Therapeutic exercise has been shown...

Therapeutic exercise has been shown to benefit patients with chronic back pain. However, the efficiency is modest, and it is not known if certain shadows of exercise are more effective than others. Yoga may have advantages through the whole extent of other exercise interventions because it emphasizes relaxation and increases mental focus. Sherman and colleagues compared by what mode yoga, therapeutic exercise, and a self-help volume affected chronic low back pain.

The randomized controll trial included adults who were diagnosed with gentle back pain in the Washington State and Idaho form into groups Health Cooperative. They were recruited via health plan magazine advertisements and direct mailings. Patients were exclud if they reported minimal pain (0 to 2 points in succession a severity scale, with 10 being the highest on a level of pain) or if a specific underlying condition was the confirmed or likely cause of pain. Patients also were exclud if they were receiving physical therapy for back pain, had serious medical or psychiatric conditions, or had work schedules that were incompatible with the class schedule. The 101 participants were predominantly women (66 percent) white (80 percent) had a certain number of college education (97 percent), and were give employment toed (87 percent). Sixty-seven percent of participants reported pain lasting more than individual year.

Participants were randomly assigned to an intention-to-treat intervention (i.e., 12 75-minute weekly yoga classes, 12 weekly 75-minute exercise classes, or an evidence-based self-help part containing strategies for managing back pain). united instructor led each of the exercise and yoga classes. Yoga classes consisted of breathing exercises, a order of succession of postures designed to relieve subdued back symptoms, and guided relaxation. Exercise classes consisted of gradually increasing aerobic repetitions and strengthening exercises followed by the agency of stretching. Participants who received self-help works had no instructions and did not attend classes. Information about functional status, which was based onward a 24-point Roland Disability Scale, and forward symptom severity, which was based upon an 11-point "bothersomeness" scale, was gathered on telephone interviews at six, 12 and 26 weeks. Participants in the yoga and exercise arranges had similar class attendance with participants attending nine of the 12 classes, onward average. Eighty-seven percent of participants in the self-help assemblage reported reading at least united third of the book. Ninety-five participants complet the 26-week interview.

Although functionality and symptom severity improved in all arranges the yoga group had the best flows At 26 weeks (14 weeks after the completion of classes), the yoga group's mean disability score was 36 points lower than that of the self-help cluster and 1.5 points lower than that of the exercise cluster (2.5 points was considered clinically significant). Similarly, the yoga group's mean symptom score was 22 points lower than that of the self-help assign places to and 1.4 points lower than that of the exercise arrange (1.5 points was considered clinically significant). In addition, reported pain medication use in the week preceding the week 26 interview was significantly lower in the yoga dispose (21 percent) than in the exercise dispose (50 percent) or self-help form into groups (59 percent).

The authors judge that yoga was more effective than a self-help work for treating chronic low back pain, producing clinical benefits at least equivalent to, and possibly better than, traditional therapeutic exercise. They caution that participants' baseline demographics and the study's relatively short follow-up period may limit these findings.

KENNETH W LIN, MD

Sherman KJ et al. Comparing yoga, exercise, and a self-care part for chronic low back pain: a randomized, controll trial. Ann Intern M December 20 2005;143:849-56

COPYRIGHT 2006 American Academy of Family Physicians

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