Evaluating Yoga for Chronic Low Back Pain

背部问题是困扰成年人的潮湿普遍条件之一，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痛，但人们对它们与传统疗法的比较知之甚少。尽管有大量的随机试验评估脊椎操作和针灸治疗背痛的有效性，但没有一项试验可以评估瑜伽。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治疗慢性腰痛的常规护理进行比较。在该项目的第一阶段，我们将开发、测试和完善这种随机临床试验的各个组成部分。这将包括瑜伽和运动组的协议规范，受试者选择标准，以及招募和保留策略。在第二阶段，我们将使用第一阶段开发的研究组成部分对这些干预措施进行试点试验。我们将30名慢性腰痛患者随机分为以下三组：瑜伽组、常规治疗运动组和常规护理组。我们将在6周、122周和6个月后测量每种治疗对症状、功能、生活质量、背痛相关的利用和护理成本的影响。这项初步研究将使我们能够识别和解决未预料到的问题，估计进行充分有力的全面试验所需的样本，并对瑜伽和治疗性运动项目的有效性和安全性进行初步估计。在本项目结束时，我们将准备一份有竞争力的拨款提案，以评估瑜伽治疗慢性腰痛患者的有效性。

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.