Self-efficacy and self-care-related outcomes following Alexander Technique lessons for people with chronic neck pain in the ATLAS randomised, controlled trial

We describe pre-specified, self-efficacy and other selfcare-related outcomes for the Alexander group compared with usual care

Julia Woodman; Kathleen Ballard; Catherine Hewitt; Hugh MacPherson

2017

Scholarcy highlights

  • ATLAS was a pragmatic randomised, controlled trial recruiting patients with chronic neck pain and evaluating one-to-one Alexander Technique lessons, or acupuncture, each plus usual care, compared with usual care alone
  • The baseline characteristics of the 344 participants were similar across the Alexander Technique lesson and usual care alone groups
  • Applying things learnt during the trial, the extent of ability to put into practice the advice or teaching received, the extent to which the changes were helpful, and the changes made to exercise and relaxation by the Alexander lessons group compared with the usual care group, were all found to be related to neck pain and associated disability Questionnaire scores at both 6 and 12 months
  • Participants in the acupuncture group alone made statistically significant dietary changes as a result of the intervention when compared with the usual care group, reflecting the fact that dietary advice is a key component of acupuncture practice but not of Alexander lessons
  • Individuals with chronic neck pain who attended Alexander Technique lessons reported improvements in a wide range of outcomes related to self-efficacy and self-care, with a significantly greater degree of positive change than occurred with usual care alone
  • At 6 months, 81% of Alexander participants reported significant improvement in the way they lived and cared for themselves, increasing to 87% at 12 months
  • The log book data completed by the Alexander teachers revealed that the lesson content and delivery in the trial reflected current standard Alexander teaching practice across the UK, as shown by a recent large-scale national survey. This survey did reveal some variation in teaching practice between the three participating professional organisations, but as the majority of Alexander teachers in the UK belong to the Society of Teachers of the Alexander Technique, as do all those who worked in this trial, the teaching in the ATLAS trial can be taken to be broadly representative of current overall UK teaching practice
  • Alexander lessons promote self-efficacy and self-care by imparting knowledge and skills that help people improve the way they live and care for themselves, leading to long-term reduction in chronic neck pain

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