There are some very interesting considerations which are brought to light by the recent clinical trial on Alexander Technique. The study investigated chronic neck pain and proved the effectiveness of Alexander Technique and also acupuncture. This article examines the details of the study from an Alexander Technique teacher’s point of view.
The Clinical Trial
Publication of clinical trials brings Alexander Technique to the public eye. It broadens the exposure of The Technique and the scope for people to potentially benefit from it. To receive recognition from peer reviewed journals presents The Technique to the medical profession as the scientifically based technique it is. Most importantly to the teaching community, and those who study Alexander Technique, the study confirms empirically the benefits we have always believed Alexander Technique to bring to students.
The patients in the trial who studied Alexander Technique had an reduction in pain significantly greater than that of those who received conventional treatment. The most profound finding however, was that the improvements were sustained beyond the conclusion of their lessons.
Therapy and education
Alexander Technique is often misrepresented, or misunderstood in heath care environments. It has therapeutic benefits, but considers itself educational. The result of this research highlights the value of education in “treatment” of pain. The conventional methods lack this element, so the result challenges the mainstream attitude towards resolving pain.
The fact that the study chose to focus on chronic pain in particular is possibly to highlight the importance of training the patient in new behaviours. Alexander Technique can help in acute situations, but perhaps has a more significant contrast to conventional intervention in the case of longstanding pain. The sustained result also points towards The Technique’s capacity for prevention of pain, another area in which The Technique exceeds the capabilities of conventional treatment.
First line treatment
Interestingly, the lead author is quoted saying; “Single interventions for chronic neck pain do not on average provide long-term benefits”. This places Alexander Technique as a first line treatment for chronic pain, rather than the ‘last resort’ consideration it has historically been given by the medical fraternity.
On par with acupuncture
Alexander Technique was placed alongside acupuncture in comparison to conventional intervention. This had the unfortunate side effect of some of the publicity, such as in Time magazine, being focused on the more well known modality. On the other hand, the coverage which the result gained because of the result for acupuncture, made the study relevant enough for such journals to publish.
Acupuncture has an enormous presence globally as an effective modality. Frequently, studies are investigating its effect. Since the results in this trail for each alternative modality differed insignificantly from each other, this paper calls for Alexander Technique to have the same public support and the same research commitment, as is given to acupuncture.
The average duration of neck pain prior to the study was six years. Given that Alexander Technique gave an overall reduction in neck pain by 30% during the year of the trial, it is very curious to read that one average participants attended 70% of their individually allocated Alexander Technique sessions. Also only 9% of participants chose to pay privately for additional sessions. It leads one to question why was the attendance of sessions poor, and such a small proportion continued, when the results were so significant.
Alexander Technique works on subtle changes, and the changes are gradual. The sessions in this study were 30 minute duration. Given that 20 sessions were offered, and treatment was conducted within 4 months, presumably the sessions were more or less weekly. Over that time, a 30% reduction is pain is quite difficult to appreciate.
Improvement is never linear, it has numerous ups and downs. If we presume for the moment that improvement were consistent, a 30% improvement over 20 weeks is an improvement of 1.5% per week. The impact of each session subjectively may appear minimal, but as we can see, accumulates to an impressive amount of time. The student may not perceive this incremental improvement during the course of lessons and be discouraged.
My own preference is for sessions to be 45 - 60 minute in duration. One reason is that in the extended duration, there is more opportunity for the student to make change, sustain the change and experience the change. We can go deeper and make a more profound impression with a progressive experience in a longer session.
Report on the study do not make mention of other statistics which would be valuable to the teaching profession. Of particular interest would be if there were correlations between the attendance of lessons and the improvement reported. The author did call for more research to determine how many Alexander Technique sessions are most effective, to which we could further recommend research into lesson duration and frequency.
Pedagogical considerations would be interesting to consider, and if the data were available. The teachers in this study were all accredited by STAT, the UK’s Society of Teacher’s of Alexander Technique. STAT is part of an international society which is affiliated with AUSTAT in Australia, and AMSTAT in the US.
It would be also interesting to note if any demographic factors provided significant findings. The duration of neck pain prior to the study is one possible factor which may motivate some patients over others to engage in Alexander Technique study.
Let us hope that the positive results of this study encourage more research into Alexander Technique.
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