Alexander technique versus targeted exercise for neck pain

INTERVENTION: Participants will be assigned quasi‐randomly to groups, based in part on their availability to attend either Monday‐Wednesday or Tuesday‐Thursday evening class sessions. One group will receive ten Alexander technique classes and the other group will ten receive exercise classes, over 5 weeks. The AT classes will include information on basic biomechanical and ergonomic principles (including the anatomy of the neck, spine, and major joints of the upper and lower limbs) and benefits of widening awareness to include both the self and the environment during activity. In addition, participants will be guided in self‐observation during common daily activities such as standing, sitting, computer work, personal care tasks, and household chores. The exercise intervention exercises will be aimed at retraining the use of the deep cervical flexors, strengthening postural muscles, and increasing range of motion. The therapeutic retraining component will be based on an adaptation of the protocol described by Jull et al. Participants will place the backs of their necks on a rolled towel and gently rotated their heads as if nodding ‘yes’, with a goal of activating the deep cervical flexors rather than surface neck flexors. Postural strengthening exercises will include the use of dumbbells and resistance bands (Theraband®, Akron, OH) to target the trapezius and upper‐back muscles. The trapezius and anterior neck muscles will be stretched to increase mobility. Each exercise class will include 10 minutes of light stretching, followed by 45 minutes of retraining and strength exercises aimed at promoting a more upright posture. Follow‐up measurements will be taken immediately after the interventions end, and 6 weeks after t CONDITION: Neck pain ; Musculoskeletal Diseases PRIMARY OUTCOME: Neck disability measured using the Northwick park questionnaire at baseline, 5, and 11 weeks SECONDARY OUTCOME: ; 1. Superficial muscle activity will be measured using the CCFT at baseline, 5, and 11 weeks; 2. Self‐efficacy will be measured using the Pain Self Efficacy questionnaire at baseline, 5, and 11 weeks; 3. Intervention assessment will be measured using a questionnaire assessing impressions of the interventions will be administered after completion of the course; 4. Video‐game posture will be measured using photos at baseline, 5, and 11 weeks; INCLUSION CRITERIA: 1. Score 16% or higher on the Neck Disability Index 2. Had at least 3 months of neck pain 3. Not currently receiving specialized care 4. Available for the scheduled class times