Synopsis of Study
OBJECTIVE: To determine the effectiveness of lessons in the Alexander technique, massage therapy, and advice from a doctor to take exercise (exercise prescription) along with nurse delivered behavioural counselling for patients with chronic or recurrent back pain.
DESIGN: Factorial randomised trial.
SETTING: 64 general practices in England.
PARTICIPANTS: 579 patients with chronic or recurrent low back pain; 144 were randomised to normal care, 147 to massage, 144 to six Alexander technique lessons, and 144 to 24 Alexander technique lessons; half of each of these groups were randomised to exercise prescription.
INTERVENTIONS: Normal care (control), six sessions of massage, six or 24 lessons on the Alexander technique, and prescription for exercise from a doctor with nurse delivered behavioural counselling.
MAIN OUTCOME MEASURES: Roland Morris disability score (number of activities impaired by pain) and number of days in pain.
RESULTS: Exercise and lessons in the Alexander technique, but not massage, remained effective at one year (compared with control Roland disability score 8.1: massage -0.58, 95% confidence interval -1.94 to 0.77, six lessons -1.40, -2.77 to -0.03, 24 lessons -3.4, -4.76 to -2.03, and exercise -1.29, -2.25 to -0.34). Exercise after six lessons achieved 72% of the effect of 24 lessons alone (Roland disability score -2.98 and -4.14, respectively). Number of days with back pain in the past four weeks was lower after lessons (compared with control median 21 days: 24 lessons -18, six lessons -10, massage -7) and quality of life improved significantly. No significant harms were reported.
CONCLUSIONS: One to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons.
Reference
Little P, Lewith G, Webley F, et al. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. BMJ 2008;337:a884.
Sakiko Ishitsubo
/0 Comments/in Uncategorized /by rjSakiko Ishitsubo
Sakiko’s movement career began 30 years ago, as a young athlete. When she was 26, while in Japan, she worked with Bruce Fertman and decided to become an Alexander teacher. She moved to Colorado, studied English intensively for a year, then began her Alexander studies for the next three years in Philadelphia. Upon graduating, Sakiko was accepted into a Master’s Program in Physical Therapy. She graduated, moved back to Japan, married, had a child, and began an Alexander Teacher Training Program in Tokyo. In addition, she maintains a lively private practice.
Martha Hansen Fertman
/3 Comments/in Uncategorized /by rjMartha Hansen Fertman, Ed.D., directs the Philadelphia School for the Alexander Technique and has done so since 1983. She also maintains a private teaching practice in the Princeton, NJ area as well as in Philadelphia. Martha travels extensively to teach Alexander Technique workshops and to help train teachers in several training programs in the US, Canada and Asia. She came to the Alexander technique through a life-long engagement in the movement arts, largely through modern dance and T’ai Chi Ch’uan. She herself trained in the Alexander Technique with Kitty Wielopolska and with Marjorie Barstow, both of whom were first generation teachers. Martha continues to learn from her students, trainees, and colleagues.
More information about Martha can be found here.
loren fishman new york times jan 2013
/0 Comments/in Susan's Blog /by rjAn article was posted online recently by the Medical Director of Manhattan Physical Medicine and Rehabilitation which focuses on back pain and alternative therapies, and specifically Alexander Techique: Here is an excerpt:
Last month, a hunched-over patient came to me complaining of such severe pain that she could not bear physical therapy. All she wanted was an opium-based medication. She’d been in this situation for about four years, and said she knew what would help: either this drug or that drug, but not some other ones. I asked her about her history. When did her pain begin? Did she have any clue about the reason for it? What were her activities? While we were having this rather long conversation, I began to suspect that I knew the reason for this woman’s problem. She sat at a computer all day. Her posture was poor. She was hunched over!
It wasn’t that her posture was a result of her pain, it was that her pain was a result of her posture. I checked her physically, and sure enough, the muscles in her back were in impressive spasm. I gave her several injections that gave her quite a bit of immediate relief. Then I sent her for a massage, wrote out a plan for physical therapy and made what was perhaps the most important recommendation for the future. I referred her to a teacher of Alexander technique who could help her get to the root of her problem and correct it. So much of Alexander technique is about posture. It took nearly a month, because changing old habits can be difficult. But then this woman cancelled her scheduled follow-up appointment with me because, as she said, “I don’t need it.”
The article references the British Medical Journal study discussed previously in this blog and also an earlier New York Times article on the same issue.
Alexander technique reduces low back pain disability
/0 Comments/in Susan's Blog /by SueSynopsis of Study
OBJECTIVE: To determine the effectiveness of lessons in the Alexander technique, massage therapy, and advice from a doctor to take exercise (exercise prescription) along with nurse delivered behavioural counselling for patients with chronic or recurrent back pain.
DESIGN: Factorial randomised trial.
SETTING: 64 general practices in England.
PARTICIPANTS: 579 patients with chronic or recurrent low back pain; 144 were randomised to normal care, 147 to massage, 144 to six Alexander technique lessons, and 144 to 24 Alexander technique lessons; half of each of these groups were randomised to exercise prescription.
INTERVENTIONS: Normal care (control), six sessions of massage, six or 24 lessons on the Alexander technique, and prescription for exercise from a doctor with nurse delivered behavioural counselling.
MAIN OUTCOME MEASURES: Roland Morris disability score (number of activities impaired by pain) and number of days in pain.
RESULTS: Exercise and lessons in the Alexander technique, but not massage, remained effective at one year (compared with control Roland disability score 8.1: massage -0.58, 95% confidence interval -1.94 to 0.77, six lessons -1.40, -2.77 to -0.03, 24 lessons -3.4, -4.76 to -2.03, and exercise -1.29, -2.25 to -0.34). Exercise after six lessons achieved 72% of the effect of 24 lessons alone (Roland disability score -2.98 and -4.14, respectively). Number of days with back pain in the past four weeks was lower after lessons (compared with control median 21 days: 24 lessons -18, six lessons -10, massage -7) and quality of life improved significantly. No significant harms were reported.
CONCLUSIONS: One to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons.
Little P, Lewith G, Webley F, et al. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. BMJ 2008;337:a884.