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Findings from the development and implementation of a novel course consisting of both group and individual Alexander Technique lessons for low back pain

Findings from the development and implementation of a novel course consisting of both group and individual Alexander Technique lessons for low back pain
Findings from the development and implementation of a novel course consisting of both group and individual Alexander Technique lessons for low back pain
Objectives: to develop a mixed course of individual and group lessons in the Alexander Technique (AT) for low back pain, and (2) to explore its: (a) effectiveness and (b) acceptability to both participant AT teachers and patients.

Design: single-centre study, mixed methods.

Setting: members of the public in the Brighton area (community recruitment), and patients from six Hampshire General Practices (GP) (National Health Service (NHS) recruitment).

Participants: people with chronic or recurrent low back pain; AT teachers.

Interventions: iterative development and implementation of a 10-lesson (6 group, 4 individual) AT course.

Outcome measures: perceptions from semistructured interviews analysed using inductive thematic analysis. Descriptive analysis of RMDQ (Roland-Morris Disability Questionnaire) over 12 weeks.

Results: thirty-nine participants with low back pain were included and 32 AT teachers were interviewed, 7 of whom taught on the course. Some participants had reservations, preferring only individual lessons, but the majority found the sharing of experience and learning in groups helpful. There was also concern regarding group teaching among some AT teachers, but most also found it acceptable. By 12 weeks, RMDQ score among participants fell from 10.38 to 4.39, a change of −5.99. 29 of 39 (74%) participants had a clinically important reduction in RMDQ score of 2.5 or more.

Conclusion: some patients and practitioners had reservations about group AT lessons, but most found groups helpful. Further development is needed, but the course of individual and group lessons has the potential to cost-effectively deliver clinically important benefits to patients with back pain, who are known to improve little and slowly
back pain, complementary medicine, primary care, rheumatology
2044-6055
Little, Joseph
2677e621-94f6-47b2-8c57-fd46231ff51c
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af
Nicholls, Carolyn
a4bb94b5-6fad-46d1-a38f-a8a32c84c794
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Little, Joseph
2677e621-94f6-47b2-8c57-fd46231ff51c
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af
Nicholls, Carolyn
a4bb94b5-6fad-46d1-a38f-a8a32c84c794
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777

Little, Joseph, Geraghty, Adam, Nicholls, Carolyn and Little, Paul (2022) Findings from the development and implementation of a novel course consisting of both group and individual Alexander Technique lessons for low back pain. BMJ Open, 12 (1), [e039399]. (doi:10.1136/bmjopen-2020-039399).

Record type: Article

Abstract

Objectives: to develop a mixed course of individual and group lessons in the Alexander Technique (AT) for low back pain, and (2) to explore its: (a) effectiveness and (b) acceptability to both participant AT teachers and patients.

Design: single-centre study, mixed methods.

Setting: members of the public in the Brighton area (community recruitment), and patients from six Hampshire General Practices (GP) (National Health Service (NHS) recruitment).

Participants: people with chronic or recurrent low back pain; AT teachers.

Interventions: iterative development and implementation of a 10-lesson (6 group, 4 individual) AT course.

Outcome measures: perceptions from semistructured interviews analysed using inductive thematic analysis. Descriptive analysis of RMDQ (Roland-Morris Disability Questionnaire) over 12 weeks.

Results: thirty-nine participants with low back pain were included and 32 AT teachers were interviewed, 7 of whom taught on the course. Some participants had reservations, preferring only individual lessons, but the majority found the sharing of experience and learning in groups helpful. There was also concern regarding group teaching among some AT teachers, but most also found it acceptable. By 12 weeks, RMDQ score among participants fell from 10.38 to 4.39, a change of −5.99. 29 of 39 (74%) participants had a clinically important reduction in RMDQ score of 2.5 or more.

Conclusion: some patients and practitioners had reservations about group AT lessons, but most found groups helpful. Further development is needed, but the course of individual and group lessons has the potential to cost-effectively deliver clinically important benefits to patients with back pain, who are known to improve little and slowly

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Accepted/In Press date: 4 September 2021
Published date: 20 January 2022
Additional Information: Funding Information: Acknowledgements We are very grateful to Nigel Gibson and Jane Magpie, our PPI collaborators, for their very helpful input to both the study design, outcomes and patient documents. Contributors PL had the original idea for the study. CN developed the course and course materials, trained the teachers and ran several of the groups. JL managed all aspects of the study on a day-to-day basis, interviewed patients and teachers, analysed the qualitative and quantitative data, and wrote the first draft of the paper. AWAG supervised the qualitative work. All authors developed the protocol and contributed to revisions of the paper. JL is the gaurantor for the overall content of this paper. Funding The work was funded from three sources: a National Institute of Health Research (NIHR) Senior Investigator Award to PL; NIHR Research Capability funding; and a private donation from Mrs Ann Nussey. Publisher Copyright: © Copyright: Copyright 2022 Elsevier B.V., All rights reserved.
Keywords: back pain, complementary medicine, primary care, rheumatology

Identifiers

Local EPrints ID: 455524
URI: http://eprints.soton.ac.uk/id/eprint/455524
ISSN: 2044-6055
PURE UUID: de4a1aa8-a365-442d-a70f-4bcb34f76294
ORCID for Adam Geraghty: ORCID iD orcid.org/0000-0001-7984-8351

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Date deposited: 24 Mar 2022 17:34
Last modified: 28 Apr 2022 02:03

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Contributors

Author: Joseph Little
Author: Adam Geraghty ORCID iD
Author: Carolyn Nicholls
Author: Paul Little

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