Proposed Trigeminy Draft Page
editTrigeminy continues to lack its own page in the electrophysiology pages. I've thought over what might be the best way to approach it, and it's probably a small article mostly referencing the Bigeminy page.
[to come, saving in case lose connection]
Proposed Edits to Feldenkrais Page
editThese edits are being proposed to the Feldenkrais Method page in light of a new systematic meta-review that provides updated findings regarding the method.
Here is a summary of some suggested changes to the page.
1) Definition without "proponents claim": Some statement about how proponents make unsupported and anecdotal claims is essential and I don't want to remove skeptical or negative statements about the method for POV reasons. Given that, I would rather, when possible, read up front what the evidence states rather than what proponents claim, it's more informative. So I propose minor alterations to the definitional content.
This paper defines Feldenkrais as
The Feldenkrais Method (FM) is a technique aiming at increasing personal self-knowledge through conscious movements, developed by the physicist Moshe Feldenkrais [1,2]. This method is based on the discovery and learning of varied, alternative patterns of movement and aims to improve the human ability to learn movement [3,4].
Frankly I don't love this definition, but I think an improved definition for the page would be something combining these, and retaining some of what is there. I propose
The Feldenkrais Method is a method of alternative exercise or physical therapy that aims to improve human movement performance by engaging in varied patterns of movement.
This doesn't claim improvements, only aims as recounted in secondary literature; and I think the facts that
- lessons consist of varied movement explorations
- lessons occur in both calisthenic and physiotherapy contexts
are well established.
2) Description of the verbal and manual modalities. Central to implementation of Feldenkrais is that it has two modalities, one verbally guided called Awareness Through Movement and one hands-on called Functional Integration. These are basic facts about how the method is done that make no scientific claims, and the article is right to mention these two modalities in its intro material. A similar sentence would improve the"Description" section.
3) Effectiveness
My reading of this paper is that a total of one finding, with well supported clinical implications, survived meta-analysis. Some other studies were too homogeneous to collectively apply meta-analysis to, although the authors report that a majority showed a significant, clinically informative finding. Finally, some studies showed significant improvements on some battery or other, but the clinical implications are unclear. I'll discuss each of these three categories briefly below:
3.1 Clinically significant improvement in Timed Up n Go Test survives meta-analysis
The finding that survived meta-analysis was an improvement on the Timed Up 'n' Go test which, in the elderly, is associated with a decrease in fall risk.
3.2 Majority of heterogeneous studies on certain topics showed significant improvements
Some topics had outcomes determined too heterogeneous for formal meta-analysis. On these authors report mixed outcomes with a majority showing significant improvement in these categories:
- pain intensity
- muscle complaints
- leisure disability (full disclosure, I have no idea what that means)
- perceived exertion
3.3 Some significant improvements on rubrics whose implications are unclear
Finally, the paper reported significant performance improvements on some rubrics, but there is insufficient support to make claims for what they mean. For example, there is also performance among MS patients on the timed up-n-go but there is limited evidence suggesting what particular benefit that improvement would have for MS patients.
These topics are all I have the time to work on. Below is a proposed edit to the top of page, considering all these factors:
The Feldenkrais Method
editThe Feldenkrais Method is a type of exercise therapy devised by Israeli Moshé Feldenkrais (1904–1984) during the mid-20th century. Participants are led through varied patterns of body movement, either hands-on or verbally guided, with the aim of improving motor performance .[1]
There is no reliable medical evidence that the Feldenkrais method improves medical outcomes[2] .There is limited evidence that the Feldenkrais method improves some quality-of-life related measures and performance on some motor coordination tests[1]. It is not known if it is safe or cost-effective,[2] but researchers do not believe it poses serious risks.[3]
Description
editThe Feldenkrais Method is a method of exercise or physical therapy that aims to improve human movement performance by engaging in varied patterns of movement[1]. According to David Gorski, the Feldenkrais Guild of North America claims that the Feldenkrais method allows people to "rediscover [their] innate capacity for graceful, efficient movement" and that "These improvements will often generalize to enhance functioning in other aspects of [their] life".[4]
Feldenkrais lessons have two modalities, one verbally guided and practiced in groups, called Awareness Through Movement and one hands-on and practiced one-to-one called Functional Integration[1].
Effectiveness and reception
editThe Feldenkrais method was found in a systematic review to significantly improve performance on the Timed Up n Go test, which is associated with decreased falls in elderly populations. A meta-review found mixed results on a some quality of life measures, with the majority of high-quality studies showing improvements in pain intensity, muscle complaints, leisure disability and perceived exertion.[1]
In 2015, the Australian Government's Department of Health published the results of a review of alternative therapies that sought to determine if any were suitable for being covered by health insurance; the Feldenkrais Method was one of 17 therapies evaluated for which no clear evidence of effectiveness was found.[2] Accordingly in 2017 the Australian government identified the Feldenkrais Method as a practice that would not qualify for insurance subsidy, saying this step would "ensure taxpayer funds are expended appropriately and not directed to therapies lacking evidence".[5]
The Feldenkrais Method is promoted with anecdotal claims it can help children with autism and other developmental disorders, but such claims are not backed by reputable supporting evidence.[6] Proponents claim that the Feldenkrais Method can benefit people with a number of medical conditions, including children with autism, and people with multiple sclerosis. However, no studies in which participants were clearly identified as having an autism spectrum disorder or developmental disabilities have been presented to back these claims.[7]
There is limited evidence that workplace-based use of the Feldenkrais Method may help aid rehabilitation of people with upper limb complaints.[8]
[end of proposed edits - if you have come over from the Feldenkrais page you can stop reading here]
editLinks for my own reference
editI find it hard to search for the internal Wikipedia links I need to refer to them futher so I put a few URLs here for myself.
MEDRS: https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)
Verifiability: https://en.wikipedia.org/wiki/Wikipedia:Verifiability
Identifying reliable sources (science): https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(science)
Biomedical information: https://en.wikipedia.org/wiki/Wikipedia:Biomedical_information
MEDDEF: https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)#Definitions
To do notes for myself:
editArrhythmia page:
- Long QT citation?
- Integration of Cardiac Monitoring topic?
- Flagging / revision of "Wireless ambulatory ECG" topic?
- ^ a b c d e Berland, Rémi; Marques-Sule, Elena; Marín-Mateo, José Luis; Moreno-Segura, Noemi; López-Ridaura, Ana; Sentandreu-Mañó, Trinidad (2022-10-22). "Effects of the Feldenkrais Method as a Physiotherapy Tool: A Systematic Review and Meta-Analysis of Randomized Controlled Trials". International Journal of Environmental Research and Public Health. 19 (21): 13734. doi:10.3390/ijerph192113734. ISSN 1661-7827. PMC 9657136. PMID 36360614.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ a b c Baggoley, Chris (2015). "Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance" (PDF). Australian Government – Department of Health. ISBN 978-1-76007-171-4. Archived from the original (PDF) on 18 August 2020. Retrieved 23 July 2020.
- See lay summary from Gavura, Scott (2015). "Australian review finds no benefit to 17 natural therapies". Science-Based Medicine. Archived from the original on 2015-12-22. Retrieved 2022-10-15.
- ^ Singh, Simon; Ernst, Edzard (2008). Trick or Treatment? Alternative Medicine on Trial. Bantam Press. p. 314. ISBN 978-0-59306-129-9.
- ^ Gorski D (6 August 2009). "M.D. Anderson enters the blogosphere–and goes woo". Scienceblogs—Respectful Insolence. Archived from the original on 6 May 2016. Retrieved 16 July 2016.
- ^ Paola S (17 October 2017). "Homeopathy, naturopathy struck off private insurance list". Australian Journal of Pharmacy. Archived from the original on 18 April 2021. Retrieved 11 January 2018.
- ^ "Treatment Intervention Advisory Committee Review and Determination" (PDF). Wisconsin Department of Health Services Autism and other Developmental Disabilities Treatment Intervention Advisory Committee. 28 April 2017. Archived (PDF) from the original on 17 November 2020. Retrieved 12 November 2020.
- ^ Collet-Klingenberg, Lana (October 31, 2014). "Treatment Intervention Advisory Committee Review and Determination" (PDF). Wisconsin Department of Health Services. Archived (PDF) from the original on 31 January 2017. Retrieved 2020-10-08.
In sum, it is the decision of the committee that Feldenkrais Theraphy does not have a study in which participants were clearly identified as having and autism spectrum disorder or developmental disability and no no authoritative bodies hace recognized the treatment as having emerging evidence...
- ^ Hoosain M, de Klerk S, Burger M (2018). "Workplace-Based Rehabilitation of Upper Limb Conditions: A Systematic Review". J Occup Rehabil (Systematic review). 29 (1): 175–193. doi:10.1007/s10926-018-9777-7. hdl:10019.1/103897. PMID 29796982. S2CID 44087712. Archived from the original on 21 April 2022. Retrieved 6 June 2022.
Workplace-based work hardening, case manager training and Feldenkrais should be implemented with caution, as only one study supported each of these interventions.