Yoga Therapy to Improve Function among Veterans with Chronic Low Back Pain

瑜伽疗法可改善患有慢性腰痛的退伍军人的功能

• 批准号: 8499085
• 负责人: Erik J Groessl
• 金额: --
• 依托单位: VA SAN DIEGO HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-10-01 至 2016-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8499085
• 关键词: Activities of Daily Living; Address; Affect; Analgesics; Analysis of Covariance; Anxiety; Area; Back Pain; Behavioral Medicine; Breathing; Caring; Characteristics; Chronic; Chronic low back pain; Clinic; Clinical; Complex; Conflict (Psychology); Costs and Benefits; Data; Effectiveness; Ensure; Gulf War; Health; Healthcare; Home environment; Intervention; Learning; Level of Evidence; Life; Link; Low Back Pain; Medical Records; Medication Management; Mental Depression; Mental Health; Methods; Military Personnel; Modality; Modeling; Moods; Outcome; Pain; Patients; Persistent pain; Pharmaceutical Preparations; Physical therapy; Physical therapy exercises; Physiological; Population; Posture; Primary Health Care; Productivity; Provider; Questionnaires; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Rest; Risk; Self Care; Self Efficacy; Self-Administered; Series; Services; Spinal Manipulation; Stretching; Students; Symptoms; System; Veterans; Woman; Women' s Health; Yoga; alternative treatment; bodily sensation; chronic back pain; chronic pain; cohort; comparison group; cost; deep breathing exercises; disability; effective therapy; experience; flexibility; follow-up; grasp; group intervention; health care service utilization; health related quality of life; improved; improved functioning; instructor; men; preference; programs; psychologic; randomized trial; secondary outcome

DESCRIPTION (provided by applicant): Impact for Veterans: Chronic low back pain (CLBP) is a highly prevalent condition for veterans, especially those who were actively deployed in military conflicts. In addition to chronic pain, CLBP leads to significant amounts of disability, reduced health-related quality of life (HRQOL), and increased health care utilization. Existing treatments for CLBP typically have small to moderate effects, and patients often seek additional treatment options. Yoga is an inexpensive treatment option with increasing evidence supporting its efficacy. However, it has not been studied among veterans with CLBP. Project Background: Chronic low back pain is highly prevalent, especially among veterans who were actively deployed. CLBP has been shown to result in more disability, higher health care utilization, reduced productivity, and lower HRQOL. Existing treatments for CLBP such as medication, physical therapy, exercise, and spinal manipulation have been shown to have small to moderate effects. Since patients live with chronic conditions for many years, and often for the rest of their lives, they appreciate being able to choose the treatments that best fit with their current values and preferences. In addition, some of these existing treatments are less expensive to provide than others, often because they are delivered in group format. Pilot data from a clinical yoga program show decreases in pain and depression, and increases in energy and HRQOL among veterans with CLBP. Primary Objectives: Our primary objective is to conduct a randomized trial, in which the health outcomes of veterans assigned to yoga is compared to the health outcomes of veterans assigned to delayed treatment with yoga. Our primary hypothesis is that veterans with CLBP assigned to the yoga will have improvements in functional ability that are significantly greater than the comparison group that does not receive yoga right away. Secondary outcomes include pain, psychological symptoms, energy, and HRQOL. Project Methods: We will recruit 144 VA patients with CLBP through VA primary care, pain service, physical therapy, and behavioral medicine clinics. Patients will be screened to ensure they can participate safely. Eligible patients will be randomized to yoga therapy or to the delayed treatment comparison group, which will be allowed to start yoga 12 weeks later. Yoga therapy consists of twice weekly yoga sessions led by a certified yoga practitioner for 12 weeks. Patients are encouraged to practice yoga postures at home unless their pain increases. The comparison group agrees to not participate in yoga or similar interventions for 12 weeks. Otherwise, both groups receive care as usual. Questionnaire data, medical record data, and some physiological data will be collected at baseline, 12 weeks, and at a 6-month follow-up. The main outcome data will be analyzed using ANCOVA and linear random effects models.

描述（由申请人提供）： 对退伍军人的影响：慢性下腰痛（CLBP）对于退伍军人来说是一种非常普遍的状况，尤其是那些积极部署在军事冲突中的人。除慢性疼痛外，CLBP还会导致大量的残疾，与健康相关的生活质量降低（HRQOL）以及增加的医疗保健利用。现有的CLBP治疗通常具有小到中等的影响，患者经常寻求其他治疗选择。瑜伽是一种廉价的治疗选择，越来越多支持其功效的证据。但是，尚未对具有CLBP的退伍军人进行研究。项目背景：慢性下腰痛非常普遍，尤其是在积极部署的退伍军人中。 CLBP已被证明会导致更多的残疾，更高的医疗保健利用，生产率降低和HRQOL降低。现有的CLBP治疗方法，例如药物，物理疗法，运动和脊柱操纵，已显示出较小至中度的作用。由于患者患有慢性病多年，而且经常在余生中生活，因此他们很高兴能够选择最适合当前价值和偏好的治疗方法。此外， 这些现有治疗方法中的一些通常比其他治疗更便宜，这通常是因为它们以小组格式交付。来自临床瑜伽计划的试验数据显示，疼痛和抑郁症的抑郁症减少，CLBP退伍军人的能量和HRQOL的增加。主要目标：我们的主要目标是进行一项随机试验，其中将分配给瑜伽的退伍军人的健康结果与分配给延迟瑜伽治疗的退伍军人的健康结果进行了比较。我们的主要假设是，将CLBP分配给瑜伽的退伍军人将有改善功能能力的改善，其功能能力明显大于没有立即接受瑜伽的比较组。次要结果包括疼痛，心理症状，能量和HRQOL。项目方法：我们将通过VA初级保健，疼痛服务，物理治疗和行为医学诊所招募144名VA患者。将对患者进行筛查，以确保他们可以安全参与。合格的患者将是 随机分配给瑜伽疗法或延迟治疗比较组，该组将在12周后开始瑜伽。瑜伽疗法包括由认证瑜伽从业者领导的每周两次瑜伽课程，为期12周。鼓励患者在家练习瑜伽姿势，除非疼痛增加。比较组同意在12周内不参加瑜伽或类似干预措施。否则，两组都照常照顾。问卷数据，病历数据和一些生理数据将在基线，12周以及6个月的随访中收集。将使用ANCOVA和线性随机效应模型分析主要结果数据。