Table 2.

Description of the included studies.

First Author (Year)	Study Objective	Type of Study	Population	Mean Age (SD)	Gender (M/F)	Groups (n)	Follow-Up and Outcomes Measures	Results
Quintero (2009) [25]	Evaluate the efficacy of FM to improve head posture and reduce nocturnal bruxism in children.	RCT with two parallel groups.	Children with bruxism.	4.73 (0.60)	NA	FG (13): ATM sessions, 3 h/once a week for 10 weeks. CG (13): Not specified.	Outcome measures: –Head posture (4 angles obtained from a lateral cephalometry) –Craniovertebral angle obtained from a photograph of the head Evaluation: –Pre-intervention –Post-intervention	There was a significant increase in the craniovertebral angle in the FG compared with the CG. The head posture in the FG after the intervention was less anterior and downward than the head posture in the CG.
Torres-Unda (2017) [21]	Evaluate the efficacy of FM to improve physical function and balance in middle-aged persons with intellectual disabilities.	RCT with two parallel groups.	Middle-aged subjects with intellectual disability	48.94 (6.01)	NA	FG (21, 16 analyzed): ATM sessions, 1 h/once a week for 30 weeks. CG (20, 16 analyzed): No intervention.	Outcome measures: –Physical Function Tests (SPPB) –Balance (stabilometry) Evaluation: –Pre-intervention –Just before the last session	SPPB: There was a significant improvement in the physical function of the FG compared with the CG (p < 0.01). Stabilometry: There was a significant decrease in the sway area in the FG (p < 0.05).
Lundqvist (2014) [14]	Evaluate the efficacy of FM to improve pain in persons with visual impairment and chronic neck/scapular pain.	RCT with two parallel groups.	Subjects with visual impairment and chronic neck/scapular pain.	53.3 (10.3)	10/51	FG (30): Combined sessions of ATM and FI, 2 h/once a week for 12 weeks. GC (31): No intervention.	Outcome measures: –Pain during palpation of the left and right occipital muscles, upper trapezius and levator scapulae muscles, measured with VAS. –Muscle complaints (subscale of the VMBC questionnaire) –Body pain (SF-36 subscale) Evaluation: –Pre-intervention –Post-intervention –One year after the intervention	Pain during palpation: There were significant between-group differences in the evolution of pain at post-intervention and at one-year follow-up. There were no significant changes in pain in the FG, while pain increased significantly in the CG. Muscular complaints: There were significant between-group differences in the evolution of the score at post-intervention. The score decreased significantly in the FG. Body pain: There were no significant differences.
Lundblad (1999) [23]	Investigate the effects of FM vs. physical therapy on neck and shoulder pain in industrial workers.	RCT with three parallel groups.	Women with neck or shoulder pain.	33 (9)	0/97	FG (33, 20 analyzed): Four sessions of FI and 12 sessions of ATM, 50 min/once a week, and home-based exercises for 16 weeks. PTG (32, 15 analyzed): Physical therapy sessions, 50 min/twice a week and home-based exercises for 16 weeks. CG (32, 23 analyzed): No intervention (waiting list).	Outcome measures: –Neck and shoulder ROM. –Estimated VO2 max during submaximal cycloergometry. –Endurance score: Sum of pain intensity (VAS) during a static shoulder flexion. –Cortical control score. –Physiological capacity based on isokinetic endurance test of the shoulder flexors on the dominant side (Surface EMG). –Measurement of painful neck and shoulder complaints: pain intensity (VAS), sick leave, prevalence and disability in leisure and work (questionnaires). Evaluation: –5 months before the intervention –1.5 months after the intervention.	In the FG, there were significant decreases in neck and shoulder complaints as well as in leisure disability. In the other two groups, there were either no changes (PTG) or complaints worsened (CG).
Chinn (1994) [19]	Evaluate the effect of one session of FM on functional reach of persons with neck, dorsal or shoulder pain.	RCT with two parallel groups.	Subjects with neck, dorsal or shoulder pain.	ND	1/22	FG (12): Follow the instructions of a 22-min audio of ATM related to neck and shoulders. A researcher made verbal and tactile clarifications if it was necessary. CG (11): Follow the instructions of a 16-min audio of simulated ATM related to neck and shoulders.	Outcome measures: –Functional Reach Test –Perceived exertion level during the Functional Reach Test measured with VAS. Evaluation: –Pre-intervention –Post-intervention	VAS: There was a significant reduction in the perceived exertion at post-intervention for the FG (p < 0.05). There were no significant differences in the CG. Functional reach: There were no significant differences in any group.
Paolucci (2017) [15]	Evaluate the efficacy of FM to reduce pain and improve interoceptive awareness in subjects with chronic low back pain.	RCT with two parallel groups.	Subjects with chronic low back pain.	FG: 61.21 (11.53) CG: 60.70 (11.72)	11/42	FG (26): ATM sessions, 1 h/twice a week for five weeks. CG (27): Physical therapy sessions (back school), 1 h/twice a week for five weeks.	Outcome measures: –Pain (VAS and MPQ) –Disability (WDI) –Quality of life (SF-36) –Mind-body interactions (MAIA) Evaluation: –Pre-intervention –Post-intervention –3 months after the start of the intervention	There were no significant between-group differences regarding the reduction of chronic pain. There was a correlation between the evolution of pain (VAS) and the Noticing subscale of the MAIA scale (R = 0.296, p = 0.037). There were significant changes in both groups in pain (p < 0.001) and disability (p < 0.001) over the investigation period.
Smith (2001) [16]	Determine the effect of one session of FM on pain and anxiety in people with chronic low back pain.	RCT with two parallel groups.	Subjects with chronic low back pain.	50.8 (16.2)	10/16	FG (14): Follow the instructions of a 30-min audio of ATM related to breathing. CG (12): Listen to a 30-min narration.	Outcome measures: –Pain (SF-MPQ) –Anxiety (STAI) Evaluation: –Pre-intervention –Post-intervention	Pain: There was a significant decrease in the affective dimension of pain in the FG. Anxiety: No significant differences.
Ahmadi (2020) [13]	Compare the effects of FM and core stability exercises on quality of life, pain, disability, interoceptive awareness and core musculature in subjects with chronic non-specific low back pain.	RCT with two parallel groups.	Subjects with chronic non-specific low back pain.	FG: 42.6 (11.6) CG: 38.89 (12.52)	NA	FG (30): ATM sessions, 30–45 min/ twice a week for five weeks. CG (30): Educational program and home-based core stability exercises with a prescribed progression for five weeks.	Outcome measures: –Quality of life (WHOQOL-BREF) –Pain (MPQ) –Disability (ODQ) –Interoceptive awareness (MAIA) –Diameter of the transversus abdominis muscle in contraction and at rest. Evaluation: –Pre-intervention –Post-intervention	There were statistically significant between-group differences for quality of life (p = 0.006), interoceptive awareness (p < 0.001) and disability (p = 0.021) in favor of the FG. Pain: McGill’s pain score decreased significantly in both groups, but there were no significant between-group differences. Transversus abdominis diameter at rest and in contraction: There was a significant increase in both groups, but the increase was significantly greater in the CG.
Johnson (1999) [22]	Evaluate the efficacy of FM to improve the emotional status and function in subjects with multiple sclerosis.	RCT with crossover design.	Subjects with multiple sclerosis.	44.8 (1.4)	5/15	FG (10): ATM Sessions, 45 min/once a week for eight weeks. CG (10): Simulated manual treatment, 1 h/ once a week, for eight weeks.	Outcome measures: –Manual dexterity test (9HPT) –Anxiety and depression (HAD) –Confidence in functional ability (MS Self-Efficacy Scale) –Symptoms scale (MS Symptom Inventory) –Functionality scale (MS Performance Scales) –Scale of perceived stress Evaluation: –Pre-intervention –Between interventions –Post-intervention	Significant differences in perceived stress, as well as a tendency to reduce anxiety, were reported after the Feldenkrais sessions. MS Self-Efficacy Scale: There were non-significant trends towards greater self-efficacy after both Feldenkrais and simulation sessions. There were no differences in the other measures.
Stephens (2001) [26]	Determine the efficacy of FM to improve balance, balance confidence and functional capacity confidence in persons with multiple sclerosis.	RCT with two parallel groups.	Subjects with multiple sclerosis.	FG: 56.2 (9.9) CG: 51.8 (10.2)	4/8	FG (6): 8 ATM sessions, 2–4 h (20 h in total) over a ten weeks period. CG (6): Four 90-min educational sessions by experts in multiple sclerosis over a ten weeks period.	Outcome measures: –Balance (fall register, Equiscale, mCTSIB and LOS) –Balance confidence (ABC) –Functional capacity confidence (MS Self-Efficacy Scale) Evaluation: –Pre-intervention –Post-intervention	There was a statistically significant increase in the mCTSIB score in the FG; the FG had significantly fewer abnormal mCTSIB tests and demonstrated better balance confidence compared with the CG. There was a trend towards improvement in all other measures in the FG compared with the CG.
Teixeira-Machado (2015) [27]	Determine the efficacy of FM to improve quality of life and depression in elderly patients with Parkinson’s disease.	RCT with two parallel groups.	Elderly patients with Parkinson’s disease.	FG: 60.70 (2.55) CG: 61 (2.70)	NA	FG (15): 50 ATM sessions, 1 h/twice a week. CG (15): Educational reading about fall prevention, medication and daily life management.	Outcome measures: –Quality of life (PDQL) –Depression (BDI) –Cognitive status (MMSE) Evaluation: –Pre-intervention –Post-intervention	There was a significant improvement in quality of life scores (p = 0.004) as well as a reduction in the level of depression (p = 0.05) in the FG compared with the CG. The mental state score increased significantly in the FG (p < 0.001) and decreased in the CG (p = 0.04).
Teixeira-Machado (2017) [28]	Evaluate the efficacy of the exercise based on FM to change the functional capacity of elderly patients with Parkinson’s disease.	RCT with two parallel groups.	Elderly patients with Parkinson’s disease.	GF: 60.70 (2.55) GC: 61 (2.70)	NA	FG (15): 50 ATM sessions, 1 h/twice a week. CG (15): Educational reading about fall prevention, medication and physical activity.	Outcome measures: –Functional tests to assess balance, mobility, strength and gait speed (walk in a figure-eight trajectory, TUG, lying rollover, standing 360° turn-in-place, functional reach, sitting/standing, BBS and hip flexion strength). Evaluation: –Pre-intervention –Post-intervention	There were significant differences between groups in the evolution of the functional test score. In all tests, the FG performed significantly better (p ≤ 0.05) compared with the CG.
Vrantsidis (2009) [17]	Evaluate the effects of an ATM program to improve balance and function in elderly patients.	RCT with two parallel groups.	Elderly patients.	74.9 (8.2)	13/42	FG (29, 26 analyzed): ATM sessions, 40–50 min/ once a week for eight weeks. CG (33, 29 analyzed): No intervention (waiting list).	Outcome measures: –Activities questionnaire (Frenchay Activity Index and Human Activity Profile) –Quality of life (AQoL) –Fear of falling (Modified FES) –Cognitive status (Abbreviated Mental Test Score) –Functional tests to evaluate balance, gait and function (FSST, TUG, Step Test, Timed Sit-to-Stand Test, gait speed and duration of the double-support phase). –Force platform measures assessing gait, balance and function. Evaluation: –Within three weeks before the intervention. –Within two to three weeks after the intervention.	There was a significant improvement for the FG compared with the CG in the Modified FES score (p = 0.003) and gait velocity (p = 0.028), as well as a strong tendency for improvement in the TUG score (p = 0.056). There were no significant between-group differences in the other measures.
Ullmann (2010) [20]	Determine the efficacy of FM to improve balance, mobility, gait and balance confidence in elderly patients.	RCT with two parallel groups.	Elderly patients.	75.6 (7.3)	14/33	FG (25): ATM sessions, 1 h/3 times per week for five weeks. CG (22): No intervention (waiting list).	Outcome measures: –Balance (Tandem test) –Mobility (TUG and TUG with cognitive tasks) –Gait characteristics (GAITRite Walkway System) –Balance confidence (ABC) –Fear of falling (FES) Evaluation: –Pre-intervention –Post-intervention	There was a significant improvement for the FG compared with the CG in balance (p = 0.03), mobility (p = 0.042) and fear of falling (p = 0.042). No other significant changes were reported. However, FG participants showed improvements in balance confidence (p = 0.054) and TUG with added cognitive task (p = 0.067).
Nambi (2014) [24]	Compare the efficacy of Pilates Method and FM to improve functional balance, mobility and quality of life in elderly persons.	RCT with three parallel groups.	Elderly patients.	G: 70.4 (2.8) PIG: 70.8 (2.8) CG: 69.35 (3.0)	37/23	FG (20): ATM sessions, three times a week for six weeks. GPI (20): Pilates exercises three times a week for six weeks. CG (20): A program consisting of 5 min of warm-up, 12 min of walking at a comfortable speed and 5 min of cool-down. Three times a week for six weeks.	Outcome measures: –Forward reach test –Mobility (TUG) –Functional Balance (Dynamic gait index) –Quality of life (RAND-36) Evaluation: –Pre-intervention –Post-intervention	In the FG and GPI, there was a significant improvement in all measures (p ≤ 0.001). However, GPI scored clinically better compared with the FG in all measures. In the CG there were significant improvements in the TUG (p = 0.022) and Dynamic Gait Index (p = 0.042) scores.
Palmer (2017) [18]	Evaluate the FM efficacy to improve balance, mobility and functional capacity in elderly patients.	RCT with two parallel groups.	Elderly patients.	76	16/108	FG (70, 45 analyzed): ATM sessions, either 2 h/twice a week for six weeks or 2 h/once a week for twelve weeks. CG (54, 36 analyzed): No intervention (waiting list).	Outcome measures: –Forward reach test –Mobility (TUG) –Balance (Base of support and tandem posture) –Difficulty in performing tasks (OPTIMAL modified) –Self-determined questionnaire on individual priorities and the effectiveness of the intervention Evaluation: –Pre-intervention –Post-intervention	There were significant correlations between the number of attended lessons and both functional reach test and modified OPTIMAL scores. A significantly higher proportion of the FG (versus CG) reported positive changes in the self-determined questionnaire in both prioritized and newly identified activities.

M/F, Male/Female; RCT, Randomized Controlled Trial; FM, Feldenkrais Method; ATM, Awareness through movement; FI, Functional Integration; FG, Feldenkrais group; CG, Control Group; PTG, Physical Therapy Intervention Group; PIG, Pilates Intervention Group; NA, not available; SPPB, Short Physical Performance Battery; VAS, Visual Analogue Scale; VMBC, Visual, Musculoskeletal, and Balance Complaints; SF-36, 36-Item Short-Form Health Survey; ROM, Range of movement; VO2max, Maximum oxygen volume; EMG, Electromyography; MPQ, McGill Pain Questionnaire; WDI, Waddel Disability Index; MAIA, Multidimensional Assessment of Interoceptive Awareness Questionnaire; SF-MPQ, Short-Form McGill Pain Questionnaire; STAI, State Trait Anxiety Inventory; WHOQOL-BREF, World Health Organization’s quality of life instrument short form; ODQ, Oswestry Disability Questionnaire; 9HPG Nine-Hole Peg Test; HAD Hospital Anxiety and Depression Scale; MS Multiple sclerosis; mCTSIB, Basic Balance Master modified Clinical Test of Sensory Interaction in Balance; LOS Limits of Stability; ABC, Activities-specific Balance Confidence Scale; PDQL, Parkinson’s Disease Quality of Life Questionnaire; BDI, Beck Depression Inventory; MMSE, Mini Mental State Questionnaire; TUG, Timed-Up-and-Go Test; BBS, Berg Balance Scale; AQoL, Assessment of Quality of Life instrument; FES, Falls Efficacy Scale; FSST, Four Square Step Test; RAND-36, RAND 36-Item Short Form Survey Instrument; OPTIMAL, Outpatient Physical Therapy Improvement in Movement Assessment Log.