Trial reportBMJ (Clinical research ed.)2008
Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain.
Trial report in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01060280 (The Effectiveness of the Physiotherapy Techniques Group GDS and Individual GDS for the Treatment of Nonspecific Low Back Pain in Primary Care. A Cluster, Randomized, Controlled Trial.), which is not on this map. Cited by 63 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effectiveness of the Physiotherapy Techniques Group GDS and Individual GDS for the Treatment of Nonspecific Low Back Pain in Primary Care. A Cluster, Randomized, Controlled Trial.
Who cites it
63 citing papers in PubMed, 9 syntheses or guidelines pooled it, 227 citations in OpenAlex.
- Pooled it
- Exercise therapy for chronic low back pain.The Cochrane database of systematic reviews · 2021Pooled it
- The effect of journal impact factor, reporting conflicts, and reporting funding sources, on standardized effect sizes in back pain trials: a systematic review and meta-regression.BMC musculoskeletal disorders · 2015Pooled it
- Massage for low-back pain.The Cochrane database of systematic reviews · 2015Pooled it
- The Alexander Technique and musicians: a systematic review of controlled trials.BMC complementary and alternative medicine · 2014Pooled it
- Modifying patterns of movement in people with low back pain -does it help? A systematic review.BMC musculoskeletal disorders · 2012Pooled it
- Cost-effectiveness of general practice care for low back pain: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2011Pooled it
- Low back pain (chronic).BMJ clinical evidence · 2010Pooled it
- How do we define the condition 'recurrent low back pain'? A systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2010Pooled it
- Supporting self-management with an internet intervention for low back pain in primary care: a RCT (SupportBack 2).Health technology assessment (Winchester, England) · 2025Trial
- The Effect of Massage Force on Relieving Nonspecific Low Back Pain: A Randomized Controlled Trial.International journal of environmental research and public health · 2022Trial
- Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial.BMJ (Clinical research ed.) · 2021Trial
- Trial
- Self-efficacy and embodiment associated with Alexander Technique lessons or with acupuncture sessions: A longitudinal qualitative sub-study within the ATLAS trial.Complementary therapies in clinical practice · 2018Trial
- Trial
- Trial
- Reductions in co-contraction following neuromuscular re-education in people with knee osteoarthritis.BMC musculoskeletal disorders · 2016Trial
- Trial
- Compliance effects in a randomised controlled trial of yoga for chronic low back pain: a methodological study.Physiotherapy · 2014Trial
- Trial
3 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 3 countries.
Funding
Abstract
objectiveTo determine the effectiveness of lessons in the Alexander technique, massage therapy, and advice from a doctor to take exercise (exercise prescription) along with nurse delivered behavioural counselling for patients with chronic or recurrent back pain.
designFactorial randomised trial.
setting64 general practices in England.
participants579 patients with chronic or recurrent low back pain; 144 were randomised to normal care, 147 to massage, 144 to six Alexander technique lessons, and 144 to 24 Alexander technique lessons; half of each of these groups were randomised to exercise prescription.
interventionsNormal care (control), six sessions of massage, six or 24 lessons on the Alexander technique, and prescription for exercise from a doctor with nurse delivered behavioural counselling.
main outcome measuresRoland Morris disability score (number of activities impaired by pain) and number of days in pain.
resultsExercise and lessons in the Alexander technique, but not massage, remained effective at one year (compared with control Roland disability score 8.1: massage -0.58, 95% confidence interval -1.94 to 0.77, six lessons -1.40, -2.77 to -0.03, 24 lessons -3.4, -4.76 to -2.03, and exercise -1.29, -2.25 to -0.34). Exercise after six lessons achieved 72% of the effect of 24 lessons alone (Roland disability score -2.98 and -4.14, respectively). Number of days with back pain in the past four weeks was lower after lessons (compared with control median 21 days: 24 lessons -18, six lessons -10, massage -7) and quality of life improved significantly. No significant harms were reported.
conclusionsOne to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons.
trial registrationNational Research Register N0028108728.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.