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. 2013:2013:130818.
doi: 10.1155/2013/130818. Epub 2013 Apr 17.

Mediators of yoga and stretching for chronic low back pain

Karen J Sherman  1 , Robert D Wellman, Andrea J Cook, Daniel C Cherkin, Rachel M Ceballos
Affiliations

Mediators of yoga and stretching for chronic low back pain

Karen J Sherman et al. Evid Based Complement Alternat Med. 2013.

Abstract

Although yoga is an effective treatment for chronic low back pain, little is known about the mechanisms responsible for its benefits. In a trial comparing yoga to intensive stretching and self-care, we explored whether physical (hours of back exercise/week), cognitive (fear avoidance, body awareness, and self-efficacy), affective (psychological distress, perceived stress, positive states of mind, and sleep), and physiological factors (cortisol, DHEA) mediated the effects of yoga or stretching on back-related dysfunction (Roland-Morris Disability Scale (RDQ)). For yoga, 36% of the effect on 12-week RDQ was mediated by increased self-efficacy, 18% by sleep disturbance, 9% by hours of back exercise, and 61% by the best combination of all possible mediators (6 mediators). For stretching, 23% of the effect was mediated by increased self-efficacy, 14% by days of back exercise, and 50% by the best combination of all possible mediators (7 mediators). In open-ended questions, ≥20% of participants noted the following treatment benefits: learning new exercises (both groups), relaxation, increased awareness, and the benefits of breathing (yoga), benefits of regular practice (stretching). Although both self-efficacy and hours of back exercise were the strongest mediators for each intervention, compared to self-care, qualitative data suggest that they may exert their benefits through partially distinct mechanisms.

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Figures

Figure 1
Figure 1
Model describing possible mechanisms underlying the effectiveness of yoga for chronic low back pain.
See this image and copyright information in PMC

References

    1. Galantino ML, Bzdewka TM, Eissler-Russo JL, et al. The impact of modified hatha yoga on chronic low back pain: a pilot study. Alternative Therapies in Health and Medicine. 2004;10(2):56–59. - PubMed
    1. Jacobs BP, Mehling W, Goldberg H, et al. Feasibility of conducting a clinical trial on hatha yoga for chronic low back pain: methodological lessons. Alternative Therapies in Health and Medicine. 2004;10(2):80–83. - PubMed
    1. Sherman KJ, Cherkin DC, Erro J, Miglioretti DL, Deyo RA. Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Annals of Internal Medicine. 2005;143(12):849–856. - PubMed
    1. Williams KA, Petronis J, Smith D, et al. Effect of Iyengar yoga therapy for chronic low back pain. Pain. 2005;115(1-2):107–117. - PubMed
    1. Tekur P, Singphow C, Nagendra HR, Raghuram N. Effect of short-term intensive yoga program on pain, functional disability and spinal flexibility in chronic low back pain: a randomized control study. Journal of Alternative and Complementary Medicine. 2008;14(6):637–644. - PubMed

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