This document discusses the Alexander Technique, an educational method to develop lifelong skills for self-care through recognizing and avoiding habitual misuse affecting posture and movement. It notes the technique benefits aging populations dealing with issues like back pain, Parkinson's disease, balance, and coordination. Several scientific studies found the Alexander Technique lessons improved balance by about 40%, reduced back pain symptoms, and helped with Parkinson's disease symptoms like posture, walking, and reduced medication changes. The document concludes the Alexander Technique lessons could benefit some older adults' mental and physical well-being and be a helpful intervention for some geriatric contexts.

1. 2015
Deborah Bayardino George
deborahbayardino@gmail.com
1/5/2015

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Contents
1. Executive Summary..............................................................................................................................4
2. Introduction .........................................................................................................................................6
3. Alexander Technique Lessons ..............................................................................................................7
4. Standards..............................................................................................................................................7
5. Benefits ................................................................................................................................................7
6. The Alexander Technique for the Aging Population ..........................................................................10
7. Applicability........................................................................................................................................12
8. Bio.......................................................................................................................................................12
9. Reference ...........................................................................................................................................14
APPENDIX I – FUNCTIONAL REACH TEST.....................................................................................................18
APPENDIX II – LOWER BACK PAIN IMPROVEMENTS...................................................................................19
APPENDIX III – PARKINSON’S DISEASE........................................................................................................20

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1. Executive Summary
The Alexander Technique (AT) is an educational method that offers an individualized
approach designed to develop lifelong skills for self care. The AT helps people recognize,
understand, and avoid habitual misuse affecting postural tone and neuromuscular
coordination¹.
Approximately 40% of Americans use self-care approaches, for specific conditions or to
promote overall well-being, developed outside of mainstream conventional medicine¹².
Globally, the number of older persons (aged 60 years or over) is expected to reach more
than 2 billion in 2050²⁶, approximately 22% of the global population¹³, exceeding the
number of children for the first time in history.
The rapidly growing population of older adults is searching for alternatives to promote a
higher quality of life, not to necessarily substitute the traditional medicine, but to
complement it.
Recent reports indicate that Alexander Technique is clinically beneficial for back pain,
Parkinson's disease, balance³ and coordination in the older adults.
 Back pain affects 49% of the older adult population and is a significant cause of
morbidity in older patients, including depression, functional disability and decreased
quality of life⁴. A series of 24 private lessons in the Alexander Technique from
certified teachers provides long term benefits for patients with chronic or recurrent
low back pain¹.
 Parkinson’s disease affects 1 million older Americans⁵ and ageing is the greatest risk
factor for the development of the disease⁶. Specific improvements such as posture

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and balance, walking, speech, better coping with disability, reduced stress and panic,
decreased tremor and rigidity were demonstrated by a randomized controlled trial
of the Alexander Technique for idiopathic Parkinson’s disease. In addition, the
incidence of changes in medication in order to improve symptoms or side-effects
was strikingly reduced after AT lessons. The AT is likely to benefit most moderately
mobile, nondemented people with Parkinson’s disease who are interested in a
technique for self-help⁷.
 In Oregon, falls are the leading cause of fatal and nonfatal injuries for adults 65 and
older⁸. After 16 AT lessons, an approximate 40% of improvement in balance⁹ and an
overall increase in movement speed¹⁰ were demonstrated. It is recommended that
the AT lessons should be incorporated into balance training as a self-care approach
to improving balance¹⁰.
 There are increased suggestions that after AT lessons individuals can apply a novel
strategy for the sit-to-stand (STS) task which could help impaired population rise
from a chair³.
 There are indications that postural tone is deeply related with coordination. It was
demonstrated that dynamic modulation of postural tone can be enhanced through
long-term training in AT and it could constitute an important direction for
therapeutic intervention³ ¹⁴ ¹⁵ ¹⁶.
 In addition to that, studies indicated that the sustained beneficial effects from the
AT are due to continued application of learnt skills⁷. In other words, the benefits of
the AT lessons have a confirmed long lasting effect due to its educational facet.

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In conclusion, the Alexander Technique lessons are mentally and physically beneficial to
some older adults and it could most likely be an intervention in some geriatric contexts⁹.
2. Introduction
The Alexander Technique (AT) is an educational method in which individuals learn about
their own neuromuscular behavior patterns. The AT also teaches us how to avoid habitual
misuse interfering with the natural functioning of the organism. Its main objective is a
psychophysical re-education, teaching how the body and mind can work together while
performing all daily activities. Furthermore, it helps to detect and reduce excess tension by
promoting welfare².

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3. Alexander Technique Lessons
The one-on-one AT lessons employ a nonexercise approach to the improvement of the use
and function of oneself. Using skilled hand contact, the teacher observes and assesses
changes in muscle activity, balance and coordination resulting from mental activity⁷. The
teacher also facilitates the learning experience through verbal guidance within a 45 minutes
length lesson.
This technique’s approach to human development is holistic, emphasizing the individual’s
overall condition and wellness. It views each person with the capacity and the responsibility
for optimizing his or her sense of well-being.
4. Standards
The Alexander Technique has been applied to the general public worldwide for over 100
years. Teachers complete a 3-year training course, 1600 hours, with 80% devoted to hands-
on practical experience, to acquire practical competence of the AT in themselves as a basis
for teaching³. Training courses are overseen by the Society of the Alexander Technique
(STAT, United Kingdom) and its international affiliated societies, such as the American
Society for the Alexander Technique (AmSAT)¹⁵. The Oregon Center for the Alexander
Technique is currently located in Portland, Oregon, and there are approximately 20 teachers
located in this city.
5. Benefits
The AT lessons help people improve balance, coordination, sit-to-stand strategies, general
state of well-being, respiratory capacity²⁵, posture, reduce lower back pain, stress, stiffness
and anxiety.

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Scientific researches about the benefits of the Alexander Technique have demonstrated
statistically significant improvements.
Here are some conclusions from 8 published scientific studies:
 Approximately 40% of improvement in balance was found after 16 AT lessons. The
author concluded that “our aging population stands to benefit from fuller access to
this self-empowering resource”⁹.
 Another study mentioned that AT lessons resulted in specific improvements in
dynamic balance tasks by emphasizing perceptual awareness and cognitive
strategies¹⁰.
 The British Medical Journal (BMJ) compared the benefits of AT lessons with massage
sessions and prescribed exercises. The results were 86%, 33% and 0% reduction in

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days in pain respectively. In addition, there were 42%reduction in Roland disability
from AT lessons. The results for prescribed exercises and massage sessions were
17% and 0% respectively¹.
 Reduced in medication change and improvement in specific actions were found in
the Randomized trial of the AT for Parkinson’s disease. Moreover, there were
indications that after AT lessons, individuals felt significantly better⁷.
 A series of studies in coordination is investigating the mechanisms of postural tone
and its correlations with the Alexander Technique. The authors suggest that postural
tone can be altered through AT training. They also suggest that AT lessons could
help develop a novel strategy for the sit-to-stand (STS) task. “The STS strategy could
help impaired populations rise from a chair, such as the elderly and those with
Parkinson’s disease.” If the AT lessons could regulate and improve the tonic postural
activity, as suggested by these researchers, The Alexander Technique could be an
effective training for the aging population by reducing interferences with movement
³ ¹⁴ ¹⁵ ¹⁶.
There are also testimonials about the benefits as follows:
 “In addition to its physiologic and musculoskeletal benefits, the Alexander
Technique is extremely helpful in relieving the psychological states of depression
and anxiety that so often accompany chronic pain and disease. It is my belief, based
on professional experience, that the Alexander Technique should be part of all
preventative health and education programs. It is as basic as good nutrition.” Harold
Wise, MD, PC, New York, NY²⁷.

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6. The Alexander Technique for the Aging Population
The recent gerontology literature brings insights that challenges us to rethink our
assumptions about aging and helps up to understand the uniqueness and diversity of the
aging experience¹⁷.
Here are some concepts congruent with the Alexander Technique:
 Mind and body connection is an essential model of care especially for older ones¹⁸.
The Alexander Technique sees the individuals as psychophysical units.
 Resilience is the ability to positively negotiate with adversities which is an important
skill in advanced age¹⁹. The AT is a strategic tool to deal with demands of life.
 Positive Aging is to have the goal of adapting and making the best of our situation,
even if it means chronic illness and decline. Instead of postponing decline, it is

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recognized that decline is to be expected, and so it is compensated and adapted. It
does not mean remaining healthy as long as possible but adapting to losses when
they occur²⁰. The AT teaches us to make better plans and to choose what is more
appropriate for one’s circumstances.
 Behavioral Plasticity is the ability to comport oneself in new ways for dealing with a
variety of demands²¹. It is the potentiality of change itself ²². The AT teaches us to
use ourselves in new ways by changing habitual uses.
 Latent Reserve is the reserve capacity that can be activated through learning or
training in later stages of life²². The AT is a learning process. Like learning to play a
guitar, one learns to manage oneself.
 Life Long Opportunity for growth is the potential to develop as long as we live²³

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7. Applicability
The aging population not only has the ability to learn the Alexander Technique, but also has
an incredible opportunity on their hands to contradict all the fixed ideas about how one
should age. As Frederick Mathias Alexander once wrote: “we never reach the point when
we may be said to finish learning”²⁴.
The Alexander Technique facilitates the development of mental and physical proficiencies
by supporting personal growth. It is most likely to be beneficial to independent older
adults, with low impaired cognition and with few comorbidities. It could be offered in
wellness programs available in community centers and assisted living facilities, for example.
It could also be suitable in outreach programs in which residents receive a variety of
supportive services in their houses, in alignment with the aging-in-place movement.
This technique is easily implemented since not much equipment is necessary for private
lessons which are a table (i.e. massage table) and a regular chair.
8. Bio
Deborah Bayardino George is a multi-cultural educator with progressive teaching in the
Alexander Technique since 2010. She has been a dedicated instructor of body-mind
practices for more than 15 years and has taught more than 300 hundred clients.
She is certified by the American Society for the Alexander Technique (AmSAT) and has a
home-based studio in the SW area of Portland. She began her 3 year AT training at the
Oregon Center for the Alexander Technique where, currently, she assists the director with
teacher training.

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She received her BA in Social Communication, completed an additional 3 years course in
Movement re-education and was certified as Pilates Instructor in Brazil.
In March 2015 she will have concluded her Graduate Certificate in Gerontology from
Portland State University.
“You translate everything, whether physical, mental or
spiritual, into muscular tension.” F.M. Alexander

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9. Reference
¹ Little, P., Lewith, G., Webley, F., Evans, M., Beattie, A., Middleton, K., Barnett, J., Ballard,
K., Oxford, F., Smith, P., Yardley, L., Hollinghurst, S., Sharp, D. (2008). Randomized
Controlled trial of Alexander technique lessons, exercise, and massage for chronic and
recurrent back pain. British Medical Journal. 337:a884
² Reveillau, R. (2014). Alexander Technique: What is it? Retrieved December 2nd, 2014,
from http://www.tecnicadealexander.com/technique.php
³ Cacciatore, T.W., Gurfinkel, V.S., Horak, F.B., Day, L.B. (2011). Prolonged weight-shift and
altered spinal coordination during sit-to-stand in practitioners of the Alexander
Technique. Gait & Posture Journal. Vol. 34, Issue 4, pages 496-501
⁴ Meng, C. F., Wang, D., Ngeow, J., Lao, L., Peterson, M., Paget, S. (2003). Acupuncture for
chronic low back pain in older patients: a randomized, controlled trial. S Rheumatology
Journal. Vol.42 (12), pp.1508-1517
⁵ Pan, S., Stutzbach, J., Reichwein, S., Lee, B. J., Dahodwala, N. (2014). Knowledge and Attitudes
About Parkinson’s Disease Among a Diverse Group of Older Adults. Journal of Cross-
Cultural Gerontology. 29:339-352
⁶ Collier, T. J., Kannan, N. M., Kordomer, J. (2011). Ageing as a primary factor for Parkinson’s
disease: evidence from studies of non-human primates. Nature Reviews Neuroscience
Journal. Vol 12, p. 359-366
⁷ Stallibras, C., Chalmers, C. (2002). Randomized controlled trial of the Alexander Technique for
Idiopathic Parkinson’s disease. Clinical Rehabilitation Journal, Vol. 16, page 695-708

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⁸ Falls Prevention for Older Adults. Retrieved February 28th
, 2014, from Oregon Public Health
DivisionWebsite:http://public.health.oregon.gov/PreventionWellness/SafeLiving/FallPre
vention/Pages/index.aspx
⁹ Dennis, R.J., (1999). Functional Reach Improvement in Normal Older Women After Alexander
Technique Instruction. Journal of Gerontology. Vol. 54A, No 1, M8-M11
¹⁰ Baston, G., Barker, S. (2008). Feasibility of Group Delivery of the Alexander Technique on
Balance in the Community-Dwelling Elderly: Preliminary Findings. Activities, Adaptation
and Aging Journal. Volume 32, Issue 2, pages: 103-119
¹² National Center for Complementary and Alternative Medicine. (2014). Complementary,
Alternative, or Integrative Health: What’s In a Name?. Retrieved December 1st, 2014,
from http://nccam.nih.gov/health/whatiscam
¹³ U.S Census Bureau. (2008). Retrieved December 1st, 2014 from http:// www.census.gov/
acs/www/data_documentation/2008_release/
¹³ WHO, World Health Organization. (2002). Active Ageing: A Policy Framework. Retrieved
October 24th, 2014 from http://www.who.int/ageing/publications/active_ageing/en/
¹³ WHO, World Health Organization. (2007). Global AGe-Friendly Cities Guide. Retrieved
December1st,2014fromhttp://www.who.int/ageing/publications/Global_age_friendly_c
ities_Guide_English.pdf
¹³ Metro. (2009). 20 and 50 year Regional population and employment range forecasts.
RetrievedDecember1st,2014fromhttp://www.oregonmetro.gov/sites/default/files/appe
ndix_12_forecast.pdf

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¹⁴ Cacciatore, T. W., Mian, O. S., Peters, A., Day, B. L. (2014). Neuromechanical Interference of
Posture on Movement: evidence from Alexander Technique Teachers Rising from a
Chair. Journal of Neurophysiology. Volume 112, pages: 719-729
¹⁵ Cacciatore, T.W., Horak, F.B., Henry, M. (2005). Improvement in Automatic Postural
Coordination Following Alexander Technique Lessons in a Person with Low Back Pain.
Physical Therapy Journal of the American Physical Therapy Association. 85(6):585-578
¹⁶ Cacciatore, T.W., Gurfinkel, V.S., Horak, F.B., Cordo, P.J., Ames, K.E. (2011). Increased
dynamic regulation of postural tone through Alexander Technique training. Human
Movement Science Journal. Vol. 30. Issue 1, pages 74-89
¹⁷ Ray, R & Cole, T. (2009). Critical and reflective gerontology. Ageing & Society. Vol 29. P. 649-
658
¹⁸ Berdayes, V., Esposito, L., Murphy, J. W. (2004). The body in human inquiry: interdisciplinary
explorations of embodiment. In Longino, C. & Powell, J., Embodiment and the Study
of Aging (p.199-214). Cresskill, N.J. : Hampton Press
¹⁹ Wild, K., Wiles, J. L., Allen, R. E. S. (2011). Resilience: thoughts on the value of the concept of
critical gerontology. Aging and Society. Vol: 33, pages: 137-158
²⁰ Wykle, M.,L., Whitehouse, P. J., Morris RN, D.,L.(2005). Successful aging through the life
span : intergenerational issues in health. In H.R. Moody, From successful Aging to
Conscious Aging (p.55-68). New York : Springer Pub. Co
²¹ Baltes, P. B. & Baltes, M., M. (1990). Successful aging: Perspectives from the behavioral
sciences. In P. B. Baltes, Psychological perspectives on successful aging: The model
of selective optimization with compensation (p. 1-34). New York: Cambridge

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²² Rabello de Castro, L., Rabello de Castro, G. (2001). Coping in old age: Considerations from
the point of view of case studies from Brazil. Indian Journal of Gerontology. Vol.
15, issue1-2, p. 183
²³ Papalia, D.E., Cap, C.J., & Feldman, R.D. (2006). Adult Development and Aging, 3rd
Ed.
McGraw-Hill
²⁴ Alexander, F. M. (2004). Constructive Conscious Control of the Individual (3rd
ed.). London,
UK: Mouritz
²⁵ Austin, J. H. M., Ausubel, P. (1992). Enhanced Respiratory Muscular Function in Normal
Adults after Lessons in Proprioceptive Musculoskeletal Education without Exercises.
CHEST Journal. Vol.102 (2), p.486 (5).
²⁶ United Nations Department of Economic and Social Affairs ǀ Population Division. (2013).
World Population Ageing 2013. Retrieved December 15th
, 2014 from
http://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldP
opulationAgeing2013.pdf
²⁷ American Society for the Alexander Technique (AmSAT) (2014). What have doctors said about
the Alexander Technique?. Retrieved December 16th
from
http://www.amsatonline.org/faq#t19n677

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APPENDIX I – FUNCTIONAL REACH TEST

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APPENDIX II – LOWER BACK PAIN IMPROVEMENTS

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APPENDIX III – PARKINSON’S DISEASE