Abstract
This study assessed the feasibility, acceptability, potential symptom targets, and underlying therapeutic mechanism of a novel self-management training for Parkinson's disease (PD) care-partner dyads.
This single-arm preliminary study evaluated an online, dyad-based group Alexander technique (AT) training designed to enhance daily functional performance. Participants included 14 individuals with PD (Hoehn & Yahr Stages 1–3) and 12 care partners, meeting via Zoom twice weekly (105–120 min) for 8–9 weeks. Assessments included objective physical measures (balance, posture, physical performance),proactive inhibitory control (preparation time) and subjective evaluations (symptom management, course satisfaction, dyadic dynamics).
The study found high feasibility and acceptability, along with significant improvements in overall symptom management (d=0.92), functional reach (d=0.85), and proactive inhibitory control (d=0.91). The largest symptom management improvements occurred in drooling (d=1.49), falls (d=0.74), stooped posture (d=0.73), and shuffling gait (d=0.70). Self-reported agency increased marginally, driven by gains in physical control (d=0.66). Exploratory analysis revealed relationships between changes in objective measures and self-reported improvements: reductions in falls and stooped posture significantly correlated with increased proactive inhibitory control, while improved management of shuffling gait correlated significantly with a more upright cranio-vertebral angle.
An online AT-based group intervention for people living with PD and their care partners may provide practical self-management strategies that can immediately be applied in daily life, with ongoing benefits. Improvement in proactive psychomotor inhibitory control and body schema may be key mechanisms by which AT confers benefit. Future studies should examine combination and comparison of AT with exercise.