A First Approximation: Effects of Feldenkrais lessons on Women with Breast Cancer
Monday, April 1, 2013
by: Lori Thompson Sweet, PT, GCFT

Section: Recovery

It was a calm spring afternoon when Guild Certified Feldenkrais Practitionercm (GCFP) Paulette Dolin, called me to share an inspired idea. From her experience working with clients, Paulette found that the Feldenkrais Method® was a helpful recovery tool for breast cancer patients. She wanted quantify what she was seeing. Being a Feldenkrais® practitioner myself, I was confident that Paulette was right, and as a physical therapist, I knew of measurement tools that could help us obtain data in the language and framework of the medical profession.

According to the Centers for Disease Control and Prevention, the second most common form of cancer in females, one in eight women will be diagnosed with the disease in her lifetime1. Many experience debilitating emotional, physiological and functional limitations as a result of breast cancer treatments. In this project, our purpose was to investigate whether or not the Feldenkrais Method could provide a valuable contribution to the treatment regime of women with breast cancer. We hypothesized that survivors would notice reduced pain, improved function (measurable and perceived), and improved range of motion in the affected arm after five Awareness Through Movement® (ATM®) lessons. Paulette suggested that we should use ATM lessons from Unbound!, a series created by Alice Brydges, GCFP, dancer and t’ai chi teacher, specifically for breast cancer survivors.

We cast a wide net for our student participants by contacting local support groups and medical practitioners for volunteers. Our final sample included 28 participants, ages ranging from 43 to 76 years old, who had received a broad range of medical treatments for their breast cancers.

Six San Francisco Bay area Feldenkrais® practitioners agreed to participate in the study. Their duties included performing the pre- and post-test measurements and teaching the ATM lessons. Measurements included the Disability of Shoulder and Hand Index (DASH), shoulder range of motion, and pain scale ratings. The DASH is a questionnaire that asks about symptoms as well as one’s ability to perform activities that include the use of the arm. Participants numerically rated their ability from “No Difficulty” to “Unable.” Some of the abilities measured include opening a new or tight jar, carrying a heavy object (over ten pounds), and playing a musical instrument (e.g., “Are you playing your musical instrument as well as you would like?”; “Are you spending your usual amount of time practicing?”). The practitioner-researchers worked with me as a group to learn how to use a goniometer, a tool that measures joint motion in angles for the purposes of  measuring range of motion (ROM) while reaching forwards and sideways with the arm. The DASH, range of motion, and pain scale ratings were taken by the practitioner leading the class at the start of the first lesson and after the end of the last lesson.

We did not know what to expect from our adventure. After a long group effort of number crunching and some volunteer time from a physical therapist pal who knows his statistics, we had our results. Using a statistical tool called the Pearson test, we found a positive correlation: As the students’ pain intensities dropped, their self-rated level of disability dropped. When we compared the pre- and post-DASH data, we found a reduction in disability measurements for the students. Therefore, our hypothesis was supported: Participants had measurable improvements in function as a result of their participation in classes. (Our range of motion data did not show any obvious patterns of change.)

We created a self-assessment report in order to gather qualitative information from our subjects regarding their perceptions of body image. One student noted that after the series “the right side is still stronger, but the two sides becoming more connected and more equal.” Another student stated, “I feel I am more….balanced.” Another student mentioned, “I am more flexible.”

One of our practitioner-researchers offered this reflection about her experience with the study: “What I can say is that the lessons with the six students I had were very meaningful. The women told me they had been given no hope of improving function after completing physical therapy. But as a result of the Feldenkrais study, all of them improved in range of motion, but the best of all was the change in attitude, and self-esteem.”

In summary, this pilot study gives us a possible starting point for our Feldenkrais community to delve deeper into the research of how our method can improve the comfort level and functional skills of women receiving breast cancer treatment. We hope that our “first approximation” will inspire others to take this to the next level as a possible topic for a more complete research project.

Thank you to the many people who helped create and complete this project- Paulette Dolin, Karen Poplawski, Jeanette Cosgrove, Charlotte Chavez, Cynthia Calmenson, Susan Miller, Deborah Norton, Manny Bakis, Peter Boffey, Pat Buchanan and our amazing, brave participants who were willing to help us all learn a little more about how the Feldenkrais Method may just have an important part in the role of recovery from breast cancer.


 by Pat Buchanan, PhD, ATC, PT, GCFT, Chair, Esther Thelen Research Committee

Alice Brydges, Guild Certified Feldenkrais Practitioner (1996), is a former professional dancer and long-time t’ai chi and chi gong instructor. Soon after graduating from her training, Alice was invited to teach t’ai chi and chi gong classes at the University of California, San Francisco, to cancer patients at Mt. Zion’s Cancer Resource Center. Despite it’s slow, mindful pace, she found her students were having difficulties with many of the t’ai chi movements, and—most especially—with the energy demands of remaining upright for  a significant period of time, due to exhaustion from chemotherapy.

“I knew I needed to get them inside and lying down on the floor—fast” says Alice. “So I transformed the class into an Awareness Through Movement-based class that could be taught in a variety of positions. Before I knew it, I had a completely new class, full of women in varying stages of recovery from mastectomies. It was a bit overwhelming, as I could only imagine what they were going through.”

One day after class, one of Alice’s students approached her to ask if she would consider creating a program for ALL women who were undergoing treatment for breast cancer, in order to experience the tremendous benefits of the Feldenkrais Method. “I immediately had the idea for “Unbound!” says Alice. “It went through my mind like a lightning-bolt….’Yes!!!  Audio lessons that women could do at home!’"

"We started the very next week, experimenting with lessons and specific portions of lessons to discover what movements and concepts were most beneficial. We went through dozens of lessons….the entire process took two years,” she recalls. “I learned sooooo much. It was a complete ‘Labor of Love’! I will forever be grateful to the wonderful, courageous women in my class. Without them, Unbound! would not have been possible. I am excited and honored to see where others are taking the work -- my program was presented at the Mayo Clinic a few years ago by fellow Feldenkrais Practitioner Lisa Walker—and I am delighted that the lessons served as a source of inspiration and provided the foundation for the intervention in this study. Let’s keep exploring!”
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