Low back pain is a significant public health problem and one of the most commonly reported reasons for the use of Complementary Alternative Medicine. A randomized control trial was conducted in subjects with non-specific chronic low back pain comparing Iyengar yoga therapy to an educational control group. Both programs were 16 weeks long. Subjects were primarily self-referred and screened by primary care physicians for study of inclusion/exclusion criteria. The primary outcome for the study was functional disability. Secondary outcomes including present pain intensity, pain medication usage, pain-related attitudes and behaviors, and spinal range of motion were measured before and after the interventions. Subjects had low back pain for 11.2+/-1.54 years and 48% used pain medication. Overall, subjects presented with less pain and lower functional disability than subjects in other published intervention studies for chronic low back pain. Of the 60 subjects enrolled, 42 (70%) completed the study. Multivariate analyses of outcomes in the categories of medical, functional, psychological and behavioral factors indicated that significant differences between groups existed in functional and medical outcomes but not for the psychological or behavioral outcomes. Univariate analyses of medical and functional outcomes revealed significant reductions in pain intensity (64%), functional disability (77%) and pain medication usage (88%) in the yoga group at the post and 3-month follow-up assessments. These preliminary data indicate that the majority of self-referred persons with mild chronic low back pain will comply to and report improvement on medical and functional pain-related outcomes from Iyengar yoga therapy.
Low back pain is a significant public health problem that has reached epidemic proportions. It places a substantial burden on the workforce and the health care system.1It has proven very difficult to treat, and it is one of the most commonly reported reasons for the use of complementary and alternative medicine.2 Many different methods of Yoga exist and each has its own technique for preventing and treating disease. This article describes the rationale and method for the therapeutic application of Iyengar Yoga for chronic low back pain. Preliminary results are also presented from a pilot study evaluating the efficacy of a 16-week program of Iyengar Yoga therapy in persons with non-specific chronic low back pain.
The purpose of this investigation was to determine which stretching technique, static or ballistic, is most effective for increasing hamstring muscle length when delivered at the same stretching dose over a 4-week training program. A single-blind, randomized controlled trial design was used in this investigation. Thirty-two participants (16 women and 16 men) between the ages of 18 and 27 years participated in the study. All participants who had a pre-training knee extension angle of less than 20° were excluded from the study. Subjects were randomly assigned to one of 3 groups: ballistic stretching, static stretching, or control group. Participants in the experimental stretching groups (ballistic and static stretching) performed one 30-second stretch 3 times per week for a period of 4 weeks. Statistical analysis consisted of a 2-way analysis of variance (group × sex) with an a priori alpha level of 0.05. No interaction between group and sex was identified (p = 0.4217). The main effect of sex was not statistically significant (p = 0.2099). The main effect for group was statistically significant at p < 0.0001. Post hoc analysis revealed that both static and ballistic stretching group produced greater increases in hamstring length than the control group. The static stretching group demonstrated a statistically greater increase in hamstring muscle length than the ballistic stretching group. No injuries or complications were attributed to either stretching program.
The purpose of this study was to determine if segmental skeletal length contributes to vertical jump (VJ) displacement in recreational athletes. Skeletal length measurements of the trunk, femur, tibia, and foot were obtained by palpation of bony landmarks and a standard tape measure. A pilot study (n = 10) examined the intratester and intertester reliability for each skeletal measure. The pilot investigation revealed fair to excellent intratester and intertester reliability. Seventy-eight recreational athletes (55 men and 23 women) with a mean age of 21.9 +/- 2.9 years participated in the investigation. Multiple regression analysis with gender as a categorical indicator variable revealed a significant gender difference; therefore, men and women were analyzed separately. Regression analysis for men identified foot length (p < 0.033, R(2) = 0.08) as the only significant skeletal length predictor of VJ displacement. None of the skeletal length measures was predictive of VJ displacement in women. Based on the results of this investigation, intrinsic skeletal length is not a strong predictor of VJ displacement in young adult recreational athletes.
Considerable research over the last decade has focused on classification-based treatments for acute low back pain (LBP). 3,4,9,[17][18][19][20]23,24,56 Much of this research has been influenced by the treatment-based-classification (TBC) model proposed by Delitto et al. 9 A major tenet of the TBC model is to stage patients based on the severity of LBP-related disability and functional status rather than the traditional time-based method. Delitto et al 9 identified 3 stages of LBP: stage 1 (acute), stage 2 (subacute), and stage 3 (chronic). They reported that individuals in stage 1 often have an inability to perform basic mechanical activities, such as sitting, walking, and standing, and typically score greater than 40 on an LBP disability questionnaire similar to the Oswestry Low Back Pain Disability Questionnaire (mOSW). Those in stage 2 are characterized as having limitation in instrumental activities of daily living (eg, mowing grass, vacuuming) and commonly have an mOSW score between 20 and 40. Those in stage 3 are described as having deficits in performing high-level, physical-demand activities (eg, work) and frequently have an mOSW score of less than 20.Compared to the stage 1 category in the TBC model, which has been significantly updated and revised, 4,14,17,18,23,56 few studies have examined the variables associated with level of LBP-related disability in subjects with stage 2 and stage 3 LBP. The Delitto et al 9 TBC model identified impairment-based interventions for individuals with stage 2 LBP that address deficits in flexibility, strength, cardiovascular function, coordination, and body T T METHODS:Data analyzed were from working individuals with nonacute LBP (n = 235). The response variable was dichotomized by mOSW score (less than 20 or 20 or greater), and the regressor variables included 27 self-report, sociodemographic, impairment-based, and kinematic measures used to assess individuals with LBP. Logistic regression was used to identify variables associated with mOSW. T T RESULTS:One hundred eleven subjects had a mOSW score of 20 or greater, and 124 subjects had a mOSW score of less than 20. Logistic regression analysis identified 4 variables associated with LBP-related disability (mOSW): duration of LBP (P = .006), numeric pain rating (P<.0001), Fear-Avoidance Beliefs Questionnaire physical activity subscale (P = .0007), and limits of stability movement velocity in the forward direction (P = .02). The best model had an R 2 (u) of 0.25. T T CONCLUSION:The odds of LBP-related disability (mOSW) in this sample of nonacute working individuals were found to increase with longer duration of LBP, higher numeric pain rating scores, higher Fear-Avoidance Beliefs Questionnaire physical activity subscale scores, and slower limits of stability movement velocity in the forward direction. The identification of limits of stability movement velocity is a novel finding that may support a link between sensorimotor balance deficits and disability in working individuals with nonacute LBP.
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