Evaluating Yoga for Chronic Low Back Pain

背部问题是困扰成年人的潮湿的普遍状况之一，也是使用补充或替代医学(CAM疗法)的主要原因。尽管CAM疗法普遍用于治疗背部疼痛，但人们对它们与传统疗法的比较知之甚少。尽管已经有许多随机试验评估了脊椎手法和针灸治疗背部疼痛的有效性，但还没有找到评估瑜伽的试验。这项研究将为一项全面的试验奠定基础，该试验将瑜伽与传统运动和常规护理进行比较，以治疗慢性下腰痛。在这个项目的第一阶段，我们将开发、测试和改进这种随机临床试验的各个组成部分。这将包括瑜伽和锻炼小组中协议的详细说明，主题选择标准，以及招募和保留战略。在第二阶段，我们将使用在第一阶段开发的研究部分来进行这些干预措施的试点试验。我们将30名慢性下腰痛患者随机分为以下几组：瑜伽、常规运动疗法和常规护理。我们将在6周、122周和6个月后衡量每种治疗对症状、功能、生活质量和与背部疼痛相关的利用和护理成本的影响。试点研究将使我们能够识别和解决意想不到的问题，估计足够强大的全面试验所需的样本，并获得对瑜伽和治疗性锻炼计划的有效性和安全性的初步估计。在这个项目结束时，我们将准备一份竞争性的赠款提案，以评估瑜伽作为慢性下腰痛患者的治疗效果。

Back problems are among the moist prevalent conditions afflicting adults and are a leading reason for using complementary or alternative medical (CAM therapies). Despite the common use of CAM therapies for back pain, little is known about how they compare with conventional treatments. Although there have been numerous randomized trials evaluating the effectiveness of spinal manipulation and acupuncture for back pain, no trials could be identified that evaluated yoga. This study will lay the groundwork for a full-scale trial that compares yoga with conventional exercise and usual care for chronic low back pain. During Phase I of this project, we will develop, test, and refine individual components of such a randomized clinical trial. This will include specification of protocols in the yoga and exercise groups, subject selection criteria, and recruitment and retention strategies. During Phase II, we will use the study components developed during Phase I to conduct a pilot trial of these interventions. We will randomized 30 persons with chronic low back pain to each of the following groups: yoga, a conventional therapeutic exercise program, and usual care. We will measure each treatment's impact on symptoms, function, quality of live, and back pain-related utilization and costs of care after 6 weeks, 122 weeks, and 6 months. The pilot study will permit us to identify and resolve unanticipated problems, to estimate the samples required for an adequately powered full-scale trial, and to obtain preliminary estimates of the effectiveness and safety of yoga and the therapeutic exercise program. At the conclusion of this project, we will be well-positioned to prepare a competitive grant proposal to evaluate the effectiveness of yoga as a treatment for persons with chronic low back pain.