Changes in pain intensity and health related quality of life with Iyengar yoga in nonspecific chronic low back pain: A randomized controlled study

Abstract

Background:Nonspecific chronic low back (nCLBP) pain is prevalent among adult population and often leads to functional limitations, psychological symptoms, lower quality of life (QOL), and higher healthcare costs. The purpose of this study was to determine the efficacy of Iyengar yoga therapy on pain intensity and health related quality of life (HRQOL) with nCLBP.Aim of the Study:To compare the effect of Iyengar yoga therapy and conventional exercise therapy on pain intensity and HRQOL in nonspecific chronic low back pain.Materials and Methods:Experimental study with random sampling technique.Subjects/Intervention:Sixty subjects who fulfilled the selection criteria were randomly assigned to Iyengar yoga (yoga group, n = 30) and control group (exercise group, n = 30). Participants completed low back pain evaluation form and HRQOL-4 questionnaire before their intervention and again 4 weeks and 6 month later. Yoga group underwent 29 yogic postures training and exercise group had undergone general exercise program for 4 weeks.Statistics:Repeated measures analysis of variance (ANOVA) was used to analyze group differences over time, while controlling for baseline differences.Results:Patients in both groups experienced significant reduction in pain and improvement in HRQOL. In visual analogue scale (VAS) yoga group showed reduction of 72.81% (P = 0.001) as compared to exercise group 42.50% (P = 0.001). In HRQOL, yoga group showed reduction of 86.99% (P = 0.001) as compared to exercise group 67.66% (P = 0.001).Conclusion:These results suggest that Iyengar yoga provides better improvement in pain reduction and improvement in HRQOL in nonspecific chronic back pain than general exercise.

Yoga treatment for chronic non-specific low-back pain

“…Three studies reported methods of randomization but allocation concealment was not reported (Galantino 2004;Williams 2005;Nambi 2014), and two studies did not report details of randomization or allocation concealment (Williams 2009;Wattamwar 2013).…”

“…This measures "the extent to which participants' lives are affected by whatever level of pain they felt", a concept related to but not the same as pain . Five studies reported mental and physical quality of life Cox 2010;Tilbrook 2011;Nambi 2014), and three studies reported depression (Galantino 2004;Williams 2009). Three studies reported some measure of clinical improvement (Saper 2009;Cox 2010;, and eight studies mentioned the presence or absence of adverse events (Sherman 2005;Williams 2005;Saper 2009;Williams 2009;Tilbrook 2011;Nambi 2014).…”

“…Studies compared yoga to a waiting list or usual care (Galantino 2004;Saper 2009;Williams 2009;Cox 2010;Tilbrook 2011), to a self-care book (Sherman 2005;, to educational classes and written material (Williams 2005), or to exercise (Sherman 2005;Wattamwar 2013;Nambi 2014). Among the studies comparing yoga to a waiting list or usual care, three studies provided supplementary written advice or educational material to both intervention groups (Saper 2009;Cox 2010;Tilbrook 2011), and one study provided supplementary written material to the non-yoga intervention group only ).…”

“…In the other studies, participants were recruited from clinical populations (Sherman 2005;Cox 2010), from both clinical and community populations (Galantino 2004;Nambi 2014;Saper 2009;Tilbrook 2011;Williams 2005), or from the community (Williams 2009). For studies in which participants were recruited through a mix of clinical and community outreach, the majority of those screened appeared to be selfreferred from the community in Williams 2005, and to be physician-referred potential participants in Tilbrook 2011; the mix of recruitment sources for those screened was not described for the other studies.…”

“…Pain was assessed using a 0 to 5 scale (Wattamwar 2013), a 0 to 10 scale Williams 2005;Saper 2009;Nambi 2014), a 0 to 100 scale (Williams 2009), or the Aberdeen Back Pain Scale (Cox 2010;Tilbrook 2011). Two studies did not report pain but instead reported the pain-related outcome of 'symptom bothersomeness' (Sherman 2005;).…”