Alexander technique skills may help you become calmer, more collected, and controlled during your daily activity and when dealing with moment-to-moment challenges relating to Parkinson’s. This may have a positive effect on:

• increasing control of Parkinson’s motor and non-motor symptoms
• improving balance and posture
• managing stress
• reducing anxiety
• increasing independence and overall confidence.

In particular, research studies suggest that AT could be helpful in managing the following symptoms:

• Tremor
• Balance problems
• Posture problems
• Freezing
• Pain
• Rigidity
• Speech problems
• Fatigue
• Sleep problems
• Anxiety
• Apathy
• Depression

Once learned, AT does not require taking extra time out of your day to practice, to do exercises or to repeat any particular movements.

AT is taught in both group classes and in private sessions. While private sessions may allow greater opportunity for individualised feedback, group learning may provide additional perspectives and a sense of solidarity with others, possibly reducing social isolation. Group classes will usually be more affordable.

A blend of group classes and individual sessions can be considered. Your individual needs, goals, and the impact of your symptoms in your daily life will help you determine the best way for you to learn AT; a course of 25 private sessions of 45-60 minutes can provide a good foundation for most people.

Which skills will I learn?

Your AT instructor will help you develop:

• keener self-observation
• the ability to stay calmer and reduce tension from moment-to-moment during your day
• better ways to approach daily activities.

You may apply these skills in real-life situations, such as, for example:

• standing
• sitting
• walking
• leaning over
• lifting something from the floor
• reaching for something on a high shelf
• using your mobile phone
• having a conversation
• answering questions
• managing a noisy environment.

You may also be able to use these skills during motor activities such as:

• athletics
• exercise classes
• playing a musical instrument
• writing.

How will the instructor teach me these skills?

During an AT session, the instructor will provide verbal cues and a non-manipulative, light touch to guide your movement. This may help you become more aware of excessive tension that may be interfering with your balance and potentially causing anxiety and stress.

Another part of AT classes or sessions is the so-called Active Rest. Here, you will be lying down on a massage table or on the floor. Active Rest is aimed at teaching you to:

• deepen your sense of calm
• expand your breathing capacity
• let go of muscle rigidity
• increase expansion of your torso
• increase extension of your spine and limbs.

You will also learn how to practice Active Rest on your own at home.

Wear comfortable, loose clothing – tight clothing or thick fabrics like denim will impede your range of motion, which can interfere with your ability to balance, move freely from sitting to standing, and so forth.

Having your partner/carer attend your sessions with you may be helpful – your partner/carer may be able to support your learning with their own understanding of how to apply AT principles.

Consider attending "tune up" sessions – these may help you handle new Parkinson's-related challenges. As Parkinson's is a progressive condition, you may find it useful to return to your AT instructor for sessions when you feel the need to reinforce your skills. Your instructor may be able to help you apply your AT training to address a new symptom or challenging activity.

Alexander technique instructors are certified by national and international societies who must answer to government regulations on ethics of practice. AT complete extensive training, usually over a three-year period.

The following links may be helpful for finding certified AT teachers:

• The Complete Guide to the Alexander Technique
• AT teachers in the UK
• AT teachers worldwide
• Affiliated societies
• The Poise Project

A 2016 study indicated that a training session in new thinking based on AT principles can lead to immediate motor improvement for people with moderately severe Parkinson’s disease, including steadier balance, more upright posture, and better mobility.¹

A 2005 randomized controlled study indicated that 24 one-to-one weekly training sessions in Alexander principles reduced motor symptoms and depression in people with Parkinson’s disease, and benefits were retained after a year.²

Other studies have found benefits of AT for elderly adults with arthritic knees and balance problems.³

The UK National Institute for Health and Care Excellence (NICE) suggest in their guidelines for non-pharmacological management of motor and non-motor symptoms that people with Parkinson's disease who are experiencing balance or motor function problems consider Alexander technique.

Carers may also benefit from the physical and emotional wellbeing associated with this method and may consider taking sessions or group classes for themselves. In a recent study of an AT-based course specifically designed for carers of people living with Parkinson's⁴, participants reported that they felt the increased self-awareness they developed from the course helped them recover personal control and agency, greater independence, calmness, and overall well-being.

References

1. Specific Postural Instructions Affect Axial Rigidity and Step Initiation in Patients With Parkinson’s Disease. Neurorehabilitation and Neural Repair 2018 Feb 09. Vol. 29(9); 878–888 – view abstract
2. Randomized controlled trial of the Alexander Technique for idiopathic Parkinson's disease. Clinical Rehabilitation 2002 Nov 01. Vol. 16(7); 695-708 – view abstract
   Retention of skills learnt in Alexander technique lessons: 28 people with idiopathic Parkinson’s disease. Journal of Bodywork and Movement Therapies 2005 Apr. Vol. 9(2); 150-157 – view abstract
3. Reductions in co-contraction following neuromuscular re-education in people with knee osteoarthritis. BMC Musculoskeletal Disorders 2016 Apr 27. Vol. 17(372) – read article
   Functional Reach Improvement in Normal Older Women After Alexander Technique Instruction. Journal of Gerontology 1999 Jan 01. Vol.54A(1); M8-Mll – view abstract
   “I never thought I could do that…”: Findings from an Alexander Technique pilot group for older people with a fear of falling. European Journal of Integrative Medicine 2017 Jan. vol. 17; 79-85 – view abstract
   Feasibility of Group Delivery of the Alexander Technique on Balance in the Community-Dwelling Elderly: Preliminary Findings. Activities, Adaptation & Aging, 2008 Oct 11. Vol. 32(2); 103-119 – view abstract
4. Alexander Technique Group Classes Are a Feasible, Cost-Effective, and Promising Intervention for Balance in Older Women – view poster.

We would like to thank Monika Gross and Rajal Cohen, PhD (The Poise Project, USA) for their help in reviewing this information.

• Videos about Alexander technique on The Poise Project Vimeo channel