Yoga for Chronic Neck Pain: A Pilot Randomized Controlled Clinical Trial
Yoga for Chronic Neck Pain: A Pilot Randomized Controlled Clinical Trial
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DOI：
10.1016/j.jpain.2012.08.004
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发表时间：
2012-11-01
期刊：
影响因子：
4
通讯作者：
Kessler, Christian
中科院分区：
文献类型：
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作者：
Michalsen, Andreas;Traitteur, Hermann;Kessler, Christian
瑜伽被发现对治疗慢性下腰痛有效。我们的目的是通过随机临床试验来评估莱恩加瑜伽对慢性颈痛的疗效。77名慢性颈痛患者(年龄47.9+/-7.9岁，67名女性)在100 mm视觉模拟评分(VAS)中得分40 mm，被随机分为9周的Lyengar瑜伽计划和每周90分钟的课程(n=38)或自我护理/锻炼计划(n=38)。患者在基线、4周和10周后进行检查。主要的结果测量是从基线到第10周的平均休息疼痛(VAS)的变化。次要结果包括运动疼痛、功能障碍、生活质量(QOL)和心理结果。瑜伽组的12名患者和自我护理/锻炼组的11名患者失去了随访，自我护理组的学习不依从性更高(5名患者对10名患者)。10周时，瑜伽组平均静息疼痛从44.3+/-20.1降至13.0+/-11.6，自我护理/锻炼组从41.9+/-21.9降至34.4+/-21.1(组间差值：-20.1，95%可信区间：-30.0，-10.1；P<；.001)。10周时，瑜伽组的运动疼痛从53.4±18.5降至22.4+/-18.7，自我护理/锻炼组的运动疼痛从49.4+/-22.8降至39.9+/-21.5(组间差值：-18.7，95%可信区间：-29.3，-8.1；P<；.001)。瑜伽对疼痛相关的恐惧、残疾、生活质量和心理结果也有显著的治疗效果。敏感性分析表明，辍学率的影响微乎其微。这两个计划都得到了很好的容忍。在这项初步试验中，瑜伽似乎是治疗慢性颈痛的有效方法，并可能对心理健康和生活质量产生额外影响。瑜伽对慢性颈痛的有效性应通过更长观察期的比较有效性研究来进一步检验。观点：本文介绍了一项为期9周的瑜伽计划或自我护理锻炼对慢性颈痛患者的临床效果的随机对照试验的结果。瑜伽带来了卓越的疼痛缓解和功能改善，可能是治疗慢性颈部疼痛的有用选择。(C)2012年，美国疼痛协会
Yoga has been found effective in the treatment of chronic low back pain. We aimed to evaluate the effectiveness of lyengar yoga in chronic neck pain by means of a randomized clinical trial. Seventy-seven patients (aged 47.9 +/- 7.9, 67 female) with chronic neck pain who scored >40 mm on a 100-mm visual analog scale (VAS) were randomized to a 9-week lyengar yoga program with weekly 90-minute classes (n = 38) or to a self-care/exercise program (n = 38). Patients were examined at baseline and after 4 and 10 weeks. The primary outcome measure was change of mean pain at rest (VAS) from baseline to week 10. Secondary outcomes included pain at motion, functional disability, quality of life (QOL), and psychological outcomes. Twelve patients in the yoga group and 11 patients in the self-care/exercise group were lost to follow-up, with higher study nonadherence in the self-care group (5 versus 10 patients). Mean pain at rest was reduced from 44.3 +/- 20.1 to 13.0 +/- 11.6 at week 10 by yoga and from 41.9 +/- 21.9 to 34.4 +/- 21.1 by self-care/exercise (group difference: -20.1, 95% confidence interval: -30.0, -10.1; P < .001). Pain at motion was reduced from 53.4 18.5 to 22.4 +/- 18.7 at week 10 by yoga and from 49.4 +/- 22.8 to 39.9 +/- 21.5 by self-care/exercise (group difference: -18.7, 95% confidence interval: -29.3, -8.1; P < .001). Significant treatment effects of yoga were also found for pain-related apprehension, disability, QOL, and psychological outcomes. Sensitivity analyses suggested minimal influence of dropout rates. Both programs were well tolerated. In this preliminary trial, yoga appears to be an effective treatment in chronic neck pain with possible additional effects on psychological well-being and QOL. The effectiveness of yoga in chronic neck pain should be further tested by comparative effectiveness studies with longer observation periods.Perspective: This article presents the results of a randomized controlled trial on the clinical effects of a 9-week yoga program or self-care exercise in patients with chronic neck pain. Yoga led to superior pain relief and functional improvements and might be a useful treatment option for chronic neck pain. (C) 2012 by the American Pain Society