Comparing yoga, exercise, and a self-care book for chronic low back pain - A randomized, controlled trial
Comparing yoga, exercise, and a self-care book for chronic low back pain - A randomized, controlled trial
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DOI：
10.7326/0003-4819-143-12-200512200-00003
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发表时间：
2005-12-20
影响因子：
39.2
通讯作者：
Deyo, RA
中科院分区：
文献类型：
--
作者：
Sherman, KJ;Cherkin, DC;Deyo, RA
背景资料：慢性腰痛是一个常见的问题，只有适度有效的治疗方案。目的：确定瑜伽是否比传统的治疗性运动或自我护理书籍更有效的慢性腰痛患者。设计：随机对照试验。设置：一个非营利的综合卫生保健系统。患者：101名慢性腰痛成人。干预：12周的瑜伽或传统的治疗性锻炼课程或一本自我护理书籍。测量：主要结果是背部相关的功能状态（修改后的24点罗兰残疾量表）和疼痛的“烦恼”（11点数字量表）。主要时间点为12周。临床显著变化被认为是功能状态量表上的2.5分和困扰量表上的1.5分。次要结果是限制活动的天数、一般健康状况和药物使用情况。结果：在对基线值进行调整后，瑜伽组的背部相关功能在12周时上级书本组和锻炼组（瑜伽与书本：平均差异，-3.4 [95% CI，-5.1至-1.6] [P < 0.001];瑜伽与锻炼：平均差异，-1.8 [CI，-3.5至-0.1] [P = 0.034]）。在12周时，任何两组之间的症状困扰没有显著差异;在26周时，瑜伽组在这方面上级书籍组（平均差异，-2.2 [CI，-3.2至-1.2]; P < 0.001）。在26周时，瑜伽组的背部相关功能上级书籍组（平均差异，-3.6 [CI，-5.4至-1.8]; P < 0.001）。结论：瑜伽在改善功能和减轻慢性腰痛方面比自我护理书籍更有效，并且益处持续至少几个月。
Background: Chronic low back pain is a common problem that has only modestly effective treatment options.Objective: To determine whether yoga is more effective than conventional therapeutic exercise or a self-care book for patients with chronic low back pain.Design: Randomized, controlled trial.Setting: A nonprofit, integrated health care system.Patients: 101 adults with chronic low back pain.Intervention: 12-week sessions of yoga or conventional therapeutic exercise classes or a self-care book.Measurements: Primary outcomes were back-related functional status (modified 24-point Roland Disability Scale) and "bothersomeness" of pain (11-point numerical scale). The primary time point was 12 weeks. Clinically significant change was considered to be 2.5 points on the functional status scale and 1.5 points on the bothersomeness scale. Secondary outcomes were days of restricted activity, general health status, and medication use.Results: After adjustment for baseline values, back-related function in the yoga group was superior to the book and exercise groups at 12 weeks (yoga vs. book: mean difference, -3.4 [95% CI, -5.1 to - 1.6] [P < 0.001]; yoga vs. exercise: mean difference, -1.8 [CI, -3.5 to - 0.1] [P = 0.034]). No significant differences in symptom bothersomeness were found between any 2 groups at 12 weeks; at 26 weeks, the yoga group was superior to the book group with respect to this measure (mean difference, -2.2 [CI, -3.2 to - 1.2]; P < 0.001). At 26 weeks, back-related function in the yoga group was superior to the book group (mean difference, -3.6 [CI, -5.4 to - 1.8]; P < 0.001).Conclusions: Yoga was more effective than a self-care book for improving function and reducing chronic low back pain, and the benefits persisted for at least several months.