Comparison of yoga versus stretching for chronic low back pain: protocol for the Yoga Exercise Self-care (YES) trial.

Publisher: BioMed Central Country of Publication: England NLM ID: 101263253 Publication Model: Electronic Cited Medium: Internet ISSN: 1745-6215 (Electronic) Linking ISSN: 17456215 NLM ISO Abbreviation: Trials Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2006-

Muscle Stretching Exercises* ; Self Care* ; Yoga*; Low Back Pain/*therapy; Chronic Disease ; Disability Evaluation ; Humans ; Low Back Pain/diagnosis ; Low Back Pain/physiopathology ; Pain Measurement ; Recovery of Function ; Research Design ; Time Factors ; Treatment Outcome ; Washington

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.
Methods/design: A total of 210 participants with low back pain lasting at least 3 months will be recruited from primary care clinics of a large healthcare system based in Seattle. They will be randomized in a 2:2:1 ratio to receive 12 weekly yoga classes, 12 weekly conventional therapeutic exercise classes of comparable physical exertion, or a self-care book. Interviewers masked to participants' treatment group will assess outcomes at baseline and 6, 12 and 26 weeks after randomization. Primary outcomes will be back-related dysfunction and symptom bothersomeness. In addition, data will be collected on physical measurements (e.g., flexion) at baseline and 12 weeks and saliva samples will be obtained at baseline, 6 and 12 weeks. Information will be collected on specific physical, psychological, and physiological factors to allow exploration of possible mechanisms of action through which yoga could relieve back pain and dysfunction. The effectiveness of yoga will be assessed using analysis of covariance (using general estimating equations - GEE) within an intention-to-treat context. If yoga is found effective, further analyses will explore whether yoga's benefits are attributable to physical, psychological and/or physiological factors.
Conclusions: This study will provide the clearest evidence to date about the value of yoga as a therapeutic option for treating chronic back pain, and if the results are positive, will help focus future, more in-depth, research on the most promising potential mechanisms of action identified by this study.

Adv Data. 2004 May 27;(343):1-19. (PMID: 15188733)
Spine (Phila Pa 1976). 2000 Dec 15;25(24):3100-3. (PMID: 11124724)
Am J Epidemiol. 1995 Nov 1;142(9):904-8. (PMID: 7572970)
Altern Ther Health Med. 2004 Mar-Apr;10(2):44-9. (PMID: 15055093)
Psychosom Med. 1998 Jan-Feb;60(1):26-32. (PMID: 9492235)
JAMA. 2008 Feb 13;299(6):656-64. (PMID: 18270354)
J Altern Complement Med. 2008 Jul;14(6):637-44. (PMID: 18673078)
Spine (Phila Pa 1976). 2000 Dec 15;25(24):3115-24. (PMID: 11124727)
Epidemiology. 1990 Jan;1(1):43-6. (PMID: 2081237)
Pain. 2005 May;115(1-2):107-17. (PMID: 15836974)
Biometrics. 1986 Mar;42(1):121-30. (PMID: 3719049)
Spine (Phila Pa 1976). 2003 Feb 1;28(3):292-7; discussion 298. (PMID: 12567035)
N Engl J Med. 1995 Oct 5;333(14):913-7. (PMID: 7666878)
Behav Res Methods. 2008 Aug;40(3):879-91. (PMID: 18697684)
J Chronic Dis. 1986;39(11):897-906. (PMID: 2947907)
Arch Phys Med Rehabil. 1988 Dec;69(12):1044-53. (PMID: 2975164)
Epidemiology. 2009 Jan;20(1):18-26. (PMID: 19234398)
Ann Intern Med. 2001 Sep 4;135(5):344-51. (PMID: 11529698)
Arch Intern Med. 2001 Apr 23;161(8):1081-8. (PMID: 11322842)
Neuropsychobiology. 1989;22(3):150-69. (PMID: 2485862)
J Gen Intern Med. 1986 Sep-Oct;1(5):328-38. (PMID: 2945917)
Phys Ther. 1988 Feb;68(2):199-207. (PMID: 2963349)
JAMA. 2003 Nov 12;290(18):2443-54. (PMID: 14612481)
Spine J. 2008 Jan-Feb;8(1):1-7. (PMID: 18164448)
Spine (Phila Pa 1976). 1983 Mar;8(2):141-4. (PMID: 6222486)
Pain. 1986 Oct;27(1):69-80. (PMID: 3785965)
J Pers Soc Psychol. 1986 Dec;51(6):1173-82. (PMID: 3806354)
Ann Intern Med. 2005 Dec 20;143(12):849-56. (PMID: 16365466)
Am J Epidemiol. 2008 Sep 15;168(6):656-64. (PMID: 18682488)
Spine (Phila Pa 1976). 1998 Dec 1;23(23):2608-15. (PMID: 9854760)
Arthritis Rheum. 1989 Jan;32(1):37-44. (PMID: 2912463)
J Altern Complement Med. 2008 Nov;14(9):1123-9. (PMID: 18991515)
Ann Intern Med. 2001 Apr 17;134(8):663-94. (PMID: 11304107)
N Engl J Med. 1998 Oct 8;339(15):1021-9. (PMID: 9761803)
Spine (Phila Pa 1976). 1983 Sep;8(6):635-42. (PMID: 6228020)
West J Med. 1989 Mar;150(3):351-5. (PMID: 2525303)
N Engl J Med. 1988 Feb 4;318(5):291-300. (PMID: 2961994)
Altern Ther Health Med. 2004 Mar-Apr;10(2):56-9. (PMID: 15055095)
Med Care. 1992 Jun;30(6):473-83. (PMID: 1593914)
Natl Health Stat Report. 2008 Dec 10;(12):1-23. (PMID: 19361005)
Spine (Phila Pa 1976). 1983 Mar;8(2):145-50. (PMID: 6222487)
Spine (Phila Pa 1976). 1992 Jun;17(6):617-28. (PMID: 1308095)
Spine (Phila Pa 1976). 2009 Sep 1;34(19):2066-76. (PMID: 19701112)
Ann Intern Med. 2007 Oct 2;147(7):492-504. (PMID: 17909210)
Pain. 1995 Sep;62(3):363-372. (PMID: 8657437)
Biom J. 2006 Apr;48(2):302-18. (PMID: 16708780)
Psychoneuroendocrinology. 1999 Jul;24(5):567-79. (PMID: 10378242)
Spine (Phila Pa 1976). 1995 Sep 1;20(17):1899-908; discussion 1909. (PMID: 8560339)
J Gen Intern Med. 2001 Sep;16(9):606-13. (PMID: 11556941)
Spine (Phila Pa 1976). 2005 Aug 15;30(16):1887-92. (PMID: 16103861)
West J Med. 1975 Nov;123(5):350-9. (PMID: 128907)

Z99 AT999999 United States ImNIH Intramural NIH HHS; U01 AT003208 United States AT NCCIH NIH HHS

ClinicalTrials.gov NCT00447668

Date Created: 20100402 Date Completed: 20100726 Latest Revision: 20240317

20240317

PMC2864260

10.1186/1745-6215-11-36

20356395