Condition category
Musculoskeletal Diseases
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status
Results overdue

Plain English Summary

Background and study aims
The Alexander technique addresses the distribution and adaptivity of postural tone during everyday activity. This is thought to ameliorate pains and problems brought about by faulty habits of posture and movement. The goal of this study is to determine if group Alexander technique classes are as effective as a targeted exercise program for reducing chronic neck pain.

Who can participate?
Any adults over the age of 18 who score above 16% on a neck pain questionnaire, have had neck pain for over 3-months, are not receiving specialized care, and can attend the classes are welcome to participate.

What does the study involve?
The study involves an initial baseline screening, either 10 Alexander Technique classes or exercises class, a screening immediately following the classes, and a final screening 6 weeks after the classes end. Each screening will take 1-hour and involves 2 questionnaires, an assessment to record neck muscle activity, and playing a video-game for 5 minutes.

What are the possible benefits and risks of participating?
The possible benefits of the study are decreased neck pain and progressing the knowledge of interventions that may help with neck pain. The possible risks are increased neck pain or injury.

Where is the study run from?
North Idaho Athletic Club (USA) and the University of Idaho (USA)

When is the study starting and how long is it expected to run for?
From September 2017 to May 2018

Who is funding the study?
University of Idaho (USA)

Who is the main contact?
Dr Rajal Cohen

Trial website

Contact information



Primary contact

Dr Rajal Cohen


Contact details

Department of Psychology & Communication Studies
University of Idaho MS 3043
United States of America
+1 208-885-1073

Additional identifiers

EudraCT number

Nil known number

Nil known

Protocol/serial number


Study information

Scientific title

Alexander technique versus targeted exercise for neck pain


Study hypothesis

The Alexander Technique group, relative to the exercise group, will show reduced activity of the superficial neck flexors and reduced neck pain after the intervention.

Ethics approval

Approved 08/09/2017, University of Idaho Institutional Review Board (875 Perimeter Drive, Moscow, Idaho, 83844, USA; +1 208-885-6340;, ref: 010629

Study design

Two-group quasi-randomized pretest-posttest design

Primary study design


Secondary study design

Quasi-randomized controlled trial

Trial setting


Trial type


Patient information sheet

Not available in web format, please use contact details to request a participant information sheet.


Neck pain


Participants will be assigned quasi-randomly to groups, based in part on their availability to attend either Monday-Wednesday or Tuesday-Thursday evening class sessions. One group will receive ten Alexander technique classes and the other group will ten receive exercise classes, over 5 weeks.

The AT classes will include information on basic biomechanical and ergonomic principles (including the anatomy of the neck, spine, and major joints of the upper and lower limbs) and benefits of widening awareness to include both the self and the environment during activity. In addition, participants will be guided in self-observation during common daily activities such as standing, sitting, computer work, personal care tasks, and household chores.

The exercise intervention exercises will be aimed at retraining the use of the deep cervical flexors, strengthening postural muscles, and increasing range of motion. The therapeutic retraining component will be based on an adaptation of the protocol described by Jull et al. Participants will place the backs of their necks on a rolled towel and gently rotated their heads as if nodding ‘yes’, with a goal of activating the deep cervical flexors rather than surface neck flexors. Postural strengthening exercises will include the use of dumbbells and resistance bands (Theraband®, Akron, OH) to target the trapezius and upper-back muscles. The trapezius and anterior neck muscles will be stretched to increase mobility. Each exercise class will include 10 minutes of light stretching, followed by 45 minutes of retraining and strength exercises aimed at promoting a more upright posture.

Follow-up measurements will be taken immediately after the interventions end, and 6 weeks after the interventions end.

Intervention type



Drug names

Primary outcome measure

Neck disability measured using the Northwick park questionnaire at baseline, 5, and 11 weeks

Secondary outcome measures

1. Superficial muscle activity will be measured using the CCFT at baseline, 5, and 11 weeks
2. Self-efficacy will be measured using the Pain Self Efficacy questionnaire at baseline, 5, and 11 weeks
3. Intervention assessment will be measured using a questionnaire assessing impressions of the interventions will be administered after completion of the course
4. Video-game posture will be measured using photos at baseline, 5, and 11 weeks

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

1. Score 16% or higher on the Neck Disability Index
2. Had at least 3 months of neck pain
3. Not currently receiving specialized care
4. Available for the scheduled class times

Participant type

Healthy volunteer

Age group




Target number of participants


Total final enrolment


Participant exclusion criteria

Does not meet inclusion criteria

Recruitment start date


Recruitment end date



Countries of recruitment

United States of America

Trial participating centre

North Idaho Athletic Club
408 S Main St
United States of America

Trial participating centre

University of Idaho
875 Perimeter Dr
United States of America

Sponsor information


University of Idaho

Sponsor details

875 Perimeter Drive
United States of America
+1 208-885-6340

Sponsor type

Research council



Funder type


Funder name

University of Idaho

Alternative name(s)

UI, U of I

Funding Body Type

private sector organisation

Funding Body Subtype

Universities (academic only)


United States of America

Results and Publications

Publication and dissemination plan

Planned publication in an open-access journal.

IPD sharing statement:
The datasets generated during and/or analyzed during the current study are/will be available upon request from Rajal Cohen ( and will be shared by email. Individual requesting data may access the data indefinitely. Consent from participants was obtained and all the data has been de-identified.

Intention to publish date


Participant level data

Available on request

Basic results (scientific)

Publication list

Publication citations

Additional files

Editorial Notes

11/11/2020: Trial’s existence confirmed by the University of Idaho Institutional Review Board.