

































 Feldenkrais Research Journal  •  volume 7  (2025) 

 Systematic Review 

 The Effects of the Feldenkrais Method in the Area of Motor 
 Functioning – A Scoping Literature Review 

 Nicola Zollinger 
 BSc. Environmental Sciences, Feldenkrais Practitioner, Board Member SFV for Research, Education and 
 International Affairs 

 Contact:  nicolazollinger@feldenkrais.ch 

 Abstract 
 The Feldenkrais Method is a well-known somatic method, which uses sensorimotor learning processes to 
 improve a variety of human functioning. This scoping literature review focuses on the Feldenkrais Method 
 used to improve motor functioning and provides an overview of the quantitative literature published in this 
 area. Forty-one studies are included in this review, their study characteristics are summarized, and their 
 risk of bias assessed. Overall, the existing literature makes it seem plausible that the Feldenkrais Method 
 improves different aspects of motor functioning through principles of motor learning in different 
 populations for different conditions and aims. 

 Keywords 
 Feldenkrais Method, Motor Functioning, Motor Learning, Coordination, Functional Movement Patterns, 
 Functional Integration, Awareness through Movement, Balance, Range of Motion, Muscle Tone, 
 Breathing, Posture 

 Copyright ©:  The copyright for this paper remains  with the author(s). 

 Please cite:  (First published in the)  Feldenkrais Research Journal, volume 7  ; 2025. 

 Service marks:  The terms Feldenkrais  ®  , Feldenkrais Method  ®  , Awareness Through Movement  ®  , ATM  ®  , 
 Functional Integration  ®  , and FI  ®  are service marked  terms of the International  Feldenkrais  ®  Federation 
 (IFF) and Feldenkrais professional guilds and associations in many countries. In keeping with academic 
 conventions, they will not be service marked in the entire text as may be required in nonacademic use, 
 but only for the first and most prominent use of the terms. In recognition that these phrases are formal 
 terms referring to specific practices within the Method, and to the Method as a whole, capitalization of all 
 the words in each term has been retained. 

 Published by the International  Feldenkrais  ®  Federation  (IFF)  https://feldenkrais-method.org 
 Available online at  https://feldenkraisresearchjournal.org 

mailto:nicolazollinger@feldenkrais.ch
https://feldenkrais-method.org/
https://feldenkraisresearchjournal.org/


 Systematic Review 

 The Effects of the Feldenkrais Method in the Area of Motor 
 Functioning – A Scoping Literature Review 

 Nicola Zollinger 
 BSc. Environmental Sciences, Feldenkrais Practitioner, Board Member SFV for Research, Education and 
 International Affairs 

 Table of Contents 

 1. Introduction  p.3 
 2. Methods  p.4 
 3. Study Characteristics  p.5 
 4. Risk of Bias Assessment  p.10 
 5. Summary of the Studies  p.12 

 5.1 Mobility and Balance  p.12 
 5.1.1 Individuals with neurological conditions  p.20 

 5.2 Dexterity  p.22 
 5.3 Breathing  p.23 
 5.4 Posture  p.25 
 5.5 Muscle Tone  p.25 
 5.6 General Health Assessment  p.25 

 6. Discussion  p.26 
 6.1 Lack of Studies including Functional Integration  p.28 
 6.2 Possible Mechanisms of Action  p.29 
 6.3 Recommendations for Future Research  p.29 

 7. Conclusion  p.30 
 References  p.31 

 Appendices 

 Appendix 1 – Data Overview  p.39 
 Appendix 2 – Outcome Measurements  p.42 

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 1. Introduction 

 The Feldenkrais Method is a sensorimotor learning system and uses verbally and manually 
 guided exploration of movements to increase people’s self-awareness and to improve their 
 movement abilities (Stephens and Hillier 2020). The Feldenkrais Method is applied in different 
 domains, such as personal development, health, and in the performing arts (Russell 2020). The 
 wide field of application is due to the assumption that an improvement in sensorimotor 
 functioning also affects a person’s general well-being and can help with mental complaints as 
 well, by changing and completing a person’s self-image of action (Lyttle 1997: Russell 2020). 
 Moshe Feldenkrais (1904-1984), the founder of the Feldenkrais Method described conscious 
 human experience as consisting of the four elements ‘thinking’, ‘sensing’, ‘feeling’ and ‘moving’, 
 all of which are functions of the human nervous system and when a change in ‘sensing’ and 
 ‘moving’ is achieved, the patterns of ‘thinking’ and ‘feeling’ can also be altered (Feldenkrais 
 2011). The Feldenkrais Method is applied in two modalities: Verbally guided group sessions 
 called ‘Awareness through Movement®’ lessons and manually guided individual sessions called 
 ‘Functional Integration®’ lessons. 

 Several reviews and overviews have been done in the past, with the earliest systematic review 
 of a small number of studies by Ernst and Canter (2005), followed by a systematic review using 
 Cochrane Review methodology by Hillier and Worley (2015), and a review by Stephens and 
 Hillier (2020) which updated Hillier and Worley (2015) and provided a discussion of possible 
 mechanisms of action. Berland et al. (2022) performed a systematic review about the 
 Feldenkrais Method’s usage as a modality within physiotherapy practice and the most recent 
 systematic review by Martin et al. (2024) explored the potential of the Feldenkrais Method in the 
 realm of psychiatric care. In between there have been several limited overviews of the available 
 research literature (Buchanan 2012; Smyth 2016; Stephens 2007). The aim of this review is to 
 give a scoping review in the area of motor functioning, since improvement of motor functioning 
 is a primary and direct target of practicing the Feldenkrais Method and an important aspect in all 
 domains, in which the Feldenkrais Method is applied. By providing an overview and critically 
 assessing the risk of bias of all included studies, in addition to the existing reviews, this paper 
 proposes to shed light on  how  the Feldenkrais Method  was assessed in studies around motor 
 functioning up to now, to report on the study characteristics, the different research designs and 
 approaches, as well as the results. It also provides the interested reader with easy access to the 
 findings of the available literature in this area. The four research questions for this review were: 

 1)  What available studies exist which have assessed the effects of the Feldenkrais Method 
 in the area of motor functioning and what were their results? 

 2)  What were the study characteristics? 
 3)  What was the risk of bias of each study? 
 4)  What can be learned for future studies? 

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 How to read this review 

 This review begins with some information about how it was conducted, some general 
 characteristics of the studies (areas of research, populations, intensity and duration of 
 interventions), the two modes of Feldenkrais Method practice, and the basis of the risk of bias 
 assessment. Since this review gives a summary of 41 studies and is thus extensive in length 
 and scope, the table of content facilitates reading this review and gives readers who are looking 
 for specific studies and information a better and faster way to get oriented. For accessing all the 
 data of the studies and to identify single studies, please see the Appendices. In the narrative 
 description of each research study there is a description of the study purpose and design, 
 followed by ‘Findings’ and ‘Risk of Bias’ (identified by bold subheadings). This review finishes 
 with a discussion, including possible mechanisms of action, and recommendations for future 
 studies. 

 2. Methods 

 Type of Review 

 This review can best be conceptualized as a scoping review (Arksey and O’Malley 2005). This 
 review combines elements of a systematic review, by assessing the risk of bias, with elements 
 of a narrative review. Its aim is to give an overview of the research literature in the context of the 
 Feldenkrais Method used to improve motor functioning. It tracks the research development over 
 time, describes and summarizes the different studies, critically evaluates their risk of bias and 
 identifies research gaps in the existing literature. 

 Search Strategy and Selection Process 

 The literature research was performed using the following search engines and databases 
 between January 2021 and December 2022: Feldenkrais Zotero Research Database, Cochrane 
 Library, Scopus, Web of Science, Pubmed and Google Scholar. The following search words and 
 expressions were used: FELDENKRAIS, FELDENKRAIS METHOD, ATM, AWARENESS 
 THROUGH MOVEMENT, FI, FUNCTIONAL INTEGRATION. Additionally, all reference lists of 
 the studies found online were cross-checked for studies not found in the online databases. 

 Eligibility Criteria 

 In this review, all studies, except single case studies, were included which quantitatively 
 evaluated the effects of the Feldenkrais Method on an area of motor functioning as a main 
 outcome measure and were able to be found as full articles in digital or printed format. In total, 
 41 studies were assessed and included in this review (Figure 1). 

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 Figure 1. Flowchart for the study selection process 

 3. Study Characteristics 

 This section provides an overview of different characteristics of the included studies to get a 
 broader picture of how the effect of the Feldenkrais Method on motor functioning was assessed. 
 The complete table with all information can be found in Appendix 1 (Table 1, Parts 1 and 2). 

 Timeline Development 

 The first study found was published in 1977 (Gutman et al.). Whilst no studies were published in 
 the 1980s, nine studies were performed in the 1990s and eight studies from 2000 until 2009. 
 With 13 studies from 2010-2014 and seven studies between 2015 and 2019, the 2010s with 19 
 studies were the most active years in researching the Feldenkrais Method around motor 
 functioning until now. From 2020 until the end of 2022, three studies were conducted. 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  5 



 Figure 2. Timeline development of the number of 
 publications, which studied the effects of the 
 Feldenkrais Method on motor functioning 

 Overall, there is a weak trend towards an increase of the publication volume over time with the 
 most productive period from 2010-2014 (Figure 2). 

 Area of Study 

 Most studies reviewed looked at the effect on mobility in terms of range of motion (RoM) of a 
 body part around a joint or a fixed body point. Second, most studies looked at the effects of the 
 Feldenkrais Method on balance, mostly with elderly people to prevent falling (summarized in 
 Figure 3 below). In addition, two studies evaluated the effect on hand dexterity, two on 
 breathing, and two on posture. One study looked at the change of muscle tone following a 
 session in Functional Integration. Several studies combined measurements of different areas, 
 for example, seven studies also included measurements on quality of life and some studies 
 combined measurements in the category of mobility and balance. For an overview of the 
 different outcome measurements used in the different categories, see Appendix 2. 

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 Figure 3. Areas of study 

 Sample Populations 

 The sample size range was from very small (four participants) to large (>60), with most studies 
 having a sample size between 10 and 30 participants (Figure 4). Of the 41 studies, six studies 
 conducted a sample size calculation. The age-distribution shows a concentration of participants 
 between 20 and 30 years of age and over 60 years. Many studies were done with students in 
 university contexts, however another major focus for research has been the study of effects on 
 balance with an ageing sample population. (Cook et al. 2014; Hillier et al. 2010; Nambi et al. 
 2014). 

 Figure 4. Distribution of the number of subjects per study 

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 Figure 5. Frequency ratio symptomatic vs. healthy individuals 

 Twenty-five of 41 studies involved samples of healthy people with no illness or disability, while 
 16 studies had samples of symptomatic individuals (Figure 5). Thirty-two of the 41 studies 
 reported a mean age number and studies who reported a median figure were not included in the 
 histogram (Figure 6). 

 Figure 6. Age distribution of the different sample populations 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  8 



 Duration, Sessions, and Intensity 

 This section provides information about the duration of the interventions, the number of 
 sessions per study and how often per week a session was performed. This information gives 
 orientation for researchers who are planning a future study and are asking themselves how long 
 and how intense the intervention should be and what has been studied up to now (Figure 7). 

 Figure 7. Overview of study durations 

 The study duration ranged from one week to 30 weeks with most studies looking at sessions 
 conducted within one week. When looking at the number of sessions (Figure 8), most studies 
 looked at the effect of 7-8 sessions, but also seven (7) single-session studies were conducted. 
 The intensity (sessions/week) was low in most studies, with 1-2 sessions per week in 30 of 39 
 studies (two studies did not include information on session-intensity) (Figure 9). 

 Figure 8. Number of studies showing different numbers of practice sessions 

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 Figure 9. Overview of the intensity of practice per study, measured as sessions per week 

 Awareness Through Movement or Functional Integration 

 Even though the Feldenkrais Method consists of two parallel modalities, individual sessions in 
 Functional Integration and group sessions in Awareness Through Movement, only two of the 41 
 studies looked at the effectiveness of Functional Integration. This means that studies which 
 investigated the effect of personal sessions of the Feldenkrais Method to improve motor 
 functioning are largely underrepresented in the literature. 

 Follow up and Sample Size Calculation 

 Two of the 41 studies included follow-up measurements (Causby et al. 2016; Kang et al. 2021) 
 and six of the 41 studies performed a sample size calculation prior to the study. 

 4. Risk of Bias Assessment 

 Risk of bias of all the studies was assessed using several different methodologies. These were: 

 1) The 2011 Oxford CEBM Levels of Evidence, 
 2) PEDro-Scale for randomized controlled trials, 
 3) The ROBINS-I assessment tool for non-randomized studies of interventions. 

 The Oxford CEBM levels of evidence range from level 1-5 (2016). Since there were no 
 systematic reviews (level 1) and no articles about mechanistic reasoning included (level 5), the 
 studies were graded from level 2 to level 4. Randomized controlled studies are classified as 
 level 2, non-randomized controlled studies as level 3 and non-controlled studies as level 4. For 
 randomized controlled studies (level 2), the PEDro-Scale (Hegenscheidt et al. 2010) was used 
 to further assess their quality and for non-randomized controlled studies, the ROBINS-I 

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 assessment tool was used to evaluate the risk of bias (  www.riskofbias.info  , n.d.) A decision tree 
 was established to make the different studies comparable in their risk of bias, which led to the 
 creation of five different categories of risk of bias: ‘Very low’, ‘low’, ‘moderate’, ‘serious’ and 
 ‘critical’ (Figure 10). Randomized controlled studies with a PEDro-Score of 7 or higher were 
 given the label ‘very low’ and the ones with a PEDro-Score lower than 7 were given the label 
 ‘low’. The cut-off score of 7 for a ‘very low’ risk of bias was chosen, because it is suggested in 
 the literature that studies with a PEDro-Score of 6-8 describe a good-quality study (Maher et al. 
 2003). Non-randomized controlled studies could, depending on their ROBINS-I assessment, be 
 classified as low, moderate, serious or critical, according to the ROBINS-I-Tool assessment 
 (Sterne et al. 2016). Non-controlled studies were given the label ‘critical’. The PEDro-Score of 
 each study can be found in Table 1, Part 2 in Appendix 1. 

 Figure 10. Risk of bias decision tree 

 The quality of the studies in terms of risk of bias, ranged from ‘very low’ to ‘critical’. Figures 11 
 and 12 show the number of the different studies in each risk of bias category for the OCEBM 
 classification and the categories defined by the decision tree. In the ‘Summary’ section, the risk 
 of bias category is added at the end of each study description, for the reader to critically put into 
 perspective the results of a study. For one study (Buchanan and Vardaxis 2000), it was not 
 possible to assess its risk of bias, due to lack of information. 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  11 

http://www.riskofbias.info/


 Figure 11. Pie chart of levels of evidence 
 by OCEBM 

 Figure 12. Pie chart levels of evidence 
 by decision tree 

 5. Summary of the Studies 

 The aim of this section is to give a comprehensive overview and to present the studies and their 
 results that assessed the area of motor functioning. To improve readability, this section is 
 subdivided into the following sub-categories: ‘Mobility and Balance’, ‘Posture’, ‘Hand Dexterity’, 
 ‘Breathing’, ‘Muscle Tone’ and ‘General Health Assessment’. Within each sub-category the 
 studies are presented and described along with their year of publication. 

 5.1 Mobility and Balance 

 Out of the studies included for this review, the vast majority, 22 out of 41 studies, investigated 
 the effect of Feldenkrais Awareness through Movement (ATM) lessons on some aspects of 
 mobility and balance. 

 The first study, done by  Gutman et al. (1977)  was  a non-randomized controlled trial with a 
 healthy sample of 38 ageing participants, which compared the effects of a six-week Feldenkrais 
 Method lesson program (three hours per week) to no intervention and to a conventional 
 exercise program for the elderly.  Findings:  There  were no significant differences between the 
 groups, but the Feldenkrais Method lesson group improved in all measures, which included 
 rotational flexibility, balance, self-perceived health status and number of body parts painful or 
 difficult to move.  Risk of bias:  Serious 

 In  1991, Brown and Kegerreis  performed a randomized-controlled  study to test the difference 
 of one Awareness Through Movement lesson on a flexion task with 21 young and pain free 
 participants. Elements of kinesthetic awareness, imagery and visualization, as well as cues 
 pertaining to lightness, comfort and ease were excluded in the control group and the lesson only 
 included movement instructions. Electromyographic activity of the flexor and extensor muscles 
 along with perceived level of effort were compared pre- to post-intervention in both groups. 
 Findings:  No significant changes were found between  the groups, but within both groups there 

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 were significant changes in flexor EMG activity and in perceived exertion ratings. This study 
 suggests the Feldenkrais Method may achieve its intended goal of facilitating movement with 
 less effort and greater flexibility. It also suggests that the Feldenkrais Method may produce a 
 perceptual recognition of a physiological change in muscular activity that is not the direct result 
 of the use of suggestion, imagery, or visualization. A change was produced in the amount of 
 muscular activity required to perform a movement task.  Risk of bias:  Low 

 A randomized controlled study done by  Ruth and Kegerreis  (1992)  looked at the effect of one 
 single Awareness Through Movement lesson in 30 healthy participants on the range of motion 
 of active neck and head movements and the accompanying perceived effort compared to a 
 control group with no intervention.  Findings:  The  experimental group showed significant 
 improvements in range of motion and perceived effort, compared to the control group. This 
 study provides data that support assertions that immediate physical and perceptual changes 
 can be affected with the use of Feldenkrais Method Awareness Through Movement sequences. 
 Risk of bias:  Low 

 A randomized controlled study by  Chinn et al. (1994)  looked at the effect of a single 
 Feldenkrais Method Awareness Through Movement intervention on a functional reach task on 
 23 participants with upper back, neck, or shoulder discomfort. In the functional reach task, 
 subjects were lying supine and reaching up along a wall. Participants rated the level of 
 perceived exertion pre- and post-treatment on a visual analog scale (VAS). The control group 
 followed a sham intervention, consisting of tape-recorded instructions of general upper body 
 exercises.  Findings:  Results showed significant reduction  in exertion for the Awareness 
 Through Movement group and no significant difference in exertion for the sham treatment group. 
 In both groups, there were no significant increases in the functional reach measurement. The 
 authors concluded that a single Feldenkrais Method intervention produced positive effects in 
 participants with upper back, neck and/or shoulder discomfort.  Risk of bias:  Low 

 Hall et al. (1994)  compared in a randomized controlled  trial with 60 participants the effects of 
 Feldenkrais Method Awareness Through Movement group classes to Tai Chi classes, and to a 
 no intervention control group on balance in healthy older women. The Feldenkrais Method and 
 Tai Chi group both attended a total of 32 sessions, with two sessions per week for 16 weeks. 
 Findings:  The Feldenkrais Method group improved significantly  in the Falls Efficacy Scale 
 (FES), the Berg Balance Test, the Timed Up and Go Test, and the Pro Balance Master Test. 
 There were no significant changes in the control group with no intervention. The Tai Chi group 
 improved significantly in several outcome measurements as well. The improvement of 
 movement times in the Pro Balance Test for the Feldenkrais Method group indicates that 
 participants were quicker to respond and correct their balance, once they are outside their base 
 of support. According to the authors, both Tai Chi and Feldenkrais Method classes are suitable 
 to promote health and balance in this age group.  Risk  of bias:  Low 

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 Brown et al. (1996)  evaluated the effect of Awareness Through Movement lessons on the 
 mobility of a healthy elderly sample with 23 participants in a non-randomized controlled study. 
 The experimental group took part in three Awareness Through Movement lessons per week for 
 six weeks. The control group received no intervention.  Findings:  The Awareness Through 
 Movement group showed significant improvements in right ankle dorsiflexion and in the Timed 
 Up and Go test. No significant improvements were found in the functional reach test and other 
 active range of motion measurements. Whilst participants did not show a significant change in 
 the Dartmouth COOP measures of perceived functioning and health, 10 out of 12 participants 
 showed improvement in their scores from pre-exercise to post-exercise.  Risk of bias: 
 Moderate 

 James et al. (1998)  investigated the effects of a  Feldenkrais Method Awareness Through 
 Movement program and relaxation procedures on hamstring length measured by knee 
 extension. In a randomized controlled trial, 48 healthy undergraduate students were randomly 
 allocated to either Feldenkrais Method lessons, relaxation, or a control group with no 
 intervention. Participants in the Feldenkrais Method and relaxation group participated in four 
 45-minute lessons over a two-week period.  Findings:  No significant effects were found between 
 groups and even though there was a trend present for the Feldenkrais Method group for an 
 increase in hamstring length, the degree of change was not statistically significant. The authors 
 questioned whether a test like the active knee extension test, which measures hamstring length 
 in relative isolation is an appropriate way to assess the effectiveness of the Feldenkrais Method, 
 since it is suggested that the Feldenkrais Method improves functional movement patterns, 
 rather than single-joint action.  Risk of bias:  Very  low 

 In a similar study,  Hopper et al. (1999)  measured  the effect of a single Awareness Through 
 Movement lesson for participants, with and without prior experience of the Feldenkrais Method, 
 as well as the effect of four lessons over a two-week period on hamstring length, flexibility, and 
 perceived exertion. In studying the effect of a single Feldenkrais Method lesson for those with 
 no prior experience, 75 healthy participants were randomly allocated to either the Feldenkrais 
 Method group or the control group. The participants in the control group listened to relaxing 
 music for 45-minutes, whereas the Feldenkrais Method group performed the lesson 
 “Lengthening the hamstrings and spine” by Frank Wildman. Findings: Participants in the 
 Feldenkrais Method group improved significantly in sit and reach measurements after one 
 lesson, but their counterparts in the control group did not. No significant effects were found in 
 perceived exertion and in the active knee extension test after one lesson with no prior 
 experience. After four lessons, both the experimental and control group showed significant 
 improvements in the sit and reach measurements over time. For perceived exertion, the 
 Feldenkrais Method group experienced significantly less exertion during the sit and reach test 
 across all measurement times. No significant differences between groups were found for the 
 modified active knee extension measurements. The authors argued that their research provides 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  14 



 support that the Feldenkrais Method works by providing alternative motor patterns (Bate 1994) 
 and new methods of muscle recruitment to improve functional movements.  Risk of bias:  Low 

 Buchanan and Vardaxis (2000)  measured the effects  of eight Feldenkrais Awareness Through 
 Movement group lessons over two weeks on balance during standing, in a non-randomized 
 controlled design. The sample consisted of 20 adult, injury-free women. An AMTI force plate 
 was used to measure several characteristics in standing.  Findings:  The center of pressure 
 distribution (COP) changed within the Feldenkrais Method group from elliptical to circular. This 
 was achieved by decreasing the extreme excursions in the medial-lateral and anterior-posterior 
 direction in sway, thus suggesting that the Feldenkrais Method can improve balance and 
 postural control in standing.  Risk of bias:  Not enough  information 

 To study the effect of sensory-imagery in a Feldenkrais Method Awareness through Movement 
 lesson on mobility,  Dunn and Rogers (2000)  had 12  healthy participants listen to a 30-minute 
 guided sensory-imagery lesson, in which only one side of the body, the left side was imagined to 
 be brushed with a soft bristle over different body segments and the right side served as a 
 control. To test the differences between the two sides, participants were asked to perform a sit 
 and reach test, with one foot’s sole resting at the inside of the opposite knee and the other leg 
 stretched out against the upright side of a box. Like this, the forward-bending mobility was 
 measured for each side.  Findings:  Results showed that  the side that was actively imagined 
 during the sensory exercise, felt lighter and longer for most participants after the guided lesson 
 (two participants reported that the opposite side from that which they worked on felt lighter and 
 longer). For 10 out of 12 participants there was a significant increase in forward flexion on that 
 side. The authors concluded that exercises directed to sensory responses could be beneficial 
 for the enhancement of functional movement.  Risk of  bias:  Low 

 Stephens et al. (2005)  studied the effect of 10 Awareness  Through Movement lessons 
 undertaken within two days, on coordination, economy of movement and general health in a 
 healthy elderly population with 31 participants. The study was a non-randomized controlled 
 study (using a convenience sample) and the participants were between the ages 68 and 89 and 
 healthy. There was no intervention in the control group. In their data analysis, Stephens et al. 
 divided the participants into two groups, one “young/old” (under 78 years old) and an “old/old” 
 group (78 and over).  Findings:  In the results of the  coordination task (supine to stand), they 
 observed significant changes as an interaction of group x age x time. In both measures, 
 movement time and movement units, there was a significant decrease in the younger group and 
 an increase in the older group. This result is quite puzzling, since both age groups in the 
 experimental group reported that the supine to stand task became easier after the Awareness 
 Through Movement lessons. The authors suggest that the older group realized that they could 
 move more slowly and carefully in a complex movement, that is unfamiliar for most 
 80-year-olds. No significant changes were observed in the economy of movement task. There 

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 was a significant improvement in the vitality and mental health scores in the experimental group. 
 Risk of bias:  Moderate 

 Stephens et al. (2006)  conducted a randomized controlled  study, where they measured the 
 effect of Awareness Through Movement lessons on an active knee extension test in a healthy 
 sample of 33 individuals. There was no intervention in the control group. Participants in the 
 Awareness Through Movement lesson group were asked to perform a 15-minute Awareness 
 Through Movement session five times a week during a three-week period, guided by an 
 audiotaped Awareness Through Movement lesson sequence. The lesson consisted of variations 
 of movements, requiring lengthening of the hamstring muscle in different postural 
 configurations.  Findings:  Even though the effectively  practiced session ranged between 8 and 
 15 minutes and the total minutes of practice ranged from 80 to 300, a regression analysis 
 showed no significant effect on hamstring length change in the Awareness Through Movement 
 group as a result of number of practice sessions, total number of practiced minutes or the 
 amount of delay between the last practice session and the final measurement. Overall, the 
 Awareness Through Movement group gained significantly more hamstring muscle length, 
 compared to the control group, with a mean number of 11 sessions and 177 practiced minutes. 
 Risk of bias:  Low 

 In a large randomized controlled study with 55 participants,  Vrantsidis et al. (2009)  studied the 
 effectiveness and acceptability of Feldenkrais Method Awareness Through Movement lessons 
 to improve balance in a healthy elderly sample. The intervention consisted of a twice-weekly 
 group class over eight weeks. There was no intervention in the control group. The Awareness 
 Through Movement classes were part of the “Getting Grounded Gracefully” program, which is 
 designed to specifically improve balance in a variety of postural configurations.  Findings:  There 
 was a significant change in the Modified Falls Efficacy Scale for the intervention group, a 
 significant improvement in gait speed and a non-significant improvement in the timed up-and-go 
 test. These results all suggest some improvement in dynamical balance in the intervention 
 group compared to the control group. This is one of the few studies which conducted a sample 
 size calculation prior to the study and who blinded assessors. The authors conclude that even 
 though the study was underpowered to detect a clinically meaningful change, these results and 
 the positive participant feedback on the Feldenkrais Method classes warrant further research on 
 the Feldenkrais Method to improve function and balance in older people.  Risk of bias: 
 Very Low 

 In  2010, Hillier et al.  tested the effects of Feldenkrais  Method classes compared to a control 
 group, who participated in a generic balance class. Twenty-two individuals of a healthy, ageing 
 population self-selected one of the two classes, without being aware of which class they chose. 
 The study was described as a pseudo-randomized controlled trial. Both classes were held once 
 per week for eight weeks.  Findings:  The results showed  significant improvements in both 
 classes for the Patient Specific Functional Scale (PSFS) and the Functional Reach Test (FRT). 
 Only the Feldenkrais Method group improved significantly in the single leg stance test (SLS). 

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 Neither the Feldenkrais Method group, nor the balance class reached significance for the Timed 
 Up-and-Go test and the Walk on the Floor with Eyes Closed (WOFEC) measurement.  Risk of 
 bias:  Low 

 In a similar, randomized controlled study in  2010,  Ullmann et al.  studied the effects of a 
 five-week (60 min, three times per week) Feldenkrais Method lesson program on mobility and 
 balance in a healthy, ageing sample with 47 participants (mean age 76 years). There was no 
 intervention in the control group. The outcome measures were balance (tandem stand), mobility 
 (timed up-and-go), gait characteristics, balance confidence and fear of falling.  Findings: 
 Balance and mobility increased significantly in the Feldenkrais Method group, and fear of falling 
 decreased significantly. The authors concluded that the Feldenkrais Method exercises offer an 
 effective way to improve balance and mobility in older adults.  Risk of bias:  Low 

 Heister (2010)  looked at the effects of Awareness  Through Movement lessons on different 
 samples of athletes, including 30 individuals. It was a pre-post study design with no control 
 group. The three different subgroups were ageing athletes above 30 years of age, professional 
 athletes consisting of girls between 10-14 years who train in gymnastics for 15-25 hours a week, 
 and a group of disabled athletes with impaired vision. The intervention took place during 2 x 1 
 hours for four weeks. Outcome measure was a self-assessment questionnaire, asking about the 
 self-perception during a single-leg stance with eyes closed on each leg.  Findings:  The author 
 reported significant improvements in the feeling of stability, shoulder tension and freedom of 
 breath in all subgroups and in the number of equalizing movements in most subgroups.  Risk of 
 bias:  Critical 

 Connors et al. (2011)  also studied the effects of  a Feldenkrais Method program to improve 
 balance in older adults in a non-randomized controlled study with 63 participants. The 
 Awareness Through Movement classes of the “Getting Grounded Gracefully” program were 
 conducted twice a week for one hour for 10 weeks. There was no intervention for the control 
 group.  Findings:  The Feldenkrais Method group showed  significant improvements at re-testing 
 on all measures, including the activities specific balance confidence questionnaire (ABC), the 
 Four-Square Step Test (FSST) and self-selected gait speed. The Feldenkrais Method class was 
 thought by the authors to enable a freer gait style, resulting from improved balance confidence 
 due to greater intersegmental control between the lower limbs, pelvis, trunk, and head.  Risk of 
 bias:  Moderate 

 Bellafiore et al. (2012)  looked at the influence of  Feldenkrais Method classes on spine health in 
 professional orchestral musicians in a randomized controlled trial with a small sample (n=17). 
 There was no intervention in the control group. The experimental group took part in two hours of 
 Awareness Through Movement classes per week for four weeks.  Findings:  There was no 
 significant effect detected on muscle fitness and flexibility of the spine, measured by a sit and 
 reach and trunk lift test. There was a positive trend in both measures in participants in the 
 Feldenkrais Method group and a slight worsening in the control group, suggesting that the 

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 Awareness Through Movement classes prevented a worsening of these abilities. The authors 
 mentioned that the absence of a significant effect might be due to the small sample size and the 
 brief length of intervention.  Risk of bias:  Low 

 In a 2012 study,  Khurana et al.  investigated the effect  of Feldenkrais Method group classes on 
 hamstring lengthening in a non-controlled study with young, healthy individuals (n=25). The 
 study mentions that Feldenkrais Method classes were given for 15 consecutive days, but no 
 information about the duration of the exercises is given in the text.  Findings:  Even though the 
 study mentions an angle increase in the 90-90 Single Leg Raise test (SLR), no information is 
 given about whether this increase was significant or clinically meaningful.  Risk of bias: 
 Critical 

 A randomized controlled trial by  Bipinbhai (2013)  compared the effectiveness of the Alexander 
 Technique, the Feldenkrais Method, and conventional balance exercises to improve balance in 
 older adults with balance problems. Each of the three groups consisted of 15 individuals and 
 received lessons for five days in a week for one month.  Findings:  The Feldenkrais Method 
 group improved significantly in the assessment with the Berg Balance Scale (BBS) and the 
 Functional Reach Test (FRT) in standing. Compared to the conventional exercises, the 
 Feldenkrais Method group improved balance significantly more, when assessed with the FRT in 
 standing and the BBS. The study overall suggests that all three groups showed significant 
 improvement in some balance measures. Between group comparison suggests that the 
 Alexander Technique group and the Feldenkrais Method group improved balance more than 
 undertaking conventional exercises. While comparing the Feldenkrais Method group and the 
 Alexander Technique group, there was no significant difference in improving the balance in older 
 adults.  Risk of bias:  Very low 

 In  2013, Webb et al.  investigated the effect of Feldenkrais  Method Awareness Through 
 Movement classes on people (n=15) with osteoarthritis. The study was a prospective study with 
 pre- and post-measure, but no control group. The classes were held twice per week for 30 
 weeks.  Findings:  The participants improved in the  Four-Square Step Test (4SST) and 
 kinematic analysis showed a decreased anterior pelvic tilt, which reduced the forward inclination 
 of the trunk and reduced loads and the low back when walking. A major limitation of the study 
 was that there was no control group and that no information is given as to whether the results 
 were significant.  Risk of bias:  Critical 

 Cook et al. (2014)  performed a non-randomized controlled  study, to investigate the effect of a 
 Feldenkrais Method intervention on balance and gait in healthy women between the ages of 40 
 and 80 (n=46). The intervention was short, with one to two classes during five consecutive days. 
 Findings:  The results showed significant improvements  in quality of life, balance confidence, 
 and gait characteristics, but there were no improvements in a two-footed balance test with eyes 
 closed. The authors concluded that since it is not likely that physical properties of the muscles 

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 and tendons changed during five days of intervention, that the effects were due to changes in 
 neurological control of the muscles.  Risk of bias:  Serious 

 A randomized controlled study by  Nambi et al. (2014)  compared the effects of Feldenkrais 
 Method lessons and Pilates classes to a control group in an ambulatory geriatric population 
 (n=60). Each group had 20 participants and all groups completed six weeks of intervention with 
 three sessions per week. The control group received instructions to warm up, walk for 12 
 minutes and cool down afterwards. The outcome measurements included the Functional Reach 
 Test (FRT), Timed Up-and-Go test (TUG) and dynamic gait index for functional balance. Quality 
 of life was also measured at baseline and after six weeks of training.  Findings:  The results 
 showed significant improvement in functional balance and quality of life, both in the Feldenkrais 
 Method and the Pilates group, but not in the control group. The authors concluded that both 
 Pilates classes and Feldenkrais Method lessons are effective in improving functional balance 
 and decreasing propensity to fall in an ambulatory, geriatric population.  Risk of bias: 
 Very low 

 Maddali-Bongi et al. (2017)  performed a pilot study  to assess the effects of Feldenkrais 
 Method group sessions on patients with Ankylosing Spondylitis. There was no control group and 
 only descriptive statistics was performed. Ten patients visited a total of 10 sessions, twice per 
 week. Additionally, patient-tailored home exercises, chosen by the therapist, were performed 
 daily for 30 minutes.  Findings:  The study results  showed improvements in pain, fatigue, global 
 health status and lumbar and cervical mobility. The authors conclude that the results are 
 promising, but should be validated with larger, randomized controlled studies.  Risk of bias: 
 Critical 

 Palmer (2017)  studied the effects of Feldenkrais Method  lessons to improve healthy older 
 adults’ awareness, comfort, and function. The study design was a non-randomized controlled 
 trial with blinded assessors and 87 participants. To compare the effect of lesson intensity, the 
 experimental group was divided into two subgroups, of which one took 12 lessons in six weeks 
 and the other in 12 weeks. There was no intervention in the control group. Outcome measures 
 included Tandem Stance, Functional Reach Test, Timed Up and Go and the OPTIMAL survey 
 for self-reported changes in activities. The analysis method allowed for correlation analysis 
 between number of attended lessons and outcome measurements, since the number of visited 
 lessons differed individually (with a minimum of eight lessons).  Findings:  Results showed a 
 significant correlation between the number of lessons visited and the improvements in 
 Functional Reach and in the OPTIMAL survey for the experimental group. There was also a 
 significant improvement compared to the control group in the OPTIMAL survey for self-reported 
 changes in activities, but there was no significant difference between the experimental and 
 control group in the other outcome measures. Also, it seemed that it is not the density of the 
 sessions which is important, but the total number of visited lessons, since the six and the 
 12-weeks group experienced similar improvements.  Risk  of bias:  Moderate 

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 In a randomized controlled trial,  Torres-Unda et al. (2017)  investigated whether Feldenkrais 
 Method group classes improve functioning and body balance in middle-aged people with 
 intellectual disability (ID) (n=32). The experimental group received 30 Awareness Through 
 Movement lessons, with one lesson per week while the control group did not receive any 
 movement intervention. Physical functioning was assessed with the Short Physical Performance 
 Battery (SPPB) and balance by a stabilometry test. The SPPB is a composite score of 
 performance (0–12) based on three functional tasks: walking speed, chair rise test, and 
 standing balance (Guralnik et al. 1994).  Findings:  After 30 Awareness Through Movement 
 classes, the experimental group significantly improved their chair rise test score, their total 
 SPPB score, and significantly reduced their sway area in the stabilometric test. There was also 
 a significant interaction between group and time for the SPPB total score, meaning that 
 individuals in the experimental group improved their functioning more than controls. The 
 improvement of the SPPB total score for the experimental group was considered clinically 
 meaningful. Overall, these findings indicate that individuals with intellectual disability 
 significantly improved their physical functioning by participating in a Feldenkrais Method 
 intervention and that the Feldenkrais Method could be a good tool for the prevention of loss of 
 functioning and body balance in middle-aged individuals with intellectual disability.  Risk of bias: 
 Low 

 5.1.1 Individuals with neurological conditions 

 Seven studies within the category of mobility and balance were conducted with symptomatic 
 individuals having a neurological condition. 

 In a multiple case study,  Stephens et al. (1999)  looked  at the effect of 10 Awareness Through 
 Movement classes over 10 weeks on four women with multiple sclerosis (MS). Outcome 
 measures included the fatigue severity scale, index of wellbeing, motion analysis of gait and 
 supine to stand task.  Findings:  The primary outcome  result was an increased sense of 
 wellbeing, and improvement of balance and control of movement.  Risk of bias:  Critical 

 In a randomized controlled trial with a crossover design,  Johnson et al. (1999)  studied the 
 effect of eight individual Functional Integration (FI) sessions on 20 individuals with multiple 
 sclerosis. One half of the group received Functional Integration sessions, while the other half 
 received a sham intervention, where the practitioner moved clockwise around the table and 
 lightly laid his hands on different body parts. The sham intervention was designed to control for 
 effects of attention, touching and the personality of the practitioner. When asking the participants 
 whether they noticed the difference between the two interventions, all participants reported that 
 they noticed a difference and reported the Feldenkrais Method sessions as being more 
 effective. The outcome measures included tests for hand dexterity, MS performance scales and 
 questionnaires on psychological variables such as perceived stress, anxiety, and depression. 
 Findings:  The results showed no effect of the Feldenkrais  Method and sham sessions on MS 
 symptoms, levels of functional ability, and upper extremity performance. There was a significant 

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 difference for perceived stress and lowered anxiety after Feldenkrais Method sessions, but not 
 after the sham intervention. The authors conclude that the greatest treatment effect was on 
 psychological variables and that the importance of this cannot be underestimated, since stress 
 has been implicated in both onset and disease activity in MS.  Risk of bias:  Very low 

 Another study by  Stephens et al. (2001)  investigated  the effect of Awareness Through 
 Movement classes on people with MS in a randomized controlled design with a small sample 
 size (n=12). While the Awareness Through Movement group participated in eight Awareness 
 Through Movement classes, with a total of 20 hours during a 10-week period, the control group 
 participated in four 90 minute educational classes.  Findings:  The results showed a significant 
 improvement in the Feldenkrais Method group for balance and balance confidence. The authors 
 suggest that Awareness Through Movement classes incorporate basic principles of balance 
 training and combine it with kinaesthetically based, exploratory movements.  Risk of bias: 
 Low 

 A randomized controlled study by  Teixeira-Machado  et al. (2017)  looked at the effects of 50 
 sessions, done twice per week, in Feldenkrais Awareness through Movement classes to 
 improve motor functionality in Parkinson’s disease (PD). Thirty participants with PD were divided 
 into an experimental and a control group. The control group received educational lectures 
 during the experimental period. Outcome Measurements included a Timed-up-and-go test, 
 rollover task, 360-Degree turn-in-place task, functional-reach test, sitting-and-standing test, 
 Berg balance scale and hip-flexion strength test.  Findings:  The Feldenkrais Method Group 
 significantly improved in all measures when compared to before treatment, but also when 
 compared to the control group. The authors conclude that the Feldenkrais Method helps 
 patients with PD to improve motor functioning, without neglecting the emotional wellbeing.  Risk 
 of Bias:  Very low 

 A non-controlled study by  Kang et al. (2021)  analyzed  the effect of a dance intervention using 
 the Feldenkrais Method on motor and non-motor symptoms in nine participants with Parkinson’s 
 Disease (PD). The participants visited an Awareness Through Movement class once per week 
 during a six-month period. This is the only study analyzed for this paper, which conducted a 
 follow-up measurement after six months of the end of the intervention.  Findings:  The results 
 showed significant improvement in gait velocity and step length between three and six months, 
 but then worsened again until the follow up measurement. Mobility, as measured by the Tinetti 
 scale, decreased significantly during the intervention period. The Parkinson’s Disease Quality of 
 Life test showed a significant improvement after six months, but after 12 months, there was no 
 more effect being observable. The authors discuss several study limitations, such as small 
 sample size, no correction for type 1 error, and no control group.  Risk of bias:  Critical 

 A two-armed, randomized controlled pilot study, by  Serrada et al. (2022)  studied whether body 
 awareness training with the Feldenkrais Method can improve recovery following a stroke. 
 Participants (n=20) had a diagnosis of a stroke (three months to six years ago) and were 

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 randomly assigned to either the experimental or control group. The experimental group took part 
 in two face-to-face lessons of 45-minutes each week for 10 weeks while the control group 
 listened to recordings in their home with the same lessons. In comparison to the home-based 
 group, the class-based group reported greater acceptance and perceived effects, as well as the 
 likelihood to continue practicing the Feldenkrais Method after program completion. The 
 importance of the therapist and a connection with others for feedback, company and 
 socialization, comparison, and motivation were of utmost importance for the class-based group. 
 Findings:  Pre- and post-intervention measures showed  significant improvements in the 
 class-based group compared to the home-based group in arm and leg motor impairment scales, 
 body awareness and quality of life. The improvements in arm and leg motor functioning and 
 quality of life are clinically meaningful according to the authors. The home group took longer to 
 complete (13 – 25 weeks) and had reduced adherence, perhaps reflecting the effect of 
 peer-group versus individual motivation. Participants drop-out and withdrawal rate although low 
 and equally distributed between groups was an issue. The important clinical messages were 
 reported as the following: 1) Body awareness classes are feasible and safe for people in chronic 
 phase after a stroke. 2) Functional movements and directed attention develop a better 
 understanding of the ‘new’ body after stroke. 3) Improved body awareness may provide benefits 
 in recovery after stroke. 4) Peer support and group interaction may be beneficial for recovery. 
 Risk of bias:  Low 

 5.2 Dexterity 

 Two studies were performed investigating the effects of Feldenkrais Awareness Through 
 Movement lessons on hand dexterity. 

 A very well-designed, double-blinded randomized controlled study with healthy students (n=29) 
 by  Bitter et al. (2011)  evaluated the effect of a  single, two-hour, Feldenkrais Method sensory 
 awareness lesson for hand dexterity. The outcome measures were the Purdue Pegboard Test, a 
 grip-lift manipulandum task, and perceived changes using a questionnaire designed for the 
 study. The students were randomly assigned to one of three groups: 1) Feldenkrais Method 
 lesson with the dominant hand; 2) Feldenkrais Method lesson with the non-dominant hand; and 
 3) Sham intervention in the form of progressive muscle relaxation. A sample size calculation 
 was performed in order to have enough participants in each group to detect a meaningful effect 
 in the grip force task.  Findings:  The results showed  significant improvements in the Purdue 
 Pegboard Test for the experimental group compared to the control groups. For the grip-lift task, 
 only the maximum grip force to hold the manipulandum decreased significantly in the 
 dominant-hand group compared to the non-dominant and control group. All participants in the 
 dominant and non-dominant hand group reported that the intervention hand felt different after 
 the lesson compared to before the lesson and felt different to the hand that didn’t receive the 
 sensory attention. The authors concluded that a single sensory-awareness lesson improves 
 hand dexterity in healthy adults, making it a useful intervention for populations requiring high 

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 dexterity, such as musicians and medical professionals who require high hand dexterity.  Risk of 
 bias:  Very Low 

 In another randomised controlled trial,  Causby et  al. (2016)  investigated the effect of additional 
 sensory awareness training and motor practice for learning scalpel skills in podiatry students. 
 Forty-four participants were randomly assigned to three groups; 1) a sensory awareness group, 
 receiving one 40-minute Feldenkrais Method session and practicing two audio recordings at 
 home, one of which targeted the dominant hand. 2) a motor practice group, practicing scalpel 
 holding and, 3) a control group, who received the standard teaching only. Participants were 
 evaluated on psychological measures (intrinsic motivation inventory) and dexterity measures 
 (Purdue Pegboard Test, Grooved Pegboard Test, and a grip-lift task).  Findings:  The only 
 significant group difference over time was displayed by the control group on preload duration of 
 the non-dominant hand for the grip-lift task. But it should be noted that the groups differed 
 significantly at baseline testing, with the control group performing significantly poorer, and 
 therefore having the better improvement rate since the improvement is related to the amount to 
 improve. The authors mention several factors leading to no differences between the groups. 
 First, the low number of participants (n=44), second the short additional training period for the 
 two experimental groups (two weeks), which might not have been long enough to show training 
 effects. The authors also mention the study by Bitter et al. (2011) and say that the significant 
 effects of that study might be due to immediate testing, which does not evaluate lasting change. 
 Overall, this study showed no significant improvements of additional sensory and motor training, 
 which took place over the course of two weeks, compared to standard scalpel teaching practice. 
 Risk of bias:  Low 

 5.3 Breathing 

 Three studies were conducted to evaluate the effects of Awareness Through Movement lessons 
 on breathing abilities. 

 Ramli and Roslina (2012)  conducted a randomised controlled  trial to compare group lessons of 
 the Feldenkrais Method to improve rehabilitation in patients with chronic obstructive pulmonary 
 disease (COPD) with a standard pulmonary rehabilitation program. Thirty-six patients with a 
 mean age of 65.7 years participated in the study and both the experimental Feldenkrais Method 
 group and the control group took part in interventions twice per week for eight weeks. Outcome 
 measurements included Forced Expiratory Volume in one second (FEV1), the Borg score and 
 the 6-Minute Walk Test (6MWT). The Borg score allows patients to grade the intensity of their 
 breathlessness, while the 6MWT measures how far patients can walk in 6 minutes.  Findings: 
 Neither the experimental, nor the control group showed significant improvement in FEV1. For 
 the Borg score, there was a significant improvement in the standard protocol control group only, 
 but both groups improved significantly in the 6MWT as a within-group effect. There was no 
 significant difference detected between the two groups for the 6MWT. Since the standard 
 pulmonary rehabilitation program involves high intensity exercise and increased cardiovascular 

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 endurance, the authors suggest the change in the Borg score for the control group is a 
 consequence of desensitization. The improved distance in the 6MWT in the Feldenkrais Method 
 group is consistent with a true physiological training effect and the various movement patterns in 
 the Feldenkrais Method classes which may have improved respiratory muscle function and gas 
 exchange. The authors conclude that both interventions demonstrated relevance to COPD 
 patients. While some patients might better tolerate the Feldenkrais Method lessons, it does not 
 provide better outcomes than the standard protocol.  Risk of bias:  Low 

 Another observational pilot study was done by  Ramli  et al. (2013)  to study the Feldenkrais 
 Method as an alternative therapy for patients with chronic obstructive pulmonary disease 
 (COPD). Eleven participants, aged between 53 and 73 years participated in the study, all of 
 whom were diagnosed with a severe COPD. Patients received one Feldenkrais Method 
 Awareness Through Movement lesson per week over the course of eight weeks. The content of 
 the lessons varied from week to week and included topics of awareness, relaxation, breathing, 
 and trunk mobility. Outcome measurements before and after the intervention included the 
 6-minute Walking Test, lung function tested through spirometry and quality of life.  Findings: 
 Results showed a significant improvement in the 6-minute Walk Test and Forced Expiratory 
 Volume, both with large effect sizes. Quality of life measures did not change significantly 
 throughout the course of the intervention. The authors addressed several limitations, such as a 
 small sample size and the lack of a control group with randomized allocation. The results of this 
 pilot study were promising but need to be confirmed by future studies with a larger sample, 
 control group and random allocation of patients with COPD.  Risk of bias:  Critical 

 A well-designed randomised controlled trial by  Mohan  et al. (2021)  evaluated the effects of 
 Feldenkrais Method Awareness Through Movement lessons to improve respiratory 
 characteristics in patients with non-specific lower back pain (NS-LBP). Forty participants were 
 randomly assigned to the experimental and control group. Whilst the control group received a 
 standard physiotherapy intervention three times per week, the experimental group received 
 Feldenkrais Method Awareness Through Movement lessons combined with the routine 
 physiotherapy protocol. The authors conducted a sample size calculation and assessors 
 remained blinded to the treatment conditions. Outcome measures included respiratory muscle 
 strength, respiratory muscle endurance, assessment of breathing patterns, pain perception, 
 chest expansion, and core stability.  Findings:  Results  showed significant improvements in 
 expiratory and inspiratory muscle strength for the experimental group, but not for the control 
 group. Respiratory muscle endurance only improved significantly in the control group. 
 Additionally, there was a significant reduction in pain and a significant improvement in chest 
 expansion in the experimental group alone. Also, lumbo-pelvic stability improved in the 
 experimental group alone. Breathing patterns showed a non-significant improvement in the 
 experimental group. The authors conclude that the Feldenkrais Method is a potential additional 
 form of exercising, which could improve respiratory function, pain and lumbo-pelvic stability 
 components in populations with lower back pain.  Risk  of bias:  Very low 

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 5.4 Posture 

 Two papers studied the effect of Feldenkrais Method interventions on posture. In these two 
 studies the effect on skeletal alignment in standing was evaluated. 

 Quintero et al. (2009)  studied the effect of ten once  per week Feldenkrais Awareness Through 
 Movement sessions on head posture in bruxist children. The study design was a randomised 
 controlled trial and included 26 children between 3-6 years of age. There was no intervention in 
 the control group.  Findings:  Results showed significant  improvements in head posture after the 
 intervention compared to the control group with a clinically meaningful change in the 
 craniovertebral angle (CVA).  Risk of bias:  Very Low 

 Gil (2018)  conducted a study to assess the effects  of a Feldenkrais Method program and a 
 so-called “Motion and Posture” (MAP) program on posture and quality of life. The Motion and 
 Posture program is derived from the Feldenkrais Method but combines it with more conventional 
 stability exercises. The study design was a non-randomized controlled trial, and 243 participants 
 took part in either 14 Feldenkrais Method or MAP lessons.  Findings:  Quality of life improved in 
 both groups and lordosis gap decreased in both groups as well. Whilst the decrease of the 
 lordosis gap was bigger in the Motion and Posture group, kyphosis only improved in the 
 Feldenkrais Method group. The authors conclude that quality of life and posture can be 
 improved by both programs. Unfortunately, the paper did not provide clear information about 
 whether the improvements were statistically significant from pre- to post-intervention.  Risk of 
 bias:  Critical 

 5.5 Muscle Tone 

 One randomized controlled trial by  Brummer et al.  (2018)  studied the effect of Feldenkrais 
 Method Functional Integration on muscle tone in the supine position. Thirty volunteers received 
 one individual Functional Integration session, in randomized order either first on the right or on 
 the left side of the body. Evaluation consisted of pressure points and contact surface, 
 documented with the Xsensor-Measurement-System as well as of subjective sensations. 
 Findings:  Results showed that pressure increases differentially  on the side that is treated first 
 and overall pressure and contact surface increased significantly after the treatment. The authors 
 reported large effect sizes and observed power for all effects close to 1, meaning that a 
 replication of the study would not need a much larger sample size. In conclusion their results 
 demonstrated that the treatment sessions with the Feldenkrais Method changed muscle tone, 
 leading to a more relaxed supine position with respect to pressure and contact surface on the 
 mat.  Risk of bias:  Very low 

 5.6 General Health Assessment 

 Even though this literature review is focusing on motor functioning, the author included the 
 results of the evaluated studies described above, which also assessed the effect of Feldenkrais 

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 Method sessions on a general sense of subjective wellbeing, most often evaluated by 
 questionnaires on quality of life. 

 In the study by Gutman et al. (1977), whilst not yielding significant statistical differences 
 between groups, participants in the Feldenkrais Method group worried less about their health 
 after the intervention. Also, 26.3 % reported that they had more energy after the course, 
 compared to before. In addition, more participants (32 %) in the Feldenkrais Method group than 
 in the control groups (11-21%) reported that they slept better after the program. In the study by 
 Hall et al. (1994), participants in the Feldenkrais Method group significantly increased their 
 vitality and physical functioning, as measured by the SF-36 Quality of Life (QoL) questionnaire. 
 The multiple case study by Stephens et al. (1999) reported a generally increased sense of 
 wellbeing and the study by Stephens et al. (2005) reported an improvement of the SF-36 vitality 
 and mental health subscale scores in the experimental group, indicating an increased sense of 
 wellbeing after participating in Awareness Through Movement classes. However, the 
 observational pilot-study by Ramli et al. (2013) did not show any significant changes in Quality 
 of Life between the baseline and post-intervention period. Cook et al. (2014) mentions 
 improvements in Quality of Life after the Feldenkrais Method intervention for women between 
 40 and 80 years of age. The randomized controlled trial by Nambi et al. (2014) showed 
 significant improvements in QoL in an ambulatory geriatric population. 

 As seen by these results, the Feldenkrais Method seems to have beneficial effects on subjective 
 wellbeing, perceived stress, as well as mental health, and a general sense of health. 

 6. Discussion 

 First, it must be noted, that the studies described in this review on the Feldenkrais Method and 
 motor functioning are very heterogeneous in terms of their study characteristics, risk of bias, 
 and area of investigation. While most studies found a significant positive effect, some studies 
 did not. Focusing on the studies with a “very low” or “low” risk of bias, some patterns can be 
 detected, and the different results can lead to an overall picture. 

 In the area of  mobility and balance  , several studies  report an improvement in perceived 
 exertion of movement tasks (Brown and Kegerreis 1991; Chinn et al. 1994; Ruth and Kegerreis 
 1992) and an EMG measurement during a flexion task showed reduced muscle activity after the 
 intervention (Brown and Kegerreis 1991), suggesting that the Feldenkrais Method can improve 
 movement efficiency. Several studies report an improvement in functional movement patterns, 
 such as reaching (Bipinbhai 2013; Dunn and Rogers 2000; Hillier et al. 2010; Hopper et al. 
 1999; Nambi et al. 2014). The best studied effect is the improvement of balance and mobility in 
 the aging population (Bipinbhai 2013; Hillier et al. 2010; Nambi et al. 2014; Ullmann et al. 2010; 
 Vrantsidis et al. 2009). Interesting are the different results of two studies investigating the 
 change of hamstring flexibility, measured in an active-knee-extension test. While James et al. 
 (1998) found no significant effect after four Awareness Through Movement sessions within two 
 weeks, Stephens et al. (2006) found significant improvements after 8-15 sessions over the 

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 course of three weeks. A possible explanation for this difference might be the length and 
 intensity of the study or the lessons used as intervention to target active hamstring muscle 
 flexibility. 

 In studies with symptomatic individuals having a neurological condition, the Functional 
 Integration study by Johnson et al. (1999) showed no improvements in hand dexterity or 
 multiple sclerosis (MS) performance scales, but significant reductions in anxiety levels and 
 perceived stress. On the other hand, the Awareness through Movement study by Stephens et 
 al. (2001) showed significant improvements on balance and balance confidence in individuals 
 with multiple sclerosis. The study by Teixeira-Machado et al. (2017) found significant 
 improvements on a variety of functional outcome measures for individuals with Parkinson’s 
 disease. Serrada et al. (2022) found clinically meaningful effects of Awareness through 
 Movement classes for stroke recovery, tested by leg and arm motor-impairment scales, body 
 awareness, and quality of life. 

 For the  dexterity of the hand  , one study by Bitter  et al. (2011) found significant improvements 
 after one two-hour Feldenkrais Awareness Through Movement session compared to a sham 
 intervention of progressive muscle relaxation. In another study, when compared to a standard 
 protocol for hand dexterity teaching for learning scalpel skills over two weeks, additional 
 Awareness Through Movement sessions were not beneficial (Causby et al. 2016). Several 
 questions arise from these findings: Are the effects in the study by Bitter et al. (2011) lasting 
 effects, or were the positive results a consequence of immediate testing? Would the results of 
 the study by Causby et al. (2016) differ if it would take place over a longer period and with more 
 consistent baseline characteristics between the groups? 

 Two good studies on  breathing  both found significant  improvements in respiratory muscle 
 function (Mohan et al. 2021; Ramli and Roslina 2012). Also, the study on head posture in bruxist 
 children found clinically meaningful improvements (Quintero et al. 2009). 

 Interestingly, the Functional Integration study by Brummer et al. (2018), showing a significant 
 lowering of  muscle tone  in the supine position, corresponds  with the effect of the Functional 
 Integration study by Johnson et al. (1999) who reported decreased levels of anxiety and stress. 
 It is a well-established psychophysiological fact, that high levels of stress and anxiety are 
 directly linked to a higher overall muscle tone in the body (Hazlett et al. 1994; Plüss et al. 2009; 
 Sainsbury and Gibson 1954). 

 The several positive effects of Awareness Through Movement and Functional Integration 
 lessons on quality of life further suggest a positive effect on self-perception, body awareness, 
 and overall sense of wellbeing and vitality. 

 In comparison to standard treatment protocols and general exercises, the results are mixed. 
 The study by Hillier et al. (2010) showed small advantages of Awareness Through Movement 
 sessions in improving balance, compared to a generic balance class. Chinn et al. (1994) found 

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 an improvement in perceived exertion following Awareness Through Movement sessions 
 compared to general upper body exercises. Ramli and Roslina (2012) did not find the 
 Feldenkrais Method classes to be superior to a standard treatment approach for COPD patients. 
 Bipinbhai (2013) found the Feldenkrais Method classes to be better in improving balance in 
 older adults than a general balance class. While Causby et al. (2016) did not find the 
 Feldenkrais Method to be an improvement compared to a standard scalpel training in students, 
 the study by Henry et al. (2020) found the Feldenkrais Method being used in addition to 
 physiotherapy being more effective than physiotherapy alone in treating breathing problems for 
 people with non-specific lower back pain. 

 No studies reported risks or adverse effects, making the Feldenkrais Method a very safe form of 
 intervention. This is in line with findings from other authors (Ernst 2022). 

 When looking at the number of sessions needed to see an effect, some studies reported 
 significant improvements after only one session, while other studies showed an effect after eight 
 or more sessions over the course of several weeks. It remains unclear whether and how long 
 these effects last. The number of sessions needed to see an effect seems to depend on what 
 the goal of the intervention is and no suggestions for the amount and intensities can be given 
 based on the current findings. 

 6.1 Lack of Studies including Functional Integration 

 The reasons for having few studies including the manual modality of Functional Integration are 
 assumed to be manifold. One reason is that sessions in Functional Integration do not follow a 
 fixed protocol and there is great inter- and intra-individual variability between Functional 
 Integration sessions, even for the same conditions. This is due to the reason that the 
 Feldenkrais Method conceptualizes human organisms and their neuromuscular system as a 
 dynamic, complex, and adaptive system and therefore interventions in Functional Integration 
 follow an exploratory process, using so called meta-principles along specific technical aspects 
 of manipulation (Buchanan 2012; Russell 2020). This inter- and intra-individual variability poses 
 challenges to the replicability of Functional Integration studies. Further, it is difficult to 
 adequately control for confounding practitioner-client interaction effects, which are known to be 
 substantial in hands-on body-mind practices (Mehling et al. 2005). Nevertheless, as Mehling et 
 al. (2005) suggest, several ways exist to minimize bias in studies of hands-on bodywork for 
 challenges regarding blinding, control group and bias in recruitment and attrition. Another 
 reason for the lack of studies including Functional Integration is the cost factor, as having 
 multiple individual sessions is more resource intensive than giving group sessions. 

 The author further suggests conceptualizing hands-on studies in Functional Integration with a 
 ‘Black-Box’ Model, where the specific manipulations are of less importance. Since every 
 Functional Integration session uses the same set of basic principles, the likelihood and therefore 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  28 



 the replicability of different sessions is still given. Also, combining quantitative with qualitative 
 outcome measures might better grasp the reality of the effects of Functional Integration. 

 6.2 Possible Mechanisms of Action 

 Thinking and theorizing about the mechanism of action by which the Feldenkrais Method 
 improves motor functioning has been taken up by many authors in the past. Focusing on the 
 group modality Awareness Through Movement, there is a common understanding that the 
 Feldenkrais Method improves, changes and provides new functional whole-body movement 
 patterns (Bate 1994; Bisges and Newton 1992; Dunn and Rogers 2000; Hopper et al. 1999; 
 James et al. 1998; Rywerant 1983; Serrada et al. 2022). Stephens and Hillier (2020) provide a 
 section on the mechanism of action in their recent review, concluding that the Feldenkrais 
 Method changes the pattern of movement coordination as a result of a process of sensorimotor 
 learning. An in-depth analysis of the elements of motor learning and postural control was done 
 by Connors et al. (2011), which found that motor learning and postural control theory provides a 
 sound theoretical basis for the effectiveness of the Feldenkrais Method in improving balance. 
 Bate (1994) provided a similar approach in explaining some effects of the Feldenkrais Method 
 with motor control theories, while Stephens et al. (2001) state that Awareness Through 
 Movement sessions incorporate basic principles of balance training. An outline of several 
 principles related to the efficient use of the neuromuscular system can also be found in the 
 article of Lyttle (1997). Additionally, several authors point out the exploratory learning nature of 
 the Feldenkrais Method (Russell 2020; Wildman 1986). This is also the topic of the theoretical 
 article by Lafe and Pacheco (2019), which elaborates the connection between the Feldenkrais 
 Method and the search strategy approach to skill acquisition based on dynamical systems 
 theory. Also, the importance of awareness and attention is stressed by several authors (Clark et 
 al. 2015; Mattes 2016; Wildman 1986). Wildman (1986) described the Feldenkrais Method as a 
 process to develop attention and to improve the ability to make sensory distinctions that are 
 connected to improving motor ability. 

 6.3 Recommendations for Future Research 

 Designing and planning research programs to study the Feldenkrais Method is a difficult and 
 complex undertaking. When looking at the current literature, the author recommends the 
 following for future studies. 

 1)  Focusing on randomized controlled studies with a sample-size calculation, especially in 
 studies with symptomatic individuals where the aim is to investigate the clinical effect of 
 functional outcomes for these clinical populations. 

 2)  Studies with control groups either receiving a well-designed sham intervention or a 
 standard treatment approach. 

 3)  More studies on the effects of Functional Integration, especially with children with 
 cerebral palsy or people in neurorehabilitation in general. This is a frequently 
 recommended and utilized application of Functional Integration sessions 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  29 



 (Shelhav-Silberbush 1988; Panova et al. 2017). Currently a five-year long study with 20 
 children with cerebral palsy is being conducted at the University Hospital in Padova, 
 Italy. This is the first long-term study of this kind (Chioggia Redazione Web 2023). 

 4)  More studies with different age groups as sample population. 
 5)  Design studies to assess the effects of Feldenkrais Method interventions on joint mobility 

 and basic coordination of voluntary movement like right-left, up-down, back-front, 
 hand-eye and eye-foot coordination in comparison to assessing more complex, 
 context-dependent motor actions, such as walking, running, jumping, climbing, crawling, 
 swimming, throwing, reaching for something and changing of elementary body position. 
 The international classification on function, disability, and health (ICF) by the WHO could 
 serve as a possible framework (Stucki 2005). 

 6)  Use repeated measurements designs to compare the effect of different amounts of 
 sessions and intensities. 

 7)  Include follow-up assessments to assess the retention of intervention effects. 

 7. Conclusion 

 In many areas of study and for many aspects of motor functioning, studying the various 
 possibilities and potential of the Feldenkrais Method has been limited. Nevertheless, this 
 scoping review of research studies and scholarly literature about the Feldenkrais Method and 
 motor functioning gives evidence and makes it seem plausible that the Feldenkrais Method 
 works through principles of motor control and motor learning to improve functions mediated 
 through the neuromuscular system. Functions such as balance, mobility, intra- and 
 inter-muscular coordination, whole-body coordination, breathing, posture, and muscle tone can 
 be improved by the Feldenkrais Method. Further research is needed to specify the effects and 
 the amount of practice needed for the retention of newly found functional movement patterns in 
 the variety of the population who can benefit from the Feldenkrais Method. 

 Acknowledgements 

 The author thanks the Swiss Feldenkrais Association, SFV, for their financial funding, which 
 made this review possible. Also, a big thanks to Cliff Smyth and JoAnne Page, for providing 
 valuable feedback to the first draft of this review and helping in editing this article. 

 Conflict of Interest 

 The author was member of the Board of Directors of the Swiss Feldenkrais Association (SFV) 
 while conducting this review. The author claims to have worked according to best practices and 
 in line with scientific procedures and has no personal financial benefit regarding the outcome of 
 this review. 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  30 



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 mobility and quality of life in a well elderly population: The benefits of Awareness Through 
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 Teixeira-Machado, L., de Araújo, F. M., Menezes, M. A., Cunha, F. A., Menezes, T., Ferreira, C., 
 and DeSantana, J. M. (2017) ‘Feldenkrais method and functionality in Parkinson’s 
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 Complementary Medicine  , 16 (1), 97–105. Available  at 
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 balance’.  Journal of Aging and Physical Activity  ,  17 (1), 57–76. Available at 
 doi:  https://doi.org/10.1123/japa.17.1.57 

 Webb, R., Cofré Lizama, L. E., and Galea, M. P. (2013) ‘Moving with ease: Feldenkrais Method 
 classes for people with osteoarthritis’.  Evidence-Based  Complementary and Alternative 
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 Wildman, F. (1986) ‘Learning – The missing link in physical therapy: A radical view of the 
 Feldenkrais Method’.  Physical Therapy Forum  , 5 (8) 

 www.riskofbias.info. (n.d.)  Risk of bias tools - Current  version of ROBINS-I  . [online] Available at: 
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 2024] 

 Biography 

 Nicola Zollinger completed his studies in Environmental Sciences at ETH Zurich and graduated 
 from his Feldenkrais Training in 2021 in Aurillac, France. He worked as an assistant to a lecturer 
 of mathematical system analysis at his university for three years, where he gained a deeper 
 understanding of complex systems. He also wrote the content for a series of six published 
 videos that explain the Feldenkrais Method to the public and published several articles about 
 the Feldenkrais Method on the website for complementary therapies in Switzerland. 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  38 

https://doi.org/10.1016/j.ridd.2017.08.012
https://doi.org/10.1089/acm.2008.0612
https://doi.org/10.1123/japa.17.1.57
https://doi.org/10.1155/2013/479142
https://www.riskofbias.info/welcome/home/current-version-of-robins-i
https://www.zotero.org/groups/4149568/iffrg/collections/MW22KMSN


 Appendix 1 

 Table 1, Part 1 - Data Overview 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  39 

 Nr.  Study  Year  ATM/FI  Area  Nr. of Subjects  Age  Sessions  Duration [weeks] 
 Intensity [Sessions 

 per week] 
 Healthy Sample 

 1  Gutman et al.  1977  ATM 
 Mobility, Balance, General Health 

 Assessment 
 38  70.9  18  6  3  Yes 

 2  Brown and Kegerreis  1991  ATM  Mobility  21  28  1  1  1  Yes 

 3  Ruth & Kegerreis  1992  ATM  Mobility  30  11-36  1  na  na  Yes 

 4  Hall et al.  1994  ATM  Balance, General Health Assessment  60  71.65  32  16  2  Yes 

 5  Chinn et al.  1994  ATM  Mobility  23  18-59  1  1  1  No 

 6  Brown et al.  1996  ATM  Mobility  23  75.92  18  6  3  Yes 

 7  Stephens et al.  1998  ATM  Mobility  4  38.5  10  10  1  No 

 8  James  1999  ATM  Mobility  48  23.1  4  2  2  Yes 

 9  Hopper et al.  1999  ATM  Mobility  75  18.9  1 or 4  2  2  Yes 

 10  Johnson et al.  1999  FI  Mobility  20  44.8  8  8  1  No 

 11  Buchanan & Vardaxis  2000  ATM  Balance  20  NA  8  4  2  Yes 

 12  Dunn & Rogers  2000  ATM  Mobility  12  23  1  1  1  Yes 

 13  Stephens et al.  2001  ATM  Balance  12  56.2  8  10  1  No 

 14  Batson & Deutsch  2005  ATM  Mobility, Balance  4  56  15  6  na  No 

 15  Stephens et al.  2005  ATM  Mobility, General Health Assessment  31  79  10  1  10  Yes 

 16  Stephens et al.  2006  ATM  Mobility  33  25.9  11 on average  3  4 on average  Yes 

 17  Quintero et al.  2008  ATM  Posture  26  4.7  10  10  1  No 

 18  Vrantsidis et al.  2009  ATM  Balance  55  75.4  16  8  2  Yes 

 19  Manuél Heister  2010  ATM  Balance  30  NA  8  4  2  No 

 20  Hillier et al.  2010  ATM  Balance, General Health Assessment  22  NA  8  8  1  Yes 

 21  Ullmann et al.  2010  ATM  Mobility, Balance  47  75.6  15  5  3  Yes 

 22  Connors et al.  2011  ATM  Mobility, Balance  63  75 (MD)  20  10  2  Yes 

 23  Bitter et al.  2011  ATM  Dexterity  29  23  1  1  1  Yes 

 24  Khurana et al.  2012  ATM  Mobility  25  21-26  15  2  7  Yes 

 25  Ramli & Roslina.  2012  ATM  Breathing  36  65.7  16  8  2  No 

 26  Bellafiore et al.  2012  ATM  Mobility  17  34  8  4  2  No 



 Table 1, Part 2 

 Nr.  Study  OCBM 

 Level of 

 Evidence 

 Type of control  Blinding  Follow-up  Results sign.  Sample Size 

 Calculation 

 Pedro Score 

 for RCT 

 Risk  of  Bias 

 1  Gutman et al.  3  No Intervention  No Blinding  No  No  No  NA  Serious 

 2  Brown and Kegerreis  2  ATM without suggestions  No blinding  No  Yes  No  6/11  Low 

 3  Ruth & Kegerreis  2  No Intervention  No Blinding  No  Yes  No  5/11  Low 

 4  Hall et al.  2  No Intervention  No Blinding  No  Yes  No  6/11  Low 

 5  Chinn et al.  2  Sham Intervention 

 (exercise) 

 No Blinding  No  Yes/No  No  4/11  Low 

 6  Brown et al.  3  No Intervention  No Blinding  No  Yes  No  NA  Moderate 

 7  Stephens et al.  4  No control group  No Blinding  No  na  No  NA  Critical 

 8  James  2  No Intervention/Relaxation  Blinded Assessors  No  No  No  8/11  Very Low 

 9  Hopper et al.  2  No Intervention  No Blinding  No  Yes  No  6/11  Low 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  40 

 27  Ramli et al.  2013  ATM  Breathing  11  63.8  8  8  1  No 

 28  Bipinbhai  2013  ATM  Balance  45  71.36  20  4  5  Yes 

 29  Webb et al.  2013  ATM  Mobility, General Health Assessment  15  67  60  30  2  No 

 30  Cook et al.  2014  ATM 
 Mobility, Balance, General Health 

 Assessment 
 46  60  5-10  1  5-10  Yes 

 31  Nambi et al.  2014  ATM  Balance, General Health Assessment  60  70  18  6  3  Yes 

 32  Causby et al.  2016  ATM  Dexterity  44  23  7  2  3-4  Yes 

 33  Maddali-Bongi et al.  2017  ATM  Mobility  10  55.3 
 10 + daily home 

 exercises 
 5  2  No 

 34  Palmer  2017  ATM  Balance  87  76 (MD)  12  6 or 12  1 or 2  Yes 

 35  Torres-Unda et al.  2017  ATM  Mobility, Balance  32  48.94  30  30  1  No 

 36  Teixeira-Machado et al.  2017  ATM  Mobility, Balance  30  61  50  25  2  No 

 37  Gil  2018  ATM  Posture  243  24  14  14  1  Yes 

 38  Brummer et al.  2018  FI  Muscle Tone  30  37.9  1  1  1  Yes 

 39  Mohan et al.  2021  ATM  Breathing  34  18-55  24  8  3  No 

 40  Kang et al.  2021  ATM  Mobility  9  69.1  24  24  1  No 

 41  Serrada et al.  2022  ATM  Mobility  20  68.4  20  10  2  No 



 10  Johnson et al.  2  Sham Intervention  Blinded Assessors  No  Yes  No  7/11  Very Low 

 11  Buchanan & Vardaxis  3  No Information on control 

 Group 

 No Blinding  No  Yes  No  na  NA 

 12  Dunn & Rogers  4  No control group/right body 

 side as control / 

 Pseudo-Randomization 

 No Blinding  No  Yes  No  na  Low 

 13  Stephens et al.  2  Education (4 Sessions)  No Blinding  No  Yes  No  5/11  Low 

 14  Batson & Deutsch  4  No control group  No Blinding  No  Yes  No  na  Critical 

 15  Stephens et al.  3  No Intervention  No Blinding  No  Yes  No  na  Moderate 

 16  Stephens et al.  2  No Intervention  No Blinding  No  Yes  No  5/11  Low 

 17  Quintero et al.  2  No Intervention  No Blinding  No  Yes  Yes  7/11  Very Low 

 18  Vrantsidis et al.  2  No Intervention  Blinded Assessors  No  Yes  Yes  8/11  Very Low 

 19  Manuél Heister  4  No control group  No Blinding  No  Yes/No  No  na  Critical 

 20  Hillier et al.  3  Generic Balance Class  Blinded Assessors  No  Yes  No  na  Low 

 21  Ullmann et al.  2  No Intervention  No Blinding  No  Yes  No  6/11  Low 

 22  Connors et al.  3  No Intervention  No Blinding  No  Yes  No  na  Moderate 

 23  Bitter et al.  2  Sham Intervention (PMR)  Double-Blinded  No  Yes  Yes  10/11  Very Low 

 24  Khurana et al.  4  No control group  No Blinding  No  Yes  No  na  Critical 

 25  Ramli & Roslina.  2  Pulmonary Rehabilitation 

 Program 

 No Blinding  No  No  No  5/11  low 

 26  Bellafiore et al.  2  No Intervention  No Blinding  No  No  No  6/11  low 

 27  Ramli et al.  4  No control group  No Blinding  No  Yes  No  NA  Critical 

 28  Bipinbhai  2  Alexander and Balance 

 Class 

 No Blinding  No  Yes  No  7/11  Very Low 

 29  Webb et al.  4  No control group  No Blinding  No  Yes  No  na  Critical 

 30  Cook et al.  3  No Intervention  No Blinding  No  Yes  No  NA  Serious 

 31  Nambi et al.  2  Pilates and Walking 

 exercises 

 No Blinding  No  Yes  No  7/11  Very low 

 32  Causby et al.  2  Motor practice, usual 

 teaching 

 Blinded Assessors  Yes  No  Yes  5/11  low 

 33  Maddali-Bongi et al.  4  No control group  No Blinding  No  na  No  na  Critical 

 34  Palmer  3  Waitlist  Blinded Assessors  No  Yes/No  No  na  Moderate 

 35  Torres-Unda et al.  2  No Intervention  No Blinding  No  Yes  No  6/11  low 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  41 



 36  Teixeira-Machadeo et al.  2  Educational Lecture  No Blinding  No  Yes  No  7/11  Very low 

 37  Gil  4  No control group  No Blinding  No  Yes  No  na  Critical 

 38  Brummer et al.  2  Crossover Design  No Blinding  No  Yes  No  7/11  Very low 

 39  Mohan et al. 2021  2  Physiotherapy  Blinded Assessors  No  Yes  Yes  9/11  Very low 

 40  Kang et al.  4  No control group  No Blinding  Yes  Yes/No  No  na  Critical 

 41  Serrada et al.  2  Home-based ATM Audios  Blinded Assessors  No  Yes  Yes  6/11  low 

 Appendix 2 

 Table 2 - Outcome Measurements 

 Outcome Measurement  Publication 

 Philadelphia Geriatric Centre Morale Scale  Gutman et al. 1977 

 VIRO scale (a scale for assessing interview behavior 

 of elderly people) 

 Gutman et al. 1977 

 Height, Weight, heart rate, blood pressure  Gutman et al. 1977 

 Range of Motion - Rotation Flexibility  Gutman et al. 1977 

 Balance rail test  Gutman et al. 1977 

 Dermatome scoring system for pain and stiffness  Gutman et al. 1977 

 Borg Scale perceived exertion, Visual Analog Scale 

 of perceived exertion (VAS) 

 Brown & Kegerreis 1991, Ruth & Kegerreis 1992, 

 Chinn et al 1994, Hopper et al. 1999, Ramli & 

 Roslina 2012 

 EMG activity  Brown & Kegerreis 1991 

 Range of motion with cervical goniometer  Ruth & Kegerreis 1992 

 Functional Arm reach test (supine, along wall)  Chinn et al. 1994 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  42 



 Functional Reach Test (Standing, forward reach)  Brown et al. 1996, Hillier et al. 2010, Bipinbhai 

 2013, Nambi et al. 2014, Palmer 2017, 

 Teixeira-Machado et al. 2017 

 Modified Functional Reach Test (in Sitting)  Brown et al. 1996, Bipinbhai 2013 

 SF 36 QoL, AQoL, RAND -36, SrS-22  Hall et al. 1994, Stephens et al. 2005, Vrantsidis et al. 

 2009, Hillier et al. 2010, Ramli et al. 2013, Webb et 

 al. 2013, Nambi et al. 2014, Gil 2018 

 FAI daily living index  Hall et al. 1994, Vrantsidis et al. 2009 

 Falls Efficacy Scale  Hall et al. 1994, Vrantsidis et al. 2009, Ullmann et al. 

 2010 

 Timed up and Go Test (TUG)  Hall et al. 1994, Brown et al. 1996, Vrantsidis et al. 

 2009, Hillier et al. 2010, Ullmann et al. 2010, 

 Bipinbhai 2013, Nambi et al. 2014, Palmer 2017 

 Teixeira-Machado et al. 2017 

 Berg Balance Test  Hall et al. 1994, Batson & Deutsch 2005, Bipinbhai 

 2013, Teixeira-Machado et al. 2017 

 Physical Activity Scale (PASE)  Hall et al. 1994 

 Pro Balance Master Test  Hall et al. 1994 

 Dartmouth COOP  Brown et al. 1996 

 Range of Motion – Active Knee Extension Test  James et al. 1998, Hopper et al. 1999, Stephens et al. 

 2006 

 Fatigue Severity Scale (FSS)  Stephens et al. 1998 

 Index of Wellbeing (IWB)  Stephens et al. 1998 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  43 



 PEAK Motus 2D Motion Analysis of gait and supine 

 to stand 

 Stephens et al. 1998, Stephens et al. 2005 

 Sit and reach measurement  Hopper et al. 1999, Dunn & Rogers 2000, Bellafiore 

 et al. 2012 

 Pegboard test for hand dexterity  Johnson et al. 1999, Bitter et al. 2011, Causby et al. 

 2016 

 Hospital Anxiety and Depression Scale (HAD)  Johnson et al. 1999 

 MS-Self Efficacy Scale  Johnson et al. 1999, Stephens et al. 2001 

 Perceived Stress Scale (PSS)  Johnson et al. 1999 

 Performance Quality of Life  Johnson et al. 1999 

 AMTI Force Plate for 7 standing tasks  Buchanan & Vardaxis 2000, Webb et al. 2013 

 Prospective Falls Record  Stephens et al. 2001 

 EQUISCALE Functional Balance  Stephens et al. 2001 

 mCTSIB Balance Protocol  Stephens et al. 2001, Vrantsidis et al. 2009 

 ABC Balance Confidence Scale  Stephens et al. 2001, Ullmann et al. 2010, Connors et 

 al. 2011 

 Dynamic Gait Index (DGI)  Batson & Deutsch 2005 

 Stroke Impact Scale (SIS)  Batson & Deutsch 2005, Serrada et al. 2022 

 Lateral Cephalogram  Quintero et al. 2009 

 Human Activity Profile (HAP)  Vrantsidis et al. 2009, Webb et al. 2013 

 Abbreviated Mental Score  Vrantsidis et al. 2009 

 Four Square Step Test  Vrantsidis et al. 2009, Connors et al. 2011, Webb et 

 al. 2013 

 Step Test  Vrantsidis et al. 2009 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  44 



 Clinical Stride Analyzer (CSA)  Vrantsidis et al. 2009 

 Timed Sit to Stand  Vrantsidis et al. 2009, Teixeira-Machado et al. 2017 

 Single Leg Stance time (SLS)  Hillier et al. 2010 

 Walk on Floor Eyes closed (WOFEC)  Hillier et al. 2010 

 Self-Selected Gait Speed  Ullmann et al. 2010, Connors et al. 2011 

 Grip Lift Test  Bitter et al. 2011, Causby et al. 2016 

 Trunk Lift Test  Bellafiore et al. 2012 

 6 min Walk Test (6MWT)  Ramli & Roslina 2012, Ramli et al. 2013, Webb et al. 

 2013 

 Forced Expiratory Volume  Ramli & Roslina 2012, Ramli et al. 2013 

 Stair Climbing Test  Webb et al. 2013 

 Western Ontario McMaster Universities 

 Osteoarthritis Scale 

 Webb et al. 2013 

 Tekscan Pressure Mat  Cook et al. 2014 

 Intrinsic Motivation Inventory (IMI)  Causby et al. 2016 

 Trail Making Test A & B  Ullmann et al. 2010 

 VAS for Pain  Maddali-Bongi et al. 2017 

 VAS for Fatigue  Maddali-Bongi et al. 2017 

 BAS-G  Maddali-Bongi et al. 2017 

 BASDAI  Maddali-Bongi et al. 2017 

 MASES  Maddali-Bongi et al. 2017 

 Schöber Test  Maddali-Bongi et al. 2017 

 Finger Floor Distance (FFD)  Maddali-Bongi et al. 2017 

 Tandem Stance  Palmer 2017 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  45 



 OPTIMAL Self Report  Palmer 2017 

 Short Physical Performance Battery (SPPB)  Torres-Unda et al. 2017 

 Stabilometric Platform  Torres-Unda et al. 2017 

 XSensor Pressure Mapping System  Brummer et al. 2018 

 Lesson Effect Questionnaire  Gil 2018 

 Digital Inclinometer  Gil 2018 

 Maximal Inspiratory Pressure (MIP)  Mohan et al. 2021 

 Maximal Expiratory Pressure (MEP)  Mohan et al. 2021 

 Maximum Voluntary Ventilation (MVV)  Mohan et al. 2021 

 Total Faulty Breathing Scale (TFBS)  Mohan et al. 2021 

 Cloth Tape Measure for Chest Expansion  Mohan et al. 2021 

 Pressure Biofeedback Device (PBU) for Core 

 Stability 

 Mohan et al. 2021 

 Unified Parkinson’s disease rating scale (UPDRS)  Kang et al. 2021 

 Gait Analysis  Kang et al. 2021 

 Non.motor Symptoms Scale (NMSS)  Kang et al. 2021 

 Parkinson Disease Questionnaire (PDQ-39)  Kang et al. 2021 

 Asberg Depression Rating Scale  Kang et al. 2021 

 Tinetti Scale  Kang et al. 2021 

 Hoehn and Yahr Stage  Kang et al. 2021 

 Erasmus Nottingham Sensory Assessment  Serrada et al. 2022 

 MAIA (Multidimensional Assessment of 

 Interoceptive Awareness) 

 Serrada et al. 2022 

 Fugl-Meyer Upper and Lower Extremity  Serrada et al. 2022 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  46 



 Ten metre walk test (10MWT)  Serrada et al. 2022 

 Patient specific functional scale (PSFS)  Serrada et al. 2022 

 Figure-of-eight walk test  Teixeira-Machado et al. 2017 

 Rollover Task  Teixeira-Machado et al. 2017 

 360-Degree turn-in-place task  Teixeira-Machado et al. 2017 

 Hip-flexion strength test  Teixeira-Machado et al. 2017 

 Zollinger •  Feldenkrais Research Journal, volume 7  (2025)  47 


