Clinical Question:
Is specific yoga program more effective than exercise class or self-care in
patients with
chronic low back pain?
Bottom Line:
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.
Reference:
Sherman KJ, Cherkin DC, Erro J, Miglioretti DL, Deyo RA. Comparing yoga,
exercise, and a self-care book for chronic low back pain: A randomized,
controlled trial. Ann Intern Med 2005;143:849-56.
Study Design:
Randomized controlled trial (nonblinded)
Synopsis:
Chronic low back pain is a common problem that has only modestly effective
treatment options. To determine whether yoga is more effective than
conventional therapeutic exercise or a self-care book for patients with
chronic low back pain. Randomized, controlled trial. A nonprofit, integrated
health care system. 101 adults with chronic low back pain. 12-week sessions
of yoga or conventional therapeutic exercise classes or a self-care book.
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. 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).
Participants in this study were followed for only 26 weeks after
randomization. Only 1 instructor delivered each intervention. |