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Comparing yoga,
exercise, and a self-care book for chronic low back pain: a
randomized, controlled trial.
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Annals
of Internal Medicine.
2005 Dec
20;143(12):849-56.
Sherman KJ, Cherkin DC,
Erro J, Miglioretti DL, Deyo RA.
Group Health Cooperative
and University of Washington, Seattle, Washington, USA.
Sherman.k@ghc.org
BACKGROUND:
Chronic low back pain is
a common problem that has only modestly effective treatment options.
OBJECTIVE:
To determine whether
yoga is more effective than conventional therapeutic exercise or a
self-care book for patients with chronic low back pain.
DESIGN:
Randomized, controlled
trial.
SETTING:
A nonprofit, integrated
health care system.
PATIENTS:
101 adults with
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:
Participants in this
study were followed for only 26 weeks after randomization. Only 1
instructor delivered each intervention.
CONCLUSIONS:
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.
Research
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