Alexander technique versus targeted exercise for neck pain

ISRCTN	ISRCTN16291137
DOI	https://doi.org/10.1186/ISRCTN16291137
Secondary identifying numbers	17-164

Submission date: 24/10/2020
Registration date: 16/11/2020
Last edited: 14/03/2022

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Musculoskeletal Diseases

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Plain English summary of protocol

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
rcohen@uidaho.edu

Contact information

Dr Rajal Cohen
Scientific

Department of Psychology & Communication Studies
University of Idaho MS 3043
Moscow
83844
United States of America

ORCID ID	0000-0001-6691-2561
Phone	+1 208-885-1073
Email	rcohen@uidaho.edu

Study information

Study design	Two-group quasi-randomized pretest-posttest design
Primary study design	Interventional
Secondary study design	Quasi-randomized controlled trial
Study setting(s)	Community
Study type	Treatment
Participant information sheet	Not available in web format, please use contact details to request a participant information sheet.
Scientific title	Alexander technique versus targeted exercise for neck pain
Study objectives	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(s)	Approved 08/09/2017, University of Idaho Institutional Review Board (875 Perimeter Drive, Moscow, Idaho, 83844, USA; +1 208-885-6340; irb@uidaho.edu), ref: 010629
Health condition(s) or problem(s) studied	Neck pain
Intervention	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	Other
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 study start date	08/09/2017
Completion date	01/05/2018

Eligibility

Participant type(s)	Healthy volunteer
Age group	Adult
Sex	Both
Target number of participants	30
Total final enrolment	16
Key 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
Key exclusion criteria	Does not meet inclusion criteria
Date of first enrolment	01/01/2018
Date of final enrolment	01/02/2018

Locations

Countries of recruitment

United States of America

Study participating centres

North Idaho Athletic Club

408 S Main St
Moscow
83843
United States of America

University of Idaho

875 Perimeter Dr
Moscow
83844
United States of America

Sponsor information

University of Idaho
Research council

875 Perimeter Drive
Moscow
83844
United States of America

Phone	+1 208-885-6340
Email	irb@uidaho.edu
Website	http://www.uidaho.edu/
"ROR"	https://ror.org/03hbp5t65

Funders

Funder type

University/education

University of Idaho
Government organisation / Universities (academic only)

Alternative name(s): Uidaho, U of I, VANDALS, UI
Location: United States of America

Results and Publications

Intention to publish date	01/11/2020
Individual participant data (IPD) Intention to share	Yes
IPD sharing plan summary	Available on request
Publication and dissemination plan	Planned publication in an open-access journal.
IPD sharing plan	The datasets generated during and/or analyzed during the current study are/will be available upon request from Rajal Cohen (rcohen@uidaho.edu) 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.

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Results article		19/05/2021	14/03/2022	Yes	No

Editorial Notes

14/03/2022: Publication reference added.
11/11/2020: Trial’s existence confirmed by the University of Idaho Institutional Review Board.