Steve Cheslett, Feldenkrais Practitioner & Stroke Specialist Physiotherapist
The Feldenkrais Method® and Stroke Rehabilitation
I qualified as a Physiotherapist in 1993 and have since specialised in the area of neurological and stroke rehabilitation. In 2014 I completed my four-year Feldenkrais Method practitioner training in Sussex and have subsequently been integrating Feldenkrais into my practice as a Stroke Specialist Physiotherapist, both in the NHS and in private practice.
Feldenkrais is the method of mindful movement re-education developed by scientist and martial artist Dr Moshe Feldenkrais. It is a mind-body method which fits with numerous modern scientific models of learning and neuroplasticity spanning Dynamics Systems Theory to Mindfulness.
Feldenkrais is essentially holistic and educational in its approach. I feel traditional physiotherapy has been more about doing things to our clients. In Feldenkrais we guide our students on a journey to develop self-awareness of how they do things and enable them to make new choices. We facilitate change and empower our students to become their own movement detectives!
Recovery from stroke is dependent on a phenomenon called neuroplasticity which is the brain’s ability to reorganise itself by forming new neural connections throughout its life. Following stroke there is permanent damage caused to part of the brain, usually on one side. Through neuroplasticity the brain can reorganise itself around this damage and functional recovery may take place, but the new neural connections need the right environment and guidance along the way. This is where therapeutic interventions and movement re-education come into play, including Feldenkrais.
The extent of neuroplasticity and functional recovery available are both highly individual. They are dependent on both previous levels of health and resilience and the severity and location of the stroke. Moshe Feldenkrais is described as a pioneering ‘neuroplastician’ by Norman Doidge in his recent book on the applications of neuroplasticity: The Brain’s Way of Healing. Moshe worked successfully with many stroke and neurological students during his career and he outlines his highly inventive, customised approach to working with stroke in his 1977 case study: Body Awareness as Healing Therapy: The Case of Nora.
Many students, following stroke, display an imbalance of activity which means they do too much on the ‘good’ side and inhibit activity on their affected side. In Feldenkrais we often begin by increasing awareness of the dominant or more active side first. By illustrating this asymmetry, we can help inhibit and decrease the over-activity and ultimately guide awareness to the affected side. Sometimes all that is needed is for the student to gain awareness of their dominant over-activity and the activity on the affected side is allowed to return.
In the longer term, post-stroke, Feldenkrais can be useful in maintaining and improving functional movement as neuroplasticity is life-long, and often we develop unhelpful movement habits over time. Feldenkrais can help shift these habits and give you access to more useful, alternative patterns. This can be done in one to one lessons with a Feldenkrais practitioner or in an Awareness Through Movement class setting.
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