Can the Alexander Technique improve balance and mobility in adults over 50 with visual impairments? A randomised controlled trial.

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Vision impairment is a growing public health problem in an ageing population, is an independent risk factor for falls, and compounds the effects of other risk factors by reducing mobility and physical fitness. This randomised controlled trial will investigate the effect of the Alexander Technique on balance and mobility in adults over 50 with vision impairments. 120 people over 50 years of age with vision impairments will participate in the trial. Participants will be independently mobile, with conversational English and no marked cognitive impairment. The intervention group will receive 12 home based lessons in the Alexander Technique on a weekly basis, and the control group will receive usual care. Outcome measures will be collected by assessors masked to group allocation at baseline, and at 3 and 12 months post randomisation. The primary outcome measure will be physical ability using the Short Physical Performance Battery. Secondary outcome measures will be mobility measured with actigraphy and falls measured with 12 monthly calendars. A smaller sub-study will investigate changes in gait patterns. Mood, quality of life, fall-related self-efficacy and functional vision will be measured with a series of validated questionnaires. If proven effective, the Alexander Technique will provide an additional modality to improve mobility and reduce falls risk in vulnerable adults with vision impairment.