dynamic dance workout that leaves students feeling energized, mentally clear, and emotionally upbeat. It is based on an understanding of how conscious, creative, joyful movement can positively affect the body’s muscular, nervous, and skeletal systems. In Nia, the primary goal is creating agility.
Nia was co-founded 40 years ago by fitness professionals Debbie and Carlos Rosas. It was the first group fitness program to incorporate different movement styles into one class. In a Nia class, the goal is to keep moving through a powerful fusion of dance, martial arts, and mindfulness practices set to music. Nia is non-impact, safe, and doesn’t stress the joints. Nia incorporates controlled punches and kicks along with sweeping dance movements, hand and foot techniques, and vocalization. Nia has 52 basic moves put together in simple and novel movement sequences in order to strengthen and condition the whole body.
The Alexander Technique is a practical mind-body method to improve alignment and movement in everyday activities. The Alexander Technique teaches you to use your body consciously and efficiently. You learn how to notice tension and unconstructive postural habits and how to change them. There is no music in an Alexander class; the slower pace gives participants time to explore different ways of using their bodies in functional everyday activities such as sitting, bending, and walking. This mind-body method helps participants learn how to identify and change the mental/physical (psychophysical) habits that cause stress, tension, misalignment, and pain.
The Alexander Technique was developed in the 1890s and is part of the curriculum at the Yale School of Drama, The Juilliard School, and the Royal Academy of Dramatic Art.
The Feldenkrais Method, developed by Israeli Moshe Feldenkrais during the mid-20th Century, influences the brain and behavior through a learning process involving movement exploration, trial and error, and problem-solving. The key focus of the method is to develop and tune-in to the physical sense of proprioception so as to improve all aspects of movement, from the most dynamic actions such as walking, running or dancing to the most subtle such as breathing, holding one’s head upright, or threading a needle.
Q: What can these techniques offer someone with PD?
A: These three techniques are excellent for the brain because they help students learn new skills, drop bad habits, and adapt in new ways to their environment, thus enhancing brain neuroplasticity. Learning to pay attention to how your body is moving when exercising is more important than many people realize because when our mind and body aren’t working together, which often happens in Parkinson’s, we are more likely to fall, or push ourselves too hard, which can lead to injuries. Mindful exercise programs like Feldenkrais, Alexander, and Nia train those living with PD not only to pay attention to their own body signals, but to adapt and move in new and more conscious ways. These techniques improve alignment, confidence, and trust in moving through life. Students become body literate and start to know when to step up the pace or when to stop or slow down to prevent injury or damage to the body.
Q: How can a person with PD choose from among these techniques?
A: People with Parkinson’s are resilient. They are not fragile. They may have imbalance, rigidity, stooped posture, poor body alignment, depression, and speech disorders, however, they know that exercising, speaking loudly, being expressive, working together in a group, and being challenged to think and move at the same time, are recommended and they are often open to trying new things. This is a very helpful mindset to have when learning something new or different like Nia, the Alexander Technique, or the Feldenkrais Method. These three techniques complement each other in addressing Parkinson’s symptoms.
- Connects to music which is a good choice for those who like to dance, enjoy music, and want a light aerobic workout in a group setting.
- Helps build cardiovascular endurance, coordination, balance, and gait.
- Helps with vocal symptoms of Parkinson’s by encouraging students to vocalize during class and sing along to the music.
- Addresses facial masking by incorporating emotions and acting them out.
- Strengthens and adds expression to the whole body.
- Helps combat depression, anxiety, and isolation.
- Is great for those looking to be more calm, collected, and controlled when dealing with the everyday physical challenges presented by PD.
- Can be helpful in dealing with pain, rigidity, tremors, and stooped posture because it places primary attention on the position of the head, especially its carriage by the neck and shoulders where so many people store tension.
- Gives students a way of working on themselves through mindfulness and self-observation, providing them with more control of their own bodies.
- Helps increase range of motion and encourages ease of motion.
- Reduces the effort of movement by relying on skeletal support and gravity because it is often done lying down.
- Uses a relaxing pace with subtle movements, allowing students to become more conscious of sensation, and through focused attention, learn to improve all aspects of movement.
- Reduces effort and increases the power and efficiency of movement in daily activities.
All of these techniques help reduce unnecessary strain on the body. When stress and strain are reduced, participants experience a greater sense of awareness, improved balance and coordination, increased readiness to move, and enhanced ability to breathe deeper and more easily. In summary, these techniques enhance focus and improve overall functioning.
Q: How can people with PD participate in these mindful movement-based programs?
A: For those who are interested in trying any of these three programs, you can visit their websites directly for information about specific class details. Most programs will typically involve a membership or fee per class.
Although growing in popularity and taught in many places across the country (and beyond), it is important to note that classes in these techniques might not be available everywhere. If that is the case, don’t worry – the key for people with PD is to keep moving in any way that you can. If these classes are not available in your area, classes in other mindful techniques such as yoga and tai chi might be, as well as many other types of exercise. Check the APDA Virtual Events Calendar for PD-focused exercise and movement classes that you can participate in, no matter where you live.
Tips and Takeaways
- Mindful movement-based practices can be helpful for people with PD since they emphasize awareness of movement
- Three mindful movement-based practices which are used by people with PD are the Nia Technique, the Alexander Technique, and the Feldenkrais Method
- Find what works for you. APDA can help you find many ways to move and exercise. You can register for a virtual class, or call 1-800-223-2732 to get connected to programs in your area