Improving balance and mobility in people over 50 years of age with vision impairments: Can the Alexander Technique help?

Abstract

A randomised controlled trial to determine the impact of the Alexander Technique on physical functioning in older adults with visual impairments is described. Successful fall prevention strategies in the general community designed to improve physical functioning have not reduced falls in this demographic to date, making this an important public health issue as the population ages. Older adults with visual impairments are vulnerable, and there is a need to identify acceptable and effective interventions for home-based delivery. The Alexander Technique uses verbal and tactile feedback to highlight previously unnoticed tension, and provides cognitive strategies to improve performance in everyday activities. Although there were no significant between group differences in the primary outcomes, improvements in some secondary outcomes and in the subgroup of multiple fallers, along with a trends for less total and injurious falls in the intervention group suggest an effect of Alexander Technique on physical functioning. Process evaluation suggested the intervention was acceptable but that dose may have been an issue, as the study only provided half the recommended number of Alexander lessons. The Alexander Technique is worthy of study in a larger trial powered to detect an effect on falls with the recommended number of lessons provided.