In the Mind in Movement Lab, we use tools and concepts from cognitive psychology, motor control, and biomechanics to inform and inspire questions about posture and voluntary movement in healthy young adults and in the context of aging, Parkinson's disease, fall risk, and musculoskeletal pain. We are investigating the idea that cognitive factors such as inhibitory control influence postural alignment and muscle tone, which in turn affect balance mobility, fall risk, and musculoskeletal pain.
Posture and CognitionWe are researching connections among posture, movement, and cognition. Inhibitory control is the ability to choose not to do something. Inhibitory control is heterogeneous in a healthy young population, and it decreases significantly with age. During movement preparation, inhibition may be important for linking movement elements together in the correct order, including any needed changes in posture. For instance, in step initiation, inhibitory deficits are associated with premature postural adjustments and subsequent delays in stepping.
Forward head posture may contribute to neck pain, which is the 4th leading cause of disability in the US. We hypothesize that upright posture is facilitated by engaging inhibitory control to prevent oneself from pulling one's head forward in response to compelling stimuli. We tested this by asking participants to sit at a computer and play a game. We manipulated motivation by offering some participants a reward if they get a high score. Results suggest that being highly motivated to perform well on the computer game causes people to move their heads forward (toward the computer screen) and that this tendency is associated with poor performance on a test of inhibitory control. We also found a surprisingly strong relation between forward head posture and verbal memory in older adults. We hypothesize that this may be caused by a common reliance of both functions on dopamine, which declines with age. Another study demonstrated that when people think about starting to walk, they project their heads forward in space, and that this tendency is associated with poor inhibitory control.
Biofeedback devices are commonly touted as solutions to postural problems, but if they demand attention that interferes with the primary task, they may not be the best answer. We are examining the effect of auditory biofeedback of head position on neck posture and the possible tradeoffs between attention to posture and performance on a challenging cognitive task. Results from this research could lead to improvements in biofeedback and training to improve posture in office workers at risk for neck pain.
Cognitive Influence on Muscle ActivationPostural tone, an adaptable system of regulating background muscle activity, is thought to be important for coordinating the limbs and the torso into a single functioning unit. Tone is primarily regulated subcortically, in the brainstem, but cortical regions also have an indirect influence. We have used neuroimaging to show that an area in the brainstem thought to regulate postural tone has structural and functional connections to the frontal cortex, and those connections are altered in people with Parkinson's disease who have freezing of gait. Thus, we demonstrated a three-way interaction among high level cognitive factors, postural tone, and balance and mobility.
We are studying the effects of different ways of thinking about posture on tone and mobility. We have found, for instance, that when we tell people to pull themselves up tall using muscular effort, their necks get shorter, their balance gets worse, and their movements get less smooth. In contrast, when we tell them to maintain a light upward intention with an emphasis on preventing (inhibiting) any impulse to shorten and compress the spine, their necks get longer, their balance improves, their tone becomes more adaptable, and their movements become smoother. Our first publication on this "Lighten Up" effect showed effects in Parkinson's disease. Our second publication showed similar benefits in healthy older adults, and our third showed similar effect in young adults. In a world where the idea of good posture as something effortful is still very popular, this discovery could have far-reaching implications for health education and physical therapy.
To assess axial muscle tone during standing, we use a unique custom device called Twister. Most recently, we are exploring the relations among tone, proprioception, and body awareness. A grant to a student has allowed us to also look at the effects of aging on these relations.
Studies of Alexander TechniqueFor the last several years, we've been engaging in small clinical studies investigating the acceptability and efficacy of group classes in Alexander technique (AT) for a variety of conditions. Much of this work has been done in collaboration with the Poise Project, whose mission is to bring a scientifically-validated emodied empowerment approach to broad populations, starting with care partners and people with Parkinson's disease. The Poise Project has obtained numerous grants and contracts to deliver Alexander-based courses to people living with Parkinson's disease and their care partners, or to care partners of people living with dementia. Members of the Mind in Movement Lab collect and analyze data, prepare posters, and travel to conferences. We've presented results at the World Parkinson Congress, the International Parkinson and Movement Disorders Society, the Alzheimer's Association International Conference, and elsewhere.
A student in our lab obtained two separate undergraduate research awards to deliver Alexander-based courses to people with chronic neck pain. We conducted pilot investigations testing the effects of a group class intervention on neck muscle activation, postural alignment, and self-reported pain, in a sample of adults with chronic neck pain. Courses focused on teaching participants to improve awareness of psychomotor habits, inhibit excessive muscle activity, and redistribute postural tone. Previous studies have shown that private lessons in the Alexander technique are beneficial for neck pain, but these are the first investigation of group classes, which are likely to be more affordable than private lessons for most people. The second study in this pair compared Alexander technique to an exercise class and found that the two approaches have markedly different effects on neck muscle activation and overall perspective.
Other Alexander-related research includes a study comparing AT teachers to matched controls, in which we found that AT teachers had more limb movement and less torso movement than controls, supporting the idea that AT affects the habitual distribution of muscle tone, and a theory paper explaining our ideas about how AT links cognition and tone to affect mobility.
Dr. Cohen has teamed up with several other scholars to develop a website devoted to exploring the scientific foundations of Alexander Technique.
Dr. Cohen has been interviewed by Alexander Studies Online about the "Lighten Up" series of studies.
Dr. Cohen participated in an AT research panel in 2021.
The theoretical paper by Drs. Cacciatore, Johnson, and Cohen was used as part of a video about the Alexander Technique.
Dr. Cohen and several other scholars are developing a website devoted to exploring the scientific foundations of postural tone.