Research
Following is an annotated bibliography of selected research studies involving the Alexander Technique. All were published in peer-reviewed scientific journals or presented at conferences with peer-reviewed abstracts.
To read what the medical community has to say about the Alexander Technique, go to the Science and Research tab on the FAQ page.
You may also try searching for “Alexander Technique” at pubmed.gov.
Alexander Studies Online (ASO) – a scholarly platform with entries on research material directly concerned with the Alexander Technique and references to relevant non-AT material encouraging engagement between the Alexander community and the wider world of science, scholarship and research.
Alexander Technique Science – This site is devoted to improving scientific understanding of the Alexander Technique (AT)—its principles, practices, reported and demonstrated benefits, and terminology. The content ranges from descriptions of direct experiments on the effects of AT lessons to focused explanations of relevant current science to rigorously researched history of the work. They reference recent peer-reviewed publications wherever possible.
AmSAT’s Research Committee was formed in 2012 to create and administer a grant program supporting research on the Alexander Technique by teaching members of AmSAT. Award recipients to date can be found here. For more information on this program contact info@AmSATonline.org.
February 11, 2021 Research Panel
As part of our Taking Time to Connect Chat series, a dynamic panel of researchers shared their findings with our members. Moderated by Heidi Leathwood, the panel included: Tim Cacciatore, Gabriella Minnes Brandes, Tara Fenamore, Rajal Cohen, and Monika Gross. Here is the recording of this outstanding session:
- Panelist Bios
- Presentation Slides
- Additional Resources
Potential Mechanisms of the Alexander Technique: Toward a Comprehensive Neurophysiological Model
The Alexander technique (AT) has been practiced for over 125 years. Despite evidence of its clinical utility, a clear explanation of how AT works is lacking, as the foundational science needed to test the underlying ideas has only recently become available. The authors propose that the core changes brought about by Alexander training are improvements in the adaptivity and distribution of postural tone, along with changes in body schema, and that these changes underlie many of the reported benefits. They suggest that AT alters tone and body schema via spatial attention and executive processes, which in turn affect low-level motor elements.
To engage these pathways, AT strategically engages attention, intention, and inhibition, along with haptic communication. The uniqueness of the approach comes from the way these elements are woven together. Evidence for the contribution of these elements is discussed, drawing on direct studies of AT and other relevant modern scientific literature.
Reductions in co-contraction following neuromuscular re-education in people with knee osteoarthritis
Preece, Stephen J.; Jones, Richard K.; Brown, Christopher A.; Cacciatore, Timothy W.; and Jones, Anthony K. P. BMC Musculoskeletal Disorders. Published August 27, 2016
Following AT instruction, there was a significant reduction in knee pain and stiffness and an improvement in function which appeared to be maintained at 15 months post-baseline. This study demonstrates the potential efficacy of interventions, such as the AT, which can successfully modify muscle activation patterns in patients with knee OA.
Lighten Up: Specific Postural Instructions Affect Axial Rigidity and Step Initiation in Patients With Parkinson’s Disease
Cohen, Rajal et al (2015). Neural Rehabilitation & Neural Repair, Journal of the American Society of Neurorehabilitation
Instructions based on the Alexander Technique given to people with Parkinson’s Disease led to reduced postural sway, reduced axial postural tone, greater modifiability of tone, and a smoother center of pressure trajectory during step initiation, possibly indicating greater movement efficiency.
Recently published research concludes that lessons in the Alexander Technique lead to significant reductions in neck pain and associated disability.
Conclusion of randomized controlled trial recently published in the Annals of Internal Medicine is that lessons in the Alexander Technique led to significant reductions in neck pain and associated disability. Study evaluated clinical effectiveness of Alexander Technique lessons or acupuncture versus usual care for persons with chronic, nonspecific neck pain and found that both are effective.
Download PDF of research summary Annals of Internal Medicine AT Lessons Summary here and full report here.
Neuromuscular interference of posture on movement: evidence of Alexander Technique teachers rising from chair
Timothy W. Cacciatore, Omar S. Mian, Amy Peters, Brian L. Day Journal of Neurophysiology. Published 1 August 2014 Vol. 112 no. 719-729 DOI: 0.1152/jn.00617.2013
While Alexander Technique (AT) teachers have been reported to stand up by shifting weight gradually as they incline the trunk forward, healthy untrained (HU) adults appear unable to rise in this way. This study examines the hypothesis that HU have difficulty rising smoothly, and that this difficulty relates to reported differences in postural stiffness between groups.
Neuromuscular interference of posture on movement: evidence of Alexander Technique teachers rising from chair
Taking Charge Choosing a New Direction: A Service Evaluation of Alexander Technique Lessons for Pain Clinic Patients SEAT: an Approach to Pain Management
McClean, S. and Wye, L. (June 2012) Project Report. UWE Bristol, Bristol.
A high quality clinical trial carried out in an experimental setting demonstrating the therapeutic value and effectiveness of Alexander Technique (AT) lessons for chronic back pain. Findings suggest that lessons in the AT are feasible, acceptable and beneficial in terms of improving quality of life and patients’ management of pain as well as reducing pain related NHS costs by half. Greatest changes were found in how the patients/students managed their pain (more than half stopped or reduced their medication) and the impact that the pain had on their daily lives.
Download full report here (will open in new window)
Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review
Woodman J.P., Moore N.R. International Journal of Clinical Practice January 2012
The aim of this review was to systematically evaluate available evidence for the effectiveness and safety of instruction in the Alexander Technique in health-related conditions. Conclusions: Strong evidence exists for the effectiveness of Alexander Technique lessons for chronic back pain and moderate evidence in Parkinson’s-associated disability. Preliminary evidence suggests that Alexander Technique lessons may lead to improvements in balance skills in the elderly, in general chronic pain, posture, respiratory function and stuttering, but there is insufficient evidence to support recommendations in these areas.
Alexander Technique: Training for the self-management of workers to prevent musculoskeletal disorders
Mora i Griso, Mireia. Foment del Treball Nacional de Catalunya (2011)
A descriptive and comparative study of precedents where the Alexander Technique has been applied as a tool to prevent occupational risks in different organisational settings throughout the world. Full report in English here.
Prolonged weight-shift and altered spinal coordination during sit-to-stand in practitioners of the Alexander Technique.
Cacciatore TW, Gurfinkel VS, Horak FB, Day B.Gait and Posture, June 2011.
This study compared coordination of 14 teachers of the Alexander Technique to 15 healthy control subjects during rising from a chair. The Alexander Technique teachers were able to achieve a smoother, more continuous movement than the control subjects, consistent with previous claims that the Alexander Technique teaches more efficient movement.
Increased dynamic regulation of postural tone through Alexander Technique training.
Cacciatore TW, Gurfinkel VS, Horak FB, Cordo PJand Ames KE. Human Movement Science, 2011 February; 30(1): 74–89.
This study quantified postural tone by measuring resistance in the hips, trunk, and neck to very slow twisting during standing. Comparing teachers of the Alexander Technique (who undergo 1600 hours of training over three years) to age-matched control subjects, resistance was 50% lower while phase advance was greater. Similar changes (to a lesser degree) occurred in subjects with lower back pain after undergoing ten weekly lessons in the Alexander Technique. These results suggest that the Alexander Technique enhances dynamic modulation of postural tone.
The Impact of the Alexander Technique in Improving Posture and Surgical Ergonomics during Minimally Invasive Surgery: Pilot Study.
Reddy P et al. Journal of Urology, October 2011. Volume 186, Issue 4, Supplement, Pages 1658-1662.
(Poster presentation at The American Urological Association Annual Meeting, San Francisco.)
This pilot study found that surgeons who underwent instruction in the Alexander Technique experienced a significant improvement in posture and surgical ergonomics as well as decreased surgical fatigue.
Randomised Controlled Trial of Alexander Technique Lessons, Exercise, and Massage (ATEAM) for Chronic and Recurrent Back Pain.
Little P et al (2008). British Medical Journal 337:a884.
In this study, 579 subjects with chronic and recurrent back pain were randomized to receive massage, six Alexander Technique lessons, 24 Alexander Technique lessons, or no intervention. In addition, half of the subjects were encouraged to walk regularly. A year later, the group with no intervention had 21 days of pain per month. The group with massage had 14 days of pain per month. The group with six Alexander Technique lessons reported 11 days of pain per month, and the group with 24 Alexander Technique lessons reported three days of pain per month. There were no adverse effects.
Videos (Part I and Part II) about the study from the British Medical Journal
Audio interview with the lead author of the ATEAM study.
Patients’ views of receiving lessons in the Alexander Technique and an exercise prescription for managing back pain in the ATEAM trial.
Yardley L et al (2010). Family Practice 27 (2):198-204.
Subjects from the ATEAM study (above) were interviewed about their experience with the Alexander Technique lessons and exercise. Whereas many obstacles to exercising were reported, few barriers to learning the Alexander Technique were described, since it ‘made sense’, could be practiced while carrying out everyday activities or relaxing, and the teachers provided personal advice and support. (Abstract)
Improvement in Automatic Postural Coordination Following Alexander Technique Lessons in a Person with Low Back Pain.
Cacciatore TW, Horak FB, Henry SM (2005). Physical Therapy, 85(6):565-78.
This case report describes the use of the Alexander Technique with a client with a 25-year history of low back pain. After lessons, her postural responses and balance improved and her pain decreased. The introduction includes a thorough explanation of the Alexander Technique from a scientific perspective.
Effects of Alexander Technique on Muscle Activation During a Computer-Mouse Task: Potential for Reduction in Repetitive Strain Injuries.
Shafarman E, Geisler MW (2003). American Psychological Association Convention, Toronto, Canada.
In this preliminary study of computer mouse use, subjects without Alexander Technique training could reduce muscle activation only by slowing down, whereas subjects with Alexander Technique experience were able to reduce muscle activation while continuing to move rapidly. Implications for prevention of repetitive strain injury are discussed. The work was written up in Alexander Journal, 21. Available from the Society of Teachers of the Alexander Technique (an affiliated society in the United Kingdom) or from the lead author of the study: E. Shafarman.
Randomized Controlled Trial of the Alexander Technique for Ideopathic Parkinsons Disease.
Stallibrass C, Sissons P, Chalmers C (2002). Clinical Rehabilitation, 16(7):695-708.
This study assigned 93 subjects to receive Alexander Technique lessons, massage, or no treatment. AT lessons (but not massage) led to significant improvement in self-assessed disability, both immediately after the lessons and six months later.
Functional reach improvement in normal older women after Alexander Technique instruction.
Dennis (1999). Journal of Gerontology – Series A: Biological and Medical Sciences, 54A(1): M8-M11.
Women aged 65-88 who received 8 Alexander Technique lessons showed a 36% improvement in forward-reaching distance (a common measure of balance control), while control subjects of the same age showed a 6% decrease over the same time-period.
Enhanced Respiratory Muscular Function in Normal Adults after Lessons in Proprioceptive Musculo-skeletal Education without Exercises.
Austin J, Ausubel P (1992). Chest, 102:486-490.
This study examined respiratory function in adults. Spirometry tests demonstrated that Alexander Technique lessons led to improvement of respiratory muscular function.
Early Experiences of a Multidisciplinary Pain Management Programme.
Fisher K (1988). Holistic Medicine, 3(1):47-56. (Note: the journal has since been renamed Journal of Interprofessional Medicine.)
Chronic pain sufferers participated in a multiple-intervention study. During the study, after three months, and one year later, the subjects rated the Alexander Technique as the most helpful method for relieving chronic pain.
Method for Changing Stereotyped Response Patterns by the Inhibition of Certain Postural Sets.
Jones FP (1965). Psychological Review, 72, (3):196-214.
Postural habits can be profoundly affected by the Alexander Technique, specifically by learning and applying the concept of inhibition. Frank Pierce Jones was a pioneer in the study of human movement and a teacher of the Alexander Technique. A collection of his publications can be found in the book Freedom to Change – The Development and Science of the Alexander Technique (available in AmSAT Bookstore).
The following list includes a Nobel Laureate speech and a book.
Nobel Lecture entitled Ethology and Stress Diseases. Tinbergen N (1973).
Nikolaas Tinbergen, Nobel Laureate, wrote about F. M. Alexander, the importance of Alexander’s discoveries and the benefits he and his wife experienced from lessons. He strongly recommended it as a sophisticated form of rehabilitation for all stress-related diseases, i.e., rheumatism, high blood pressure, breathing problems and sleep disorders.
Video of Nikolaas Tinbergen’s Nobel lecture, the last third of which is devoted to his discussion of Alexander’s work and its various beneficial effects.
A Study of Stress Amongst Professional Musicians.
Nielsen M (1994). In: The Alexander Technique: Medical and Physiological Aspects, Chris Stevens (Ed.) STAT Books, London.
This study examined performance stress in musicians, and found that the Alexander Technique was as effective as beta-blocker medications in controlling the stress response during an orchestra performance.
What have doctors said about the Alexander Technique?
Increasing numbers of physicians and healthcare professionals are recommending the Alexander Technique to their patients. Offered in wellness centers and health education programs worldwide, the Alexander Technique is appropriate for patients with chronic back pain, neck pain, migraines, repetitive stress injuries, balance and coordination problems, and for the depression and anxiety that often accompanies chronic pain and stress
The Alexander Technique remains the best of the self-care strategies to prevent the sequel of poor posture and poor breathing.
Harold Wise, MD, PC, New York, NY
I found the Technique to be so beneficial in my condition that I have been referring patients in certain situations for Alexander lessons over the last several years.
Howard L. Rosner, MD Director, Pain Management Service, The New York Hospital-Cornell Medical Center, New York, NY
The Alexander Technique has been very helpful in identifying the postural and breathing habits that contribute to my fatigue and muscle soreness. I found it a good value: cost effective, making me less dependent on chiropractors and more comfortable at work.
Douglas J. Bush, DMD, Chester, NJ
Habitual patterns of scrunched and tense use of the body are so engrained in our lives that the concept may seem extraordinary that unlearning these patterns can actually relieve pain and discomfort–but lessons in the Alexander Technique not only succeed for many people, they also allow a welcome sense of new ease in performance of all physical activities, e.g., playing a sport, using a computer keyboard, or playing a musical instrument. Research in which I have been involved has also shown enhanced strength of the muscles of breathing after a course of lessons.
John H.M. Austin, MD, Professor Emeritus of Radiology, Columbia University Medical Center, New York, NY
The Alexander Technique stresses unification in an era of greater and greater medical specialization. Its educational system teaches people how to best use their bodies in ordinary action to avoid or reduce unnecessary stress and pain. It enables clients to get better faster and stay better longer. This is undoubtedly the best way to take care of the back and alleviate back pain.
Jack Stern, MD, PhD, Neurosurgical Group of Westchester, White Plains, NY
Not only do I see the therapeutic benefits of this work with various patient problems, but it has helped me deal effectively with my own adverse muscular tension. I continue to experience a newfound freedom of movement in my own body that I believe is making me a more effective therapist.
Howard W. Makofsky, MS, OCS, Mastic Beach, NY
I recommend people to the Alexander Technique who have not improved with traditional rehabilitative therapies. Part of their pain may be due to posture and the improper use of their bodies. Many people who have neck or back pain and have gone through heat, ultrasound and massage with no relief can be helped by learning the Alexander Technique. It definitely works. Nothing works for everyone. As one well-versed in using physical therapy and biofeedback, I know how valuable this technique is. I highly recommend it.
Barry M. Scheinfeld, MD, Specialist in Rehabilitation Medicine and Pain Management, Community General Hospital, Harris, NY
I think I have given my patients something almost as good as magic. I have taught them what to do and not do when their backs give them trouble, and how to reduce unnecessary stress and pain. As a result, they no longer have to feel afraid and helpless when back pain occurs. Many consider themselves cured because they have been able to return to an active, normal lifestyle.
Deborah Caplan, PT, certified Alexander Technique teacher and author of Back Trouble, New York, NY
The Alexander Technique makes sense in that appropriate use of the body will lead to reduction of various musculoskeletal disorders and remediate others which are established. No equipment is needed, just the skill and training of the teacher. This technique is very worthwhile as a primary preventative therapy. It is especially useful when posture is a key factor in back injuries while lifting and for workers who perform repetitive tasks while sitting.
Robert D. Greene, MD, Emergency Department, Norwalk Hospital, Norwalk, CT
When, in spite of my instruction, a patient is having difficulty understanding how to make changes in habitual movement patterns or has a profession with particular physical demands, I typically suggest the Alexander Technique. I have found it very helpful for patients who have low body awareness or who have trouble relaxing. Improvement in these areas facilitates many physical therapy modalities, especially cervical spine joint mobilization.
Gail King, PT, MS, Backtec Orthopedic & Sports Physical Therapy, New York, NY
I fell and suffered a compression fracture of the back. Upon recommendation of a fellow therapist, I started treatment in the Alexander Technique. I have noticed not only a steady reduction of pain, but improvement in my general flexibility, balance and bearing. I use the Technique in conjunction with other physical exercise, and have found no contraindications.
Jean P. Binnie, MA, MS, NCPsychA, Hamptons Counseling Center, Hampton Bays, NY
In addition to its physiologic and musculoskeletal benefits, the Alexander Technique is extremely helpful in relieving the psychological states of depression and anxiety that so often accompany chronic pain and disease. It is my belief, based on professional experience, that the Alexander Technique should be part of all preventative health and education programs. It is as basic as good nutrition.
Jill Sanders, DO, New York, NY