The Efficacy of Yoga as an Intervention for Chronic Low Back Pain: A Systematic Review of Randomized Controlled Trials (original) (raw)
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Yoga for chronic low back pain: Analysis of randomized controlled trials
Objectives: To evaluate the efficacy of yoga as an intervention for chronic low back pain (CLBP) using a meta-analytical approach. Randomized controlled trials (RCTs) that examined pain and⁄or functional disability as treatment outcomes were included. Post-treatment and follow-up outcomes were assessed. Methods: A comprehensive search of relevant electronic databases, from the time of their inception until November 2011, was conducted. Cohen's d effect sizes were calculated and entered in a random-effects model. Results: Eight RCTs met the criteria for inclusion (eight assessing functional disability and five assessing pain) and involved a total of 743 patients. At post-treatment, yoga had a medium to large effect on functional disability (d=0.645) and pain (d=0.623). Despite a wide range of yoga styles and treatment durations, heterogeneity in post-treatment effect sizes was low. Follow-up effect sizes for functional disability and pain were smaller, but remained significant (d...
Yoga for low back pain: a systematic review of randomized clinical trials
Clinical Rheumatology, 2011
It has been suggested that yoga has a positive effect on low back pain and function. The objective of this systematic review was to assess the effectiveness of yoga as a treatment option for low back pain. Seven databases were searched from their inception to March 2011. Randomized clinical trials were considered if they investigated yoga in patients with low back pain and if they assessed pain as an outcome measure. The selection of studies, data extraction and validation were performed independently by two reviewers. Seven randomized controlled clinical trials (RCTs) met the inclusion criteria. Their methodological quality ranged between 2 and 4 on the Jadad scale. Five RCTs suggested that yoga leads to a significantly greater reduction in low back pain than usual care, education or conventional therapeutic exercises. Two RCTs showed no between-group differences. It is concluded that yoga has the potential to alleviate low back pain. However, any definitive claims should be treated with caution.
Complementary Therapies in Clinical Practice, 2010
Objective: To conduct a pilot trial of yoga for the treatment of chronic low back pain (LBP) to inform the feasibility and practicality of conducting a full-scale trial in the UK; and to assess the efficacy of yoga for the treatment of chronic low back pain. Design: A pragmatic randomised controlled trial was undertaken comparing yoga to usual care. Participants: Twenty participants who had presented to their GP with chronic low back pain in the previous 18 months were recruited via GP records from one practice in York, UK. Interventions: Twenty patients were randomised to either 12 weekly 75-min sessions of specialised yoga plus written advice, or usual care plus written advice. Allocation was 50/50. Main outcome measures: Recruitment rate, levels of intervention attendance, and loss to follow-up were the main non-clinical outcomes. Change as measured by the Roland and Morris disability questionnaire was the primary clinical outcome. Changes in the Aberdeen back pain scale, SF-12, EQ-5D, and pain selfefficacy were secondary clinical outcomes. Data were collected via postal questionnaire at baseline, 4 weeks, and 12 weeks follow-up. Results: Of the 286 patients identified from the GP database, 52 (18%) consented and returned the eligibility questionnaire, out of these 20 (6.9%) were eligible and randomised. The total percentage of patients randomised from the GP practice population was 0.28%. Ten patients were randomised to yoga, receiving an average of 1.7 sessions (range 0e5), and 10 were randomised to usual care. At 12 weeks follow-up data was received from 60% of patients in the yoga group and 90% of patients in the usual care group (75% overall). No significant differences were seen between groups in clinical outcomes apart from on the Aberdeen back pain scale at four weeks follow-up where the yoga group reported significantly less pain. Conclusion: This pilot study provided useful data and information to inform the design and development of a full-scale trial of yoga for CLBP in the UK. A key finding is the calculation of GP practice total list size required for patient recruitment in a full-scale trial, and the need to implement methods to increase class attendance.
Complementary Therapies in Clinical Practice, 2010
A systematic review revealed three small randomised controlled trials of yoga for low back pain, all of which showed effects on back pain that favoured the yoga group. To build on these studies a larger trial, with longer term follow-up, and a number of different yoga teachers delivering the intervention is required. This study protocol describes the details of a randomised controlled trial (RCT) to determine the effectiveness and cost-effectiveness of Yoga for chronic Low Back Pain, which is funded by Arthritis Research Campaign (arc) and is being conducted by the University of York. 262 patients will be recruited from GP practices in 5 centres in England. Patients will be randomised to receive usual care or 12 weekly classes of yoga. A yoga programme will be devised that can be delivered by yoga teachers of the two main national yoga organisations in the UK (British Wheel of Yoga and Iyengar Yoga Association (UK)).Trial registration: Current controlled trials registry ISRCTN81079604 (date registered 30/03/2007).
Development of generic yoga therapy protocol for nonspecific chronic low back pain
Yoga Mimamsa, 2024
Objective: To develop a generic yoga therapy protocol for nonspecific chronic low back pain (NCLBP) on the basis of previous research studies. Methods: A comprehensive PubMed search was done using keywords of "yoga" and "back pain" for English-language articles published till November 2022. PubMed showed 332 results for the keywords from 1977 to 2022. Twenty-nine studies were found eligible and the consolidation of yogic techniques were used in the studies. The study compiled 72 yogic techniques, including Asana and Pranayama, from 332 articles on yoga and back pain. Out of these, 151 were not relevant to yoga or back pain. After analyzing 181 articles, 33 were selected for review for a yoga therapy protocol, with four excluded due to inability to access full-text articles. The protocol was later validated by 14 eminent yoga therapy experts across the globe from countries including Australia,
Chronic low back pain: Can Yoga as an integrative approach be the best way forward?
Integrative Medicine Case Reports
Chronic Low Back pain (CLBP) is common public health problem, and globally one of the leading cause of disability. Several research studies advocate Yoga may add on as an effective therapy for CLBP patients. The present case study is an attempt to elucidate the outcome of Integrated Approach of Yoga Therapy (IAYT) intervention (which included loosening practices, asanas with breathing, relaxation, pranayama and meditation techniques) as an adjunct and integrative therapy to reduce pain symptoms, pain-associated disability and their overall quality of life in CLBP adult patients. The manuscript illustrates the two CLBP patients, refractory to conservative management, visiting pain clinic at Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Both the patients received a series of 60 minutes IAYT class conducted for a span of 15 days along with the institutional usual care regime as their treatment protocol. Patients were evaluated at baseline, 1 mon...
Trials, 2010
Background: Back pain, one of the most prevalent conditions afflicting American adults, is the leading reason for using complementary and alternative medicine (CAM) therapies. Yoga is an increasingly popular "mind-body" CAM therapy often used for relieving back pain and several small studies have found yoga effective for this condition. This study will assess whether yoga is effective for treating chronic low back pain compared with self care and exercise and will explore the mechanisms responsible for any observed benefits.
2022
This is a controlled randomized trial which evaluated the clinical and molecular changes resulting from Integrated approach of yoga therapy (IAYT) as an adjunct regimen and compared it with usual care for the management of chronic low back pain patients. We enrolled 29 adult patients with chronic low back pain (CLBP). Patients were randomly divided into two groups. Control group received the usual care of treatment as per institutional protocol. The yoga group received IAYT as an adjunct to usual care. Primary outcomes were pain Intensity assessed by verbal numerical rating scale (VNRS) and functional ability assessed by Modified Oswestry Disability Index (MODI). Secondary outcomes were pain catastrophizing, quality of life, fear of movement related to CLBP, type of pain, levels of ß-Endorphin and TNF α and Salivary CGRP. All parameters were measured at baseline, one month, and three months. Significant decrease in VNRS score at 1 and 3 months was observed in both the groups with ...