This document discusses personalized movement therapy programs for chronic pain patients. It begins by introducing Dr. Bonnie Feldman who has dealt with chronic musculoskeletal pain for 35 years. While physical therapy provided temporary relief, she found she needed long-term alternatives. The document then reviews various movement therapies like yoga, Pilates, tai chi and their benefits. It stresses that one size does not fit all and movement programs need to be personalized. It provides tips on factors to consider for exercise with autoimmune diseases. Overall it promotes integrating mind and body practices tailored to individual needs and symptoms for chronic pain management and improved mobility.
2. @DrBonnie360
@DrBonnie360
@YourAutoimmunityConnection
linkedin.com/in/bonniefeldman
+1 310 666 5312
drbonnie360.com
drbonnie360@gmail.com
Bonnie Feldman, DDS, MBA
DrBonnie360’s mission is to create a
connected world of personalized care for
patients with chronic diseases using the
best of conventional, functional, and digital
medicine.
We consult to entrepreneurs and others
who are developing new products and
services to improve chronic disease
research, diagnosis and care.
3. DISCLOSURE
I have no financial disclosure or conflicts of
interest with the presented material in this
presentation.
4. LEARNING OBJECTIVES
1
2
3
Why physical therapy is
not enough to manage
chronic musculoskeletal
pain and improve
mobility.
How to create
personalized
movement therapy
programs that
enhance your
patients’ mobility.
Find and explore
different kinds of
movement therapies.
5. DRBONNIE360’S STORY
• Family history of several autoimmune diseases.
• 35 years of chronic musculoskeletal pain.
• Diagnosed with Fibromyalgia 30 years ago.
• Weekly physical therapy for over 30 years.
6. LIMITATIONS OF PHYSICAL THERAPY
Reactive not
proactive
Temporary
benefits
Need long term
alternatives
7. WHY WE EXERCISE?
REDUCE MORTALITY
PREVENT & REDUCE
MORBIDITY
IMPROVE CHRONIC PAIN &
IMMUNE FUNCTION
Hoffmann, Tammy C., et al. "Prescribing exercise interventions for patients with chronic conditions." Cmaj 188.7 (2016): 510-518.
Sharif, Kassem, et al. "Physical activity and autoimmune diseases: Get moving and manage the disease." Autoimmunity reviews 17.1 (2018): 53-72.
Vina, Jose, et al. "Exercise acts as a drug; the pharmacological benefits of exercise." British journal of pharmacology 167.1 (2012): 1-12.
8.
9. BONNIE’S EXERCISE PROGRAM ON PAUSE
• Bar Method
• 3-4 times per week for 10
years
• Shingles outbreak
• Post-Shingles Chronic Fatigue
10. EXERCISE INTOLERANCE
Noakes, Timothy David OMS. "Fatigue is a brain-derived emotion that regulates the exercise behavior to ensure the protection of whole body homeostasis." Frontiers in physiology 3 (2012): 82.
What is exercise intolerance?
Why does it happen?
Why are autoimmune patients & certain other populations more likely to suffer exercise
intolerance?
11. ONE SIZE DOES NOT FIT ALL
Varied symptoms
of chronic musculoskeletal
pain
Conventional care may not
be enough
Individuals have different
symptom clusters
Hoffmann, Tammy C., et al. "Prescribing exercise interventions for patients with chronic conditions." Cmaj 188.7 (2016): 510-518.
Vina, Jose, et al. "Exercise acts as a drug; the pharmacological benefits of exercise." British journal of pharmacology 167.1 (2012): 1-12.
13. BONNIE BECOMES A FEARLESS EXPERIMENTOR
• I realized a need for mind & body exercise
• So I became a fearless experimenter:
Yoga therapy
Pilates
Gyrotonic
Feldenkrais
14. INTEGRATING MIND AND BODY VIA SOMATIC PRACTICES
UNDERSTANDING
HOW BODY WORKS
PAIN RELIEF
GREATER BODY
AWARENESS
15. YOGA THERAPY
WHAT HOW TYPES
Arora, Sarika, and Jayashree Bhattacharjee. "Modulation of immune responses in stress by Yoga." International journal of yoga 1.2 (2008): 45.
Büssing, Arndt, et al. "Effects of yoga on mental and physical health: a short summary of reviews." Evidence-Based Complementary and Alternative Medicine 2012 (2012).
Gothe, Neha P., et al. "Differences in brain structure and function among yoga practitioners and controls." Frontiers in integrative neuroscience 12 (2018).
Empowers practitioners
to progress toward
improved health & well-
being through the
application of yoga
teachings
Gentle to vigorous
movements
Breathing techniques
Meditation &
visualization practices
One-on-one private
coaching
Small-to-large
group classes
16. YOGA THERAPY VS PILATES
YOGA PILATES
Flexibility, endurance, stretch Core strength, stretch, posture
A variety of
breathing techniques
Breathing in through nose &
out through mouth
Poses/Asanas on mat
with props or not
Dynamic exercises on mat with
machines
17. PILATES THERAPY
Core strength, muscle
balance
& postural alignment
Low-impact flexibility,
strength & endurance
exercises
Mat
Machine
Group classes & one-
on-one coaching
WHAT HOW TYPES
Wells, Cherie, Gregory S. Kolt, and Andrea Bialocerkowski. "Defining Pilates exercise: a systematic review." Complementary therapies in medicine 20.4 (2012):
253-262.
18. PILATES GYROTONIC
2-dimensional
Uses spring resistance &
own weight
Teaches control &
alignment
Requires careful attention
to form & breathing
BOTH
Help elongate muscles &
build strength
Teach how to move
fluidly & create greater
body awareness
3-dimensional
Uses a pulley and weight
system
Circling, spiraling &
undulating motions to
strengthen all of the body's
internal support structures
19. GYROTONIC/GYROKENESIS METHOD
A holistic movement
system that supports
the energy opening of
pathways by
stimulating the nervous
system
Increases range of
motion and improves
strength and
movement efficiency
through circular
movements
Gyrotonic
uses proprietary
machines
Gyrokenesis |uses
mats and chairs
WHAT HOW TYPES
Seo, Hye-Ran, and Tae-Ho Kim. "The effects of Gyrotonic expansion system exercise and trunk stability exercise on muscle activity and lumbar stability for the subjects with chronic low back
pain." Journal of exercise rehabilitation 15.1 (2019): 129.
20. QI GONG
A mind-body-spirit practice
to improve mental &
physical health by
integrating posture,
movement, breathing, self-
massage, sound, and
focused intent
Slow, gentle
standing movements
More vigorous in
martial
3 types:
Medical
Martial
Meditative
WHAT HOW TYPES
Jahnke, Roger, et al. "A comprehensive review of health benefits of qigong and tai chi." American Journal of Health Promotion 24.6 (2010): e1-e25.
Wang, Chong-Wen, et al. "Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials." BMC complementary and
alternative medicine 14.1 (2014): 8.
21. TAI CHI
Sometimes described
as meditation in motion
& body
Improves muscle
strength, flexibility &
balance
A series of gentle
standing exercises &
stretches
Each posture flows
into the next without
pause
5 Types: different
styles, Yang is the best
for beginners
WHAT HOW TYPES
Jahnke, Roger, et al. "A comprehensive review of health benefits of qigong and tai chi." American Journal of Health Promotion 24.6 (2010): e1-e25.
22. FELDENKRAIS
A practice, a process &
a system of self-
improvement.
Curiosity is
the underlying driver
A philosophy
or way of life
Uses gentle movement
& directed attention
based upon physics &
biomechanics to help
people learn new &
more effective ways of
moving
Private
Functional Integration
Instruction
Awareness through
movement classes
WHAT HOW TYPES
Hillier, Susan, and Anthea Worley. "The effectiveness of the feldenkrais method: a systematic review of the evidence." Evidence-Based Complementary and
Alternative Medicine 2015 (2015).
24. CONSIDER 4 MAIN FACTORS WHEN
EXERCISING WITH AUTOIMMUNE
DISEASE
Frequen
cy
Duration Intensity Type
Wool, Andrea. “The Four Factors You Need To Consider When Exercising With Autoimmune Disease.” Autoimmune Strong,
https://www.getautoimmunestrong.com/blog/four-factors-exercise-and-autoimmune-disease.
25. WELL-BEING TEAM
FOOD AS
MEDICINE TEAM
INDIVIDUAL GROUP
FAMILY
FRIENDS
CHURCH
YOGA
MEDITATION
PSYCHOLOGISTS
BIOFEEDBACK
COACHES
NUTRITIONISTS
COACHES
MUSCULOSKELETAL
INTEGRITY TEAM
PHYSICAL THERAPY
ACUPUNCTURE
MASSAGE
CHIROPRACTIC
BIOFEEDBACK
26. MODALITY TARGET POPULATION EQUIPMENT CLAIM TO FAME
Pool exercise Older pool, floats low impact
Yoga Therapy All ages mat and props flexibility
Pilates Women 20s-80s mat to machines core strength
Gyrotonic Women Proprietary machine strength, flexibility
Qi Gong All ages none simpler to learn than Tai
Chi
Tai Chi Old folks, groups none great for groups
Feldenkrais All ages mat, chair, massage
table
meditative, slow
EXERCISE FACTORS TO CONSIDER
27. HOW TO GET STARTED
Personal
Preference =
Motivation
Poses vs
Flowing
Movements
Cognitive
Benefits
Complexity/
Intensity of
movements
Need for
Equipment
Meditative/
Breathing
Benefits
Need for
Coaching
Social Aspects
Factors
to
Consider
28. Sherry Brourman
Yoga Therapist
Jessica Zarins
Feldenkrais Practitioner
Nichole Beeks
Gyrotonic Instructor
Tricialee Friedman
Pilates Instructor
Dr. Bonnie Feldman
DDS, MBA
drbonnie360.com
John Chao
Physical Therapist
MY
TEAM
31. Dr. Kien Vuu,
Kienvuumd.com
Tomm Voss
qiwithin.com
Mayo Clinic
mayoclinic.org
Andrea Wool
getautoimmunestrong.com
MD Anderson
mdanderson.org
VIDEO CREDITS
TAI CHI QI GONG FELDENKRAIS
AUTOIMMUNE
STRONG
32. WORKS CITED
AQUA
THERAPY
Becker, Bruce E. "Aquatic therapy: scientific foundations and clinical rehabilitation applications."
Pm&r 1.9 (2009): 859-872.
Mooventhan, A., and L. Nivethitha. "Scientific evidence-based effects of hydrotherapy on
various systems of the body." North American journal of medical sciences 6.5 (2014): 199.
YOGA
Arora, Sarika, and Jayashree Bhattacharjee. "Modulation of immune responses in stress by
Yoga." International journal of yoga 1.2 (2008): 45.
Büssing, Arndt, et al. "Effects of yoga on mental and physical health: a short summary of
reviews." Evidence-Based Complementary and Alternative Medicine 2012 (2012).
Gothe, Neha P et al. “Differences in Brain Structure and Function Among Yoga Practitioners
and Controls.” Frontiers in integrative neuroscience vol. 12 26. 22 Jun. 2018,
doi:10.3389/fnint.2018.00026
33. WORKS CITED
PILATES
Wells, Cherie, Gregory S. Kolt, and Andrea Bialocerkowski. "Defining Pilates exercise: a systematic
review." Complementary therapies in medicine 20.4 (2012): 253-262.
FATIGUE
Noakes, Timothy David OMS. "Fatigue is a brain-derived emotion that regulates the exercise
behavior to ensure the protection of whole body homeostasis." Frontiers in physiology 3 (2012): 82.
GYROTONICS
Seo, Hye-Ran, and Tae-Ho Kim. "The effects of Gyrotonic expansion system exercise and trunk
stability exercise on muscle activity and lumbar stability for the subjects with chronic low back pain."
Journal of exercise rehabilitation 15.1 (2019): 129.
34. WORKS CITED
AUTOIMMUNE DISEASES
Sharif, Kassem, et al. "Physical activity and autoimmune diseases: Get moving and manage the
disease." Autoimmunity reviews 17.1 (2018): 53-72.
Stojanovich, Ljudmila, and Dragomir Marisavljevich. "Stress as a trigger of autoimmune disease."
Autoimmunity reviews 7.3 (2008): 209-213.
FELDENKRAIS
Hillier, Susan, and Anthea Worley. "The effectiveness of the feldenkrais method: a systematic review
of the evidence." Evidence-Based Complementary and Alternative Medicine 2015 (2015).
Paolucci, Teresa, et al. "Improved interoceptive awareness in chronic low back pain: a comparison of
Back school versus Feldenkrais method." Disability and rehabilitation 39.10 (2017): 994-1001.
TAI CHI & QI GONG
Jahnke, Roger, et al. "A comprehensive review of health benefits of qigong and tai chi." American
Journal of Health Promotion 24.6 (2010): e1-e25.
Wang, Chong-Wen, et al. "Managing stress and anxiety through qigong exercise in healthy adults: a
systematic review and meta-analysis of randomized controlled trials." BMC complementary and
alternative medicine 14.1 (2014): 8.
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A glance inside
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