Effects of Alexander Technique Versus Feldenkrais Somatic Training in Patients With Text Neck Syndrome
Effects of Alexander Technique Versus Feldenkrais Somatic Training on Pain, Cranio-Vertebral Angle and Disability in Patients With Text Neck Syndrome
in this era, increasing use of smart gadgets such as mobile phones, laptops, computers etc has led to rise in musculoskeletal disorders, particularly Text Neck Syndrome, which is characterized by neck and upper back pain with prolonged neck flexion and forward head posture. Somatic education approaches such as the Alexander Technique and Feldenkrais Method offer alternative strategies by emphasizing postural awareness, movement quality, and neuromuscular re-education rather than repetitive exercise alone. The study will be conducted as a randomized clinical trial and the assessor will be blind. Sample size of 46 subjects will be taken according to inclusion criteria and subjects will be allocated in two groups by computer generator software. Conventional intervention will be received as a standardized treatment protocol in both groups with additional intervention. Group A will receive Alexander technique while Group B will receive Feldenkrais technique. The data will be analyzed using appropriate statistical methods to evaluate the effectiveness of each intervention. This study's results can provide valuable information to healthcare professionals on how to manage Text neck syndrome.
Study Overview
Status
Conditions
Detailed Description
PROJECT SUMMARY:
In this modern era, increasing use of smart gadgets such as mobile phones, laptops, computers etc has led to rise in musculoskeletal disorders, particularly Text Neck Syndrome, which is characterized by neck and upper back pain with prolonged neck flexion and forward head posture. Although conventional physiotherapy interventions such as postural correction, strengthening, and stretching have demonstrated benefits; however, persistent symptoms, functional limitations, and reduced treatment adherence remain challenges. Somatic education approaches such as the Alexander Technique and Feldenkrais Method offer alternative strategies by emphasizing postural awareness, movement quality, and neuromuscular re-education rather than repetitive exercise alone. The Alexander Technique focuses on optimizing the head-neck-spine relationship, reducing unnecessary muscle tension, and modifying habitual movement patterns through conscious inhibition and direction, whereas the Feldenkrais Method employs gentle, awareness-based movement lessons and functional integration to enhance sensorimotor organization, proprioception, and movement efficiency. Both approaches may contribute to improved posture, reduced pain and enhanced functional outcomes in individuals with neck pain.
The study will be conducted as a randomized clinical trial and the assessor will be blind. Sample size of 46 subjects will be taken according to inclusion criteria and subjects will be allocated in two groups by computer generator software. Conventional intervention will be received as a standardized treatment protocol in both groups with additional somatic intervention. Group A will receive Alexander technique while Group B will receive Feldenkrais technique. The primary outcomes measured will be pain, disability, and cranio-cervical angle. The study will collect data at baseline and four weeks using validated outcome measures. The data will be analyzed using appropriate statistical methods to evaluate the effectiveness of each intervention. In this study, participants in both groups will receive treatment twice a week, with a total of eight treatment sessions over the four-week study period. The results of the study will provide valuable insights into the efficacy of Alexander technique and Feldenkrais training in managing Text neck syndrome. This study's results can provide valuable information to healthcare professionals on how to manage Text neck syndrome and may contribute to the development of future research in this area.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Imran Amjad
- Phone Number: +923324390125
- Email: imran.amjad@riphah.edu.pk
Study Locations
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Punjab Province
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Lahore, Punjab Province, Pakistan, 54000
- Recruiting
- Riaz Mansoor Trust Hospital
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Contact:
- Mehwish Irfan
- Phone Number: +923204435562
- Email: Umine2i2@gmail.com
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Male and Female are included
- Age between 18- 40 years age
- Using smart phone ≥4 hours/day
- Neck pain duration ≥3 months
- Neck pain increase by sustained posture
- NDI score range from >20 points
- Cranio-vertebral angle ≤ 48°
Exclusion Criteria:
- Any trauma or injury on cervical and thoracic spine
- History of cervical spine surgery
- Specific neck pathologies (cervical disc herniation, radiculopathy, inflammatory conditions, spinal infection and tumor)
- Congenital Spinal deformity
- Psychological problem
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: Alexander Technique
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Each patient will receive a total number of eight treatment sessions over a four-week period and each session is about 45 min. There will be 3 sessions in per week. Constructive rest-5 min, Gentle cervical rotation in supine , 4-5 each side, Head and neck release awareness in sitting, Semi supine arm awareness, Sitting Posture Re-education: Ask the patient to hold the phone at eye level, Sitting to standing by Alexander Method, Gentle cervical rotation sitting, Functional Reaching with AT Cues, Stimulated phone use training, Sustained posture awareness drill TENS (10 min), Hot pack (10 min), Soft tissue mobilization, Grade I, II matland mobilization of cervical spine, AROM (10 reps- 2 sets), Upper trapezius stretch (5 sets, hold for 15-30 sec), Levator Scapulae stretch (5 sets, hold for 15-30 sec), SCM stretch (5 sets, hold for 15-30 sec), Pectoralis major stretch (5 sets, hold for 15-30 sec), Cervical isometrics in flexion, extension and side bending (5-10 sets, hold for 10 sec). |
|
Experimental: Feldenkrais Somatic training
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TENS (10 min), Hot pack (10 min), Soft tissue mobilization, Grade I, II matland mobilization of cervical spine, AROM (10 reps- 2 sets), Upper trapezius stretch (5 sets, hold for 15-30 sec), Levator Scapulae stretch (5 sets, hold for 15-30 sec), SCM stretch (5 sets, hold for 15-30 sec), Pectoralis major stretch (5 sets, hold for 15-30 sec), Cervical isometrics in flexion, extension and side bending (5-10 sets, hold for 10 sec). Each patient will receive a total number of eight treatment sessions over a four-week period and each session is about 45 min. There will be 3 sessions in per week. Body scan in supine, small circles in supine , Chin nodding in supine lying, Jaw-neck awareness (ask the patient to open & close mouth gently), Head turning with shoulder awareness (patient is in supine position, ask the patient to turn head right while noticing left shoulder and move to the alternate sides.), Eye-head coordination (ask the patient to move eyes right first, then head follows then reverse direction.), Side-lying head lift (1 cm), Scapula-neck relationship (patient in standing, ask the patient to gently slide shoulder up/down while head rests and therapist observe neck response.), Thoracic rolling in supine, Pelvic rocking with in supine lying, Standing weight shift + head response, Walking with free neck, Text neck re education |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
NPRS (Numeric Pain Rating Scale)
Time Frame: From enrollment to end of week 4
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Numeric pain rating scale were used to measure the intensity level of the patient's pain. Scale consists of 11 points, ranging from 0 -10. 0 is no pain and 10 is the worst imaginable pain. Subjects select the number that best symbolizes their level of pain. 0= No pain 1-3= Mild pain 4-6= Moderate pain 7-10= severe pain |
From enrollment to end of week 4
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NDI (Neck Disability Index)
Time Frame: From enrolment to end of week 4
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The Neck Disability Index is the most general measure for evaluating self-perceived disability in patients with neck pain. Each question has six options to rate the disability level from 0 (no disability) to 5 (total disability). The numeric responses for each question are summed for a total score between 0 and 50. No disability= 0 - 4 Mild= 5 - 14 Moderate= 15 - 24 Severe= 25 - 34 Complete Disability = 35 - 50 |
From enrolment to end of week 4
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Photogrammetry for Cranio-vertebral angle
Time Frame: From enrollment to end of week 4
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Photogrammetry is a most commonly used noninvasive tool to assess cranio-vertebral angle or posture alignment. Participants will be asked to stand or seated in normal or relaxed posture. Lateral photographs were taken and mark the spinous process of C7 and tragus of ear. The angle between the line joining from tragus to C7 spinous process and horizontal line will be measured with the help of Image J. Software to determine cranio-vertebral angle. |
From enrollment to end of week 4
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Ali Raza, Riphah International University
Publications and helpful links
General Publications
- Shadi N, Khalaghi K, Seyedahmadi M. Comparing the effects of Pilates, corrective exercises, and Alexander's technique on upper cross syndrome among adolescent girls student (ages 13-16): a six-week study. BMC Sports Sci Med Rehabil. 2024 Jun 28;16(1):143. doi: 10.1186/s13102-024-00933-2.
- Klein SD, Bayard C, Wolf U. The Alexander Technique and musicians: a systematic review of controlled trials. BMC Complement Altern Med. 2014 Oct 24;14:414. doi: 10.1186/1472-6882-14-414.
- Qin D, Qin Y, Wang Y, Xue L, Peng Y. RETRACTED: Effects of the Alexander technique on pain and adverse events in chronic non-specific neck pain: A systematic review and meta-analysis. PLoS One. 2024 Nov 22;19(11):e0313526. doi: 10.1371/journal.pone.0313526. eCollection 2024.
- Brummer M, Walach H, Schmidt S. Feldenkrais 'Functional Integration' Increases Body Contact Surface in the Supine Position: A Randomized-Controlled Experimental Study. Front Psychol. 2018 Oct 24;9:2023. doi: 10.3389/fpsyg.2018.02023. eCollection 2018.
- Jain S, Janssen K, DeCelle S. Alexander technique and Feldenkrais method: a critical overview. Phys Med Rehabil Clin N Am. 2004 Nov;15(4):811-25, vi. doi: 10.1016/j.pmr.2004.04.005.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- REC/RCR & AHS/25/0186
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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