Secondary Outcomes from a Randomized Controlled Trial of Yoga for Veterans with Chronic Low-Back Pain.
Secondary Outcomes from a Randomized Controlled Trial of Yoga for Veterans with Chronic Low-Back Pain.
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DOI：
10.17761/2020-d-19-00036
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发表时间：
2020-01-01
影响因子：
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通讯作者：
Bormann JE
中科院分区：
文献类型：
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作者：
Groessl EJ;Liu L;Schmalzl L;Chang DG;McCarthy A;Chun WI;Sinclair C;Bormann JE
慢性腰痛（cLBP）是一种普遍的疾病，退伍军人的发病率更高。cLBP是一种持续性疾病，治疗选择具有适度的效果或显著的副作用风险，这导致最近努力探索身心干预选择并减少阿片类药物的使用。先前在社区样本中对瑜伽治疗cLBP的研究，以及最近对退伍军人进行的一项试验的主要结果表明，瑜伽可以减少背部相关的残疾和疼痛强度。这里介绍了退伍军人瑜伽试验的次要结果。在这项研究中，150名患有cLBP的退伍军人（退伍军人管理局患者）在2013年至2015年期间被随机分配到瑜伽组或接受常规护理的延迟治疗组。在基线、6周、12周和6个月时进行评估。进行意向治疗分析。瑜伽课每周两次，每次60分钟，持续12周。瑜伽课程包括身体姿势，运动，集中注意力和呼吸技巧。强烈建议在手册指导下进行家庭练习。主要结果指标是12周后的Roland-Morris残疾问卷评分。次要结果包括疼痛强度、疼痛干扰、抑郁、疲劳、生活质量、自我效能和药物使用。在12周和/或6个月时，瑜伽参与者在疼痛干扰、疲劳、生活质量和自我效能方面的改善超过了延迟治疗的参与者。与对照组相比，瑜伽参与者在许多重要的次要健康结果方面有更大的改善。尽管一些退伍军人面临亲自参加瑜伽课程的挑战，但好处还是出现了。研究结果支持更广泛地实施退伍军人瑜伽计划，并注意增加这一人群的瑜伽计划的可及性。
Chronic low-back pain (cLBP) is a prevalent condition, and rates are higher among military veterans. cLBP is a persistent condition, and treatment options have either modest effects or a significant risk of side-effects, which has led to recent efforts to explore mind-body intervention options and reduce opioid medication use. Prior studies of yoga for cLBP in community samples, and the main results of a recent trial with military veterans, indicate that yoga can reduce back-related disability and pain intensity. Secondary outcomes from the trial of yoga with military veterans are presented here. In the study, 150 military veterans (Veterans Administration patients) with cLBP were randomized to either yoga or a delayed-treatment group receiving usual care between 2013 and 2015. Assessments occurred at baseline, 6 weeks, 12 weeks, and 6 months. Intent-to-treat analyses were conducted. Yoga classes lasting 60 minutes each were offered twice weekly for 12 weeks. Yoga sessions consisted of physical postures, movement, focused attention, and breathing techniques. Home practice guided by a manual was strongly recommended. The primary outcome measure was Roland-Morris Disability Questionnaire scores after 12 weeks. Secondary outcomes included pain intensity, pain interference, depression, fatigue, quality of life, self-efficacy, and medication usage. Yoga participants improved more than delayed-treatment participants on pain interference, fatigue, quality of life, and self-efficacy at 12 weeks and/or 6 months. Yoga participants had greater improvements across a number of important secondary health outcomes compared to controls. Benefits emerged despite some veterans facing challenges with attending yoga sessions in person. The findings support wider implementation of yoga programs for veterans, with attention to increasing accessibility of yoga programs in this population.