The Alexander Technique (AT) is a method to improve habitual postural and movement coordination commonly used by performing artists [1
]. It is offered in the music and theatre departments at major colleges for the purpose of improving performance and preventing injury. Recent reports indicate AT is clinically beneficial for back pain [2
], Parkinson’s disease [3
] and balance in the elderly [4
]. However, the mechanisms underlying its clinical and claimed performance improvements are poorly understood. A greater understanding of improved coordination could have broad implications for rehabilitation.
The emphasis of AT is on axial behavior, the positional and tensional relationships within the neck and trunk, during posture and movement [5
]. In particular, AT aims to reduce unnecessary tension and maintain elongation along the spine, referred to as the head-neck-back relationship. Proponents consider this relationship fundamental to any clinical or performance benefit from AT [1
Recently, AT has been found to alter postural tone. This was observed as a reduction of stiffness along the spine and hips in response to slowly applied torsion during unsupported stance [6
]. Interestingly, this stiffness reduction resulted from an increase in the extent muscle tone dynamically adapted to yield to the applied movement. It is unclear, however, how such altered axial and proximal postural behavior may influence movement coordination. In general, the relationship between postural tone and movement coordination is not understood. In particular, the importance of regulating postural tone dynamically throughout movement has been hypothesized previously by Bernstein and others [7
], but has not been studied to date. Populations with atypical axial postural tone, such as AT, might help elucidate how tone affects movement coordination.
AT is taught by bringing attention to one’s head-neck-back relationship and specific features of movement, such as preparation and smoothness, in various postures and movements. A primary aim is to minimize abrupt shifts in tension and position along the body axis at movement onset [1
]. AT instruction uses manual guidance to increase one’s awareness of these features and facilitate the desired head-neck-back relationship. The resulting coordination is claimed to be more efficient [1
]. Movements typically performed in AT include sit-to-stand (STS), stand-to-sit, knee bends, lunges and squats. Of these, only STS has been studied with AT. Jones and colleagues found that, for this movement, horizontal head velocity, vertical acceleration and cervical extension decreased following AT training [10
]. This group also found the movement was perceived as smoother and lower in effort [11
]. Although AT may alter STS coordination, its effect is not well characterized and the significance of the resulting coordination differences is not clear.
In the present study, we aimed to better characterize STS coordination following AT training by examining 1) the overall phasing of the STS movement, 2) features of weight-shift, because it is perceived as smoother with AT, and 3) spinal coordination, because AT emphasizes axial behavior. A preliminary version of this work has appeared previously in abstract form [12