Effects of yoga, strength training and advice on back pain: a randomized controlled trial

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Among the working population, non-specific low-back pain and neck pain are one of the most common reasons for sickness absenteeism. The aim was to evaluate the effects of an early intervention of yoga - compared with strength training or evidence-based advice - on sickness absenteeism, sickness presenteeism, back and neck pain and disability among a working population.

Methods

A randomized controlled trial was conducted on 159 participants with predominantly (90%) chronic back and neck pain. After screening, the participants were randomized to kundalini yoga, strength training or evidence-based advice. Primary outcome was sickness absenteeism. Secondary outcomes were sickness presenteeism, back and neck pain and disability. Self-reported questionnaires and SMS text messages were completed at baseline, 6 weeks, 6 and 12 months.

Results

The results did not indicate that kundalini yoga and strength training had any statistically significant effects on the primary outcome compared with evidence-based advice. An interaction effect was found between adherence to recommendations and sickness absenteeism, indicating larger significant effects among the adherers to kundalini yoga versus evidence-based advice: RR = 0.47 (CI 0.30; 0.74, p = 0.001), strength training versus evidence-based advice: RR = 0.60 (CI 0.38; 0.96, p = 0.032). Some significant differences were also found for the secondary outcomes to the advantage of kundalini yoga and strength training.

Conclusions

Guided exercise in the forms of kundalini yoga or strength training does not reduce sickness absenteeism more than evidence-based advice alone. However, secondary analyses reveal that among those who pursue kundalini yoga or strength training at least two times a week, a significantly reduction in sickness absenteeism was found. Methods to increase adherence to treatment recommendations should be further developed and applied in exercise interventions.

Trial Registration

Clinicaltrials.gov NCT01653782, date of registration: June, 28, 2012, retrospectively registered.

Related collections

Most cited references 33

Record: found
Abstract: found
Article: not found

Grading the severity of chronic pain.

Michael Von Korff, Johan Ormel, Francis Keefe … (1992)

This research develops and evaluates a simple method of grading the severity of chronic pain for use in general population surveys and studies of primary care pain patients. Measures of pain intensity, disability, persistence and recency of onset were tested for their ability to grade chronic pain severity in a longitudinal study of primary care back pain (n = 1213), headache (n = 779) and temporomandibular disorder pain (n = 397) patients. A Guttman scale analysis showed that pain intensity and disability measures formed a reliable hierarchical scale. Pain intensity measures appeared to scale the lower range of global severity while disability measures appeared to scale the upper range of global severity. Recency of onset and days in pain in the prior 6 months did not scale with pain intensity or disability. Using simple scoring rules, pain severity was graded into 4 hierarchical classes: Grade I, low disability--low intensity; Grade II, low disability--high intensity; Grade III, high disability--moderately limiting; and Grade IV, high disability--severely limiting. For each pain site, Chronic Pain Grade measured at baseline showed a highly statistically significant and monotonically increasing relationship with unemployment rate, pain-related functional limitations, depression, fair to poor self-rated health, frequent use of opioid analgesics, and frequent pain-related doctor visits both at baseline and at 1-year follow-up. Days in Pain was related to these variables, but not as strongly as Chronic Pain Grade. Recent onset cases (first onset within the prior 3 months) did not show differences in psychological and behavioral dysfunction when compared to persons with less recent onset. Using longitudinal data from a population-based study (n = 803), Chronic Pain Grade at baseline predicted the presence of pain in the prior 2 weeks. Chronic Pain Grade and pain-related functional limitations at 3-year follow-up. Grading chronic pain as a function of pain intensity and pain-related disability may be useful when a brief ordinal measure of global pain severity is required. Pain persistence, measured by days in pain in a fixed time period, provides useful additional information.

0 comments Cited 404 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Treating individuals 2. Subgroup analysis in randomised controlled trials: importance, indications, and interpretation.

Peter M. Rothwell (2005)

Large pragmatic trials provide the most reliable data about the effects of treatments, but should be designed, analysed, and reported to enable the most effective use of treatments in routine practice. Subgroup analyses are important if there are potentially large differences between groups in the risk of a poor outcome with or without treatment, if there is potential heterogeneity of treatment effect in relation to pathophysiology, if there are practical questions about when to treat, or if there are doubts about benefit in specific groups, such as elderly people, which are leading to potentially inappropriate undertreatment. Analyses must be predefined, carefully justified, and limited to a few clinically important questions, and post-hoc observations should be treated with scepticism irrespective of their statistical significance. If important subgroup effects are anticipated, trials should either be powered to detect them reliably or pooled analyses of several trials should be undertaken. Formal rules for the planning, analysis, and reporting of subgroup analyses are proposed.

0 comments Cited 212 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Exercise therapy for treatment of non-specific low back pain.

Jill Alison Hayden, Maurits W van Tulder, Antti Malmivaara … (2005)

Exercise therapy is widely used as an intervention in low-back pain. To evaluate the effectiveness of exercise therapy in adult non-specific acute, subacute and chronic low-back pain versus no treatment and other conservative treatments. The Cochrane Central Register of Controlled Trials (Issue 3, 2004), MEDLINE, EMBASE, PsychInfo, CINAHL databases to October 2004; citation searches and bibliographic reviews of previous systematic reviews. Randomized controlled trials evaluating exercise therapy for adult non-specific low-back pain and measuring pain, function, return-to-work/absenteeism, and/or global improvement outcomes. Two reviewers independently selected studies and extracted data on study characteristics, quality, and outcomes at short, intermediate, and long-term follow-up. Sixty-one randomized controlled trials (6390 participants) met inclusion criteria: acute (11), subacute (6) and chronic (43) low-back pain (1 unclear). Evidence was found of effectiveness in chronic populations relative to comparisons at all follow-up periods; pooled mean improvement was 7.3 points (95% CI, 3.7 to 10.9) for pain (out of 100), 2.5 points (1.0 to 3.9) for function (out of 100) at earliest follow-up. In studies investigating patients (i.e. presenting to healthcare providers) mean improvement was 13.3 points (5.5 to 21.1) for pain, 6.9 (2.2 to 11.7) for function, representing significantly greater improvement over studies where participants included those recruited from a general population (e.g. with advertisements). There is some evidence of effectiveness of graded-activity exercise program in subacute low-back pain in occupational settings, though the evidence for other types of exercise therapy in other populations is inconsistent. There was evidence of equal effectiveness relative to comparisons in acute populations [pain: 0.03 points (95% CI, -1.3 to 1.4)]. This review largely reflects limitations of the literature, including low quality studies with heterogeneous outcome measures, inconsistent and poor reporting, and possibility of publication bias. Exercise therapy appears to be slightly effective at decreasing pain and improving function in adults with chronic low-back pain, particularly in healthcare populations. In subacute low-back pain there is some evidence that a graded activity program improves absenteeism outcomes, though evidence for other types of exercise is unclear. In acute low-back pain, exercise therapy is as effective as either no treatment or other conservative treatments.

0 comments Cited 140 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Elisabeth Björk Brämberg: +468 524 874 12 , Elisabeth.bjork.bramberg@ki.se

Gunnar Bergström: Gunnar.bergstrom@ki.se

Irene Jensen: Irene.jensen@ki.se

Jan Hagberg: Jan.hagberg@ki.se

Lydia Kwak: Lydia.kwak@ki.se

Journal

Journal ID (nlm-ta): BMC Musculoskelet Disord

Journal ID (iso-abbrev): BMC Musculoskelet Disord

Title: BMC Musculoskeletal Disorders

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2474

Publication date (Electronic): 29 March 2017

Publication date PMC-release: 29 March 2017

Publication date Collection: 2017

Volume: 18

Electronic Location Identifier: 132

Affiliations

[1 ]ISNI 0000 0004 1937 0626, GRID grid.4714.6, Unit of Intervention and Implementation Research for Worker Health, , Institute of Environmental Medicine, ; Nobels väg 13, Karolinska Institutet, 171 77 Stockholm, Sweden

[2 ]ISNI 0000 0001 2326 2191, GRID grid.425979.4, Centre for Occupational and Environmental Medicine, , Stockholm County Council, ; Solnavägen 4, 113 65 Stockholm, Sweden

Article

Publisher ID: 1497

DOI: 10.1186/s12891-017-1497-1

PMC ID: 5372262

SO-VID: 3b92d0c8-b9cb-4e2f-8796-f98398639bf9

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 6 September 2016

Date accepted : 21 March 2017

Funding

Funded by: Swedish Research Council for Health, Working life and Welfare Forte

Award ID: 2008-0849

Award Recipient : Irene Jensen

Custom metadata

ScienceOpen disciplines: Orthopedics

Keywords: randomized controlled trial,back pain,yoga,strength training,sickness absenteeism,sickness presenteeism,disability

Data availability:

ScienceOpen disciplines: Orthopedics

Keywords: randomized controlled trial, back pain, yoga, strength training, sickness absenteeism, sickness presenteeism, disability

Effects of yoga, strength training and advice on back pain: a randomized controlled trial

Read this article at

Abstract

Background

Methods

Results

Conclusions

Trial Registration

Related collections

Orthopedics

Most cited references 33

Grading the severity of chronic pain.

Treating individuals 2. Subgroup analysis in randomised controlled trials: importance, indications, and interpretation.

Exercise therapy for treatment of non-specific low back pain.

Author and article information

Contributors

Journal

Affiliations

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 360

Cited by 14

Most referenced authors 633