Exercise
and Rehabilitation Research
|
| Paper
Title |
Comparing
Yoga, Exercise, and a Self-Care Book for Chronic Low Back Pain |
| Author(s) |
Karen
J. Sherman, PhD, MPH; Daniel C. Cherkin, PhD; Janet Erro, RN, MN, PNP;
Diana L. Miglioretti, PhD; and Richard A. Deyo, MD, MPH |
| Journal
Reference |
Ann
Intern Med. 2005;143:849-856. |
| Background |
Chronic
low back pain is a common problem that has only modestly effective
treatment options. |
| Study
Design |
Randomized
control study based out of a non-profit health care system with 101 adults
suffering from chronic low back pain. |
| Intervention |
12-week
sessions of yoga or conventional therapeutic exercise classes or a
self-care book. |
| Measurements |
Primary
outcomes were back-related functional status (modified 24-point Roland
Disability Scale) and “bothersomeness” of pain (11-point numerical
scale). The primary time point was 12 weeks. Clinically significant change
was considered to be 2.5 points on the functional status scale and 1.5
points on the bothersomeness scale. Secondary outcomes were days of
restricted activity, general health status, and medication use. |
| Results |
After adjustment for baseline
values, back-related function in the yoga group was superior to the book
and exercise groups at 12 weeks (yoga vs. book: mean difference, 3.4
[95%CI, 5.1 to 1.6] [P < 0.001]; yoga vs. exercise: mean difference,1.8
[CI, 3.5 to 0.1] [P 0.034]). No significant differences in symptom
bothersomeness were found between any 2 groups at 12 weeks; at 26 weeks,
the yoga group was superior to the book group with respect to this measure
(mean difference, 2.2 [CI, 3.2 to 1.2]; P < 0.001). At 26 weeks,
back-related function in the yoga group was superior to the book group
(mean difference, 3.6 [CI, 5.4 to 1.8]; P < 0.001). |
| Limitations
and Authors' Conclusions |
Participants in this study
were followed for only 26 weeks after randomization. Only 1 instructor
delivered each intervention.
Yoga was more effective than a self-care book for improving function and
reducing chronic low back pain, and the benefits persisted for at least
several months. |
| Clinical
Significance |
In
this study it was demonstrated that yoga was more effective than generic
exercise, or self directed treatment as outlined by a booklet. Past
research has demonstrated that physical activity of all types is more
beneficial than bed rest, and core stabilizing exercises have been
associated with significant benefits. Future research may compare
core stabilizing exercises to yoga, but in the meantime it should be
remembered that any physical activity is preferred over no activity, and
that protocols including yoga and core stabilization are especially
helpful for patients with chronic low back pain. |
| NOTE:
The clinical significance review is the opinion of Dr Ken Mueller based
upon the information available at the time of posting. Unauthorized
use of the section on clinical significance is prohibited by Canadian
Copyright. The above research abstract is based on information
posted on www.annals.org.
For further information, please refer to the original article utilizing
the publication information provided. Annals of Internal
Medicine traditionally releases free full text 6 months after original
publication. January 2, 2005 |
