Yoga versus education for Veterans with chronic low back pain: study protocol for a randomized controlled trial

Abstract

BackgroundChronic low back pain is the most frequent pain condition in Veterans and causes substantial suffering, decreased functional capacity, and lower quality of life. Symptoms of post-traumatic stress, depression, and mild traumatic brain injury are highly prevalent in Veterans with back pain. Yoga for low back pain has been demonstrated to be effective for civilians in randomized controlled trials. However, it is unknown if results from previously published trials generalize to military populations.Methods/designThis study is a parallel randomized controlled trial comparing yoga to education for 120 Veterans with chronic low back pain. Participants are Veterans ≥18 years old with low back pain present on at least half the days in the past six months and a self-reported average pain intensity in the previous week of ≥4 on a 0–10 scale. The 24-week study has an initial 12-week intervention period, where participants are randomized equally into (1) a standardized weekly group yoga class with home practice or (2) education delivered with a self-care book. Primary outcome measures are change at 12 weeks in low back pain intensity measured by the Defense and Veterans Pain Rating Scale (0–10) and back-related function using the 23-point Roland Morris Disability Questionnaire. In the subsequent 12-week follow-up period, yoga participants are encouraged to continue home yoga practice and education participants continue following recommendations from the book. Qualitative interviews with Veterans in the yoga group and their partners explore the impact of chronic low back pain and yoga on family relationships. We also assess cost-effectiveness from three perspectives: the Veteran, the Veterans Health Administration, and society using electronic medical records, self-reported cost data, and study records.DiscussionThis study will help determine if yoga can become an effective treatment for Veterans with chronic low back pain and psychological comorbidities.Trial RegistrationClinicalTrials.gov: NCT02224183Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1321-5) contains supplementary material, which is available to authorized users.

Yoga therapy for military personnel and veterans: Qualitative perspectives of yoga students and instructors

“…These comments revealed perceptions that yoga is not strenuous enough, or requires incredible feats of flexibility, despite research indicating the adaptability and acceptability of yoga for different health conditions in the general population, 38,39 and more recently, in studies with veterans and military personnel. 40,15,41,42…”

Whole Health for Life - A Project Aimed At redesigning Health Care for American Veterans

“…But the research has made progress in the past few years: a new review on yoga for veterans with PTSD with positive results were published (18); one large study on yoga for veterans with chronic low back pain (LBP) also had the positive results (19), and one study about yoga for LBP in veterans is about to be published (20).…”

The Implementation of Patient-Reported Outcome Measures in Yoga Therapy

“…With the Assessment Center, users can complete questionnaires online, with the results available immediately. King et al, 2014;Middleton et al, 2013;Saper et al, 2016;Siddarth, Siddarth, & Lavretsky, 2014;Sohl et al, 2016). The initial PROMIS ® item banks were only made available in 2008, which may partly explain their lack of use to date.…”