Effect of Alexander Technique on Neck Pain and Quality of Life in Lactating Women

The pain intensity will be assessed through numeric pain rating scale for all participating women in both groups before and after the treatment program. The woman will be asked to circle the number between 0 (represents no pain) and 10 (represents the worst pain) that best represents their pain intensity. She will be asked to indicate the intensity of her current, best, and worst pain levels over the past 24 hours on the scale, the mean of these three ratings is calculated to represent the patient's overall pain intensity.

The Short Form Survey Instrument (SF-36) will be used to assess the health-related quality of life for all women in both groups before and after the treatment program. The SF-36 is a self-administered questionnaire containing 36 items, which takes about five minutes to complete. It measures health across eight multi-item dimensions, covering functional status, well-being, and overall health evaluation, each associated with 2-10 possible answers. The response to each question is extrapolated to a standardized set of answers, and the results are transferred to a scale of 0-100, where 0 represents the worst state of health and 100 represents the best state of health measured. It has good validity and reliability and can be used as a general questionnaire to assess quality of life.

The goniometer will be used to measure flexion ROM for all women in both groups before and after the treatment program. Ask the patient to sit up straight in a chair with their feet flat on the floor, their arms hanging down by their sides, and their thoracic spine resting against the back of the chair. Place the goniometer's axis over the external auditory meatus before using it. Place the stationary arm perpendicular to the floor or vertically. Place the movable arm in line with the nose's base. This should be noted as 0°. For measuring cervical flexion ROM ask the woman to nod forward and lift their chin up to their chest,

The goniometer will be used to measure extension ROM for all women in both groups before and after the treatment program. Ask the patient to sit up straight in a chair with their feet flat on the floor, their arms hanging down by their sides, and their thoracic spine resting against the back of the chair. Place the goniometer's axis over the external auditory meatus before using it. Place the stationary arm perpendicular to the floor or vertically. Place the movable arm in line with the nose's base. This should be noted as 0°. For measuring cervical extension ROM ask the woman to stare as far upward as she can until her neck is fully extended.

The goniometer will be used to measure lateral flexion ROM for all women in both groups before and after the treatment program. The goniometer fulcrum will be aligned over the spinous process of the C7. The fixed arm of the goniometer will be aligned vertically along the imaginary line between the two acromion processes. The movable arm will be aligned over the external occipital protuberance. Then, instruct the woman to flex his/her neck laterally and record readings of the goniometer at each extreme of the motion in both sides.

The goniometer will be used to measure rotation ROM for all women in both groups before and after the treatment program. The goniometer fulcrum will be aligned over the center of the subject's head, the fixed arm of the goniometer will be aligned with an imaginary line between the subject's acromion processes and the movable arm will be aligned with the tip of the subject's nose. The woman will be told to stare directly her head, ideally at eye level. Next, instruct the woman to turn her head as far to the left as she can without tipping or tilting it. Take goniometer readings at both ends of the motion and record them and repeat the procedure for the opposite direction.

Neck Disability Index (NDI) will be used for all women in both groups before and after treatment program to assess self-rated disability, including aspects beyond current pain levels, by evaluating an individual's ability to perform daily activities. Each woman will be asked to choose from NDI questionnaire which comprises 10 items, each scored on a scale of 0 to 5, resulting in a maximum total score of 50. Lower scores reflect less self-rated disability.