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Little P, Stuart B, Stokes M, et al. Alexander technique and Supervised Physiotherapy Exercises in back paiN (ASPEN): a four-group randomised feasibility trial. Southampton (UK): NIHR Journals Library; 2014 Oct. (Efficacy and Mechanism Evaluation, No. 1.2.)

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Alexander technique and Supervised Physiotherapy Exercises in back paiN (ASPEN): a four-group randomised feasibility trial.

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Appendix 4Comments from teachers fed back to Carolyn Nicholls

Teacher 1

I had one pupil, who managed both Alexander technique and physiotherapy exercise, she found Alexander technique useful to a degree within her habitual limitation whilst exercising. The pupil was attentive during her lesson and found it helped her mobility when applying the technique to her use.

I was allocated three pupils all of whom came from an area that took two buses and a ten minute uphill walk to reach me, the one pupil that actually managed to complete the course, after a few lessons was provided with a taxi to and from the lesson (I had spoken to the office regarding the surgery location initially), but somehow they were convinced it was the nearest one to myself.

The other two pupils with whom I made contact, made lesson appointments but did not turn up, having varying excuses from, they’d forgotten, to having to collect their benefit or not answering the phone at all. Unfortunately the surgery covered an area of benefits and unemployment that did not lend itself to commitment.

Teacher 2

I had four people and all of them finished the trial and were very appreciative of the Alexander technique lessons. In all four cases their back pain reduced significantly, I think actually it went completely in every case. One, who had a number of other problems, has carried on having lessons with me and another sent his wife who brought her daughter and her friend for lessons. Two of the four were also supposed to have physiotherapy sessions and one completed them together with her Alexander technique lessons satisfactorily. The other opted out of the physiotherapy because he couldn’t get enough time off from work to attend the sessions.

Teacher 3

It was generally easier for the older people to engage with the project and adhere to their commitments. Working people, particularly with children, found the amount of hours of the commitment difficult. The times for physiotherapy (morning or afternoon) was difficult for working people. Nobody dropped out.

Teacher 4

The two with Alexander technique and physio were both retired and were able to fit both types of disciplines in without a problem. They both showed positive signs of freedom of movement with all the aspects of the Alexander technique that I taught them, with a noticeable difference in being able to bend down to put on their shoes and generally to be able to walk about without as much pain as they had previous to their Alexander technique lessons.

Both enjoyed their physio exercises and found that once they had had one or two physio sessions and then came back to the Alexander technique after, they could see the benefit that having six Alexander technique lessons first before starting physio made a difference. They both reported that it would have been quite difficult to carry out some of the exercises as easily without the knowledge of the Alexander technique. One pupil remarked that the physiotherapist was quite amazed in their ability and suppleness and ease to be able to sit and stand as well as they did and was interested to know (and HOW) what the Alexander technique lessons entailed and what the Alexander technique was doing for them. The third person (male) regrettably dropped out at lesson 9 due to work commitments and sent to work in Scotland. All three pupils had a significant drop in pain over their course of lessons from most days with pain to only occasional pain, but they reported that the level of pain became less especially with the Semi Supine which they practised each day.

Teacher 5

I had one person pull out, in fact she never started, she said she was doing ‘lots‘ to help her back and didn’t want anything else. She sounded very worried on the phone, as if I was going to try and force her. Case 1 was completely changed by the sessions realising her attitude wasn’t helping her back pain, as well as making some postural change, her back pain was considerably reduced. Case 2 I could see the Alexander technique was helping her and she admitted the sessions had helped her in how she went about her day.

Teacher 6

Generally the lessons were very well received. I had one drop out after two lessons. Her reason was that the two lessons had totally cured her back pain! She was also struggling to juggle work/family commitments so did not want to put more time in when she felt she had what she needed. The only pupil that I feel did not respond had diagnosed Parkinson’s disease (and I don’t think that he should have been accepted on to the trial). One lady had back pain particularly first thing in the morning. She apparently had an old bed so I do wonder just how much this held back her progress.

Teacher 7

I had one pupil who declined the physio sessions because she had four children and it meant she would not be able to pick up from school but she did complete the Alexander technique lessons with much reduced pain by the end. I had one pupil who had both the Alexander technique and physio, she was most impressed with the obvious very apparent difference, between herself and others who had had Alexander technique lessons. All the pupils I had seemed impressed with how they felt when they remembered to direct and the reduction in pain and discomfort, however none signed up for private lessons. Could this be because at the end of 10 lessons they felt they could manage? It would be interesting to know how they feel a year on.

One pupil who had a heart op after nine lessons did not return to take up the 10th but wrote a letter to say how helpful the Alexander technique directions had been in the recovery process but was unable to make the journey out to me.

Teacher 8

Two of my pupils from the trial did physio plus the Alexander technique and found the both most helpful. They both mentioned how well the physios worked with the technique, and lying down after the exercises. One in particular continued lessons for quite a while after the study but has since drifted off. He did manage to reduce the amount of painkillers he took, of which he was taking a great deal. The second one thought she had learned enough with the Alexander technique and the physio exercises to manage on her own. Her physio continued after her lessons ended, so I don’t know how she ended the trial.

Copyright © Queen’s Printer and Controller of HMSO 2014. This work was produced by Little et al. under the terms of a commissioning contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.

Included under terms of UK Non-commercial Government License.

Bookshelf ID: NBK259311

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