Yoga or physical therapy for treatment of chronic low back pain...

OBJECTIVE: To compare clinical and demographic characteristics of individuals self-selecting yoga or physical therapy (PT) for treatment of chronic low back pain (cLBP) and to examine predictors of short-term pain and functional outcomes. DESIGN: Descriptive, longitudinal study. SETTINGS: A hospital-based clinic that offers modified integral yoga classes for cLBP and 2 outpatient PT clinics that offer exercise-based PT. PARTICIPANTS: Adults (n=53) with cLBP?12 weeks: yoga (n=27), PT (n=26). METHODS: Yoga participants attended a 6-week, once weekly, 2-hour yoga class. PT participants underwent twice weekly, 1-hour individualized PT. Data were collected at baseline and at 6 weeks. Groups were compared by using ?2 and independent samples t-tests. Hierarchical linear regression was used to predict treatment outcomes. MAIN OUTCOME MEASURES: Disability (Roland Morris Disability Questionnaire), health status (Rand Short Form 36 Health Survey 1.0), pain bothersomeness (numerical rating scale), back pain self-efficacy (Back Pain Self-Efficacy Scale), and treatment satisfaction. RESULTS: At baseline, yoga participants were significantly less disabled (P=.013), had higher health status (P=.023), greater pain self-efficacy (P=.012), and less average pain bothersomeness (P=.001) compared with PT participants. At 6 weeks, when controlling for baseline group differences, greater pain self-efficacy was the strongest predictor for reduced pain and higher function for the entire sample. A significant group interaction by baseline pain self-efficacy predicted disability at 6 weeks. PT participants with low pain self-efficacy reported significantly greater disability than those with high pain self-efficacy. Yoga participants with low and high pain self-efficacy had similar disability outcomes. CONCLUSION: These findings strengthen evidence that self-efficacy is associated with cLBP outcomes, especially in individuals self-selecting PT. Further research to evaluate outcomes after yoga and PT in participants with low pain self-efficacy is needed.

PM R. 2010 Nov;2(11):1006-15. Evans DD, Carter M, Panico R, Kimble L, Morlock JT, Spears MJ. Family and Community Nursing, Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd, Atlanta, GA 30322, USA. dian.evans@emoryhealthcare.org