Efficacy of yoga intervention for low back pain: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

KANG Yujie ,  YU Hongyan , XING Tangsiqi , CHEN Zhaokun

Department of Physical Education, Shanghai Jiaotong University, Shanghai, 200240, P.R.China;

Corresponding?author：

YU Hongyan, Email: yuhongyan@sjtu.edu.cn

Keywords：

Yoga; Low back pain; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.201906089

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objectives To systematically review the efficacy of yoga treatment for low back pain.Methods Web of Science, BBSCO Academic Source Complete, Elsevier ScienceDirect, Scopus, PubMed, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of yoga intervention for low back pain from inception to November 4^th, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed using RevMan 5.3 software.Results A total of 14 RCTs involving 1 684 patients were included. The results of meta-analysis showed that: compared with conventional treatment, the RMDQ scores of yoga treatment for low back pain was statistically significant lower (MD=–1.86, 95%CI –2.39 to –1.33, P<0.000 01). The results of subgroup analysis showed that the exercise frequency, low back pain degree, low back pain cause, intervention period and sample size had not altered efficacy of yoga.Conclusions Current evidence shows that yoga can achieve superior results in low back pain. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.

Citation： KANG Yujie, YU Hongyan, XING Tangsiqi, CHEN Zhaokun. Efficacy of yoga intervention for low back pain: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2020, 20(1): 47-52. doi: 10.7507/1672-2531.201906089 Copy

1.	Foltz V, St Pierre Y, Rozenberg S, et al. Use of complementary and alternative therapies by patients with self-reported chronic back pain: a nationwide survey in Canada. Joint Bone Spine, 2005, 72(6): 571-577.
2.	Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med, 2007, 147(7): 478-491.
3.	Wolsko PM, Eisenberg DM, Davis RB, et al. Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine (Phila Pa 1976), 2003, 28(3): 292-297.
4.	Carneiro KA, Rittenberg JD. The role of exercise and alternative treatments for low back pain. Phys Med Rehabil Clin N Am, 2010, 21(4): 777-792.
5.	Curtis K, Osadchuk A, Katz J. An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia. J Pain Res, 2011, 4: 189-201.
6.	Holtzman S, Beggs RT. Yoga for chronic low back pain: a meta-analysis of randomized controlled trials. Pain Res Manag, 2013, 18(5): 267-272.
7.	Büssing A, Ostermann T, Lüdtke R, et al. Effects of yoga interventions on pain and pain-associated disability: a meta-analysis. J Pain, 2012, 13(1): 1-9.
8.	Posadzki P, Ernst E. Yoga for low back pain: a systematic review of randomized clinical trials. Clin Rheumatol, 2011, 30(9): 1257-1262.
9.	張寧佳, 胡天琳. 瑜伽在慢性腰痛患者中應用效果的系統評價. 解放軍護理雜志, 2016, 33(10): 7-12.
10.	Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine (Phila Pa 1976), 2000, 25(24): 3115-3124.
11.	陳裔英, 喬晉琳. 下背痛的評價及其患者生活質量的評價. 中國組織工程研究與臨床康復, 2007, 11(23): 4614-4617.
12.	何高. 中文版RMDQ下腰痛量表的研制. 合肥: 安徽醫科大學, 2005.
13.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org.
14.	康玉杰, 于紅妍. 下背痛運動干預效果的元分析. 體育科學, 2019, 39(2): 63-72.
15.	王丹, 翟俊霞, 牟振云, 等. Meta分析中的異質性及其處理方法. 中國循證醫學雜志, 2009, 9(10): 1115-1118.
16.	王雪冰, 馮連世. 健身氣功五禽戲對成年人血脂影響的Meta分析. 中國運動醫學雜志, 2017, 36(2): 156-163, 182.
17.	劉鳴. 系統評價、Meta-分析設計與實施方法. 北京: 人民衛生出版社, 2011: 87-90.
18.	劉關鍵, 吳泰相, 康德英. Meta-分析中的統計學過程. 中國臨床康復, 2003, 7(4): 538-539.
19.	Sherman KJ, Cherkin DC, Wellman RD, et al. A randomized trial comparing yoga, stretching, and a self-care book for chronic low back pain. Arch Intern Med, 2011, 171(22): 2019-2026.
20.	Wattamwar RB, Nadkarni K. Effect of conventional occupational therapy and yoga in chronic low back Pain. Indian J Occup Therap, 2012, 44(2): 1-8.
21.	Standaert CJ. Is yoga an effective therapy for chronic low back pain? Clin J Sport Med, 2007, 17(1): 83-84.
22.	Grotle M, Hagen KB. Yoga classes may be an alternative to physiotherapy for people with chronic nonspecific low back pain [synopsis]. J Physioth, 2018, 64(1): 57.
23.	Ostrovsky DA. Yoga may be noninferior to physical therapy for disability and pain at 12 weeks and both might improve function more than education in low resource adults with chronic nonspecific low back pain. Explore (NY), 2017, 13(6): 424-426.
24.	Saper R, Herman P, Roseen E, et al. Yoga versus physical therapy versus education for chronic low back pain: a randomized non-inferiority trial in an underserved community-based population. Spine J, 2016, 16(10): S291.
25.	Tilbrook HE, Hewitt CE, Aplin JD, et al. Compliance effects in a randomised controlled trial of yoga for chronic low back pain: a methodological study. Physiotherapy, 2014, 100(3): 256-262.
26.	Highland KB, Schoomaker A, Rojas W, et al. Benefits of the restorative exercise and strength training for operational resilience and excellence yoga program for chronic low back pain in service members: a pilot randomized controlled trial. Arch Phys Med Rehabil, 2018, 99(1): 91-98.
27.	Cox H, Tilbrook H, Aplin J, et al. A randomised controlled trial of yoga for the treatment of chronic low back pain: results of a pilot study. Complement Ther Clin Pract, 2010, 16(4): 187-193.
28.	Tilbrook HE, Cox H, Hewitt CE, et al. Yoga for chronic low back pain: a randomized trial. Ann Intern Med, 2011, 155(9): 569-578.
29.	Monro R, Bhardwaj AK, Gupta RK, et al. Disc extrusions and bulges in nonspecific low back pain and sciatica: Exploratory randomised controlled trial comparing yoga therapy and normal medical treatment. J Back Musculoskelet Rehabil, 2015, 28(2): 383-392.
30.	張明軍. 瑜伽運動對女性慢性下背痛康復效果的分析. 體育成人教育學刊, 2012, 28(3): 61-62.
31.	江領群, 祁俊菊. 瑜伽在慢性腰背疼痛患者中的應用研究. 重慶醫學, 2017, 46(24): 3402-3404.
32.	李海, 尚艷華, 鐘惠雅, 等. 瑜伽姿勢訓練在腰椎間盤突出癥綜合康復治療中的應用觀察. 新醫學, 2010, 41(6): 397-399, 411.
33.	祁俊菊, 王仙園, 杜秋華. 瑜伽對慢性腰背痛患者康復的生物力學機制分析. 中國醫學物理學雜志, 2017, 34(7): 748-752.
34.	Cramer H, Lauche R, Haller H, et al. A systematic review and meta-analysis of yoga for low back pain. Clin J Pain, 2013, 29(5): 450-460.
35.	De Giorgio A, Padulo J, Kuva?i? G. Effectiveness of yoga combined with back school program on anxiety, kinesiophobia and pain in people with non-specific chronic low back pain: a prospective randomized trial. MLTJ, 2018, 8(1): 104-112.
36.	Hayashino Y, Noguchi Y, Fukui T. Systematic evaluation and comparison of statistical tests for publication bias. J Epidemiol, 2005, 15(6): 235-243.

1. Foltz V, St Pierre Y, Rozenberg S, et al. Use of complementary and alternative therapies by patients with self-reported chronic back pain: a nationwide survey in Canada. Joint Bone Spine, 2005, 72(6): 571-577.
2. Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med, 2007, 147(7): 478-491.
3. Wolsko PM, Eisenberg DM, Davis RB, et al. Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine (Phila Pa 1976), 2003, 28(3): 292-297.
4. Carneiro KA, Rittenberg JD. The role of exercise and alternative treatments for low back pain. Phys Med Rehabil Clin N Am, 2010, 21(4): 777-792.
5. Curtis K, Osadchuk A, Katz J. An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia. J Pain Res, 2011, 4: 189-201.
6. Holtzman S, Beggs RT. Yoga for chronic low back pain: a meta-analysis of randomized controlled trials. Pain Res Manag, 2013, 18(5): 267-272.
7. Büssing A, Ostermann T, Lüdtke R, et al. Effects of yoga interventions on pain and pain-associated disability: a meta-analysis. J Pain, 2012, 13(1): 1-9.
8. Posadzki P, Ernst E. Yoga for low back pain: a systematic review of randomized clinical trials. Clin Rheumatol, 2011, 30(9): 1257-1262.
9. 張寧佳, 胡天琳. 瑜伽在慢性腰痛患者中應用效果的系統評價. 解放軍護理雜志, 2016, 33(10): 7-12.
10. Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine (Phila Pa 1976), 2000, 25(24): 3115-3124.
11. 陳裔英, 喬晉琳. 下背痛的評價及其患者生活質量的評價. 中國組織工程研究與臨床康復, 2007, 11(23): 4614-4617.
12. 何高. 中文版RMDQ下腰痛量表的研制. 合肥: 安徽醫科大學, 2005.
13. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org.
14. 康玉杰, 于紅妍. 下背痛運動干預效果的元分析. 體育科學, 2019, 39(2): 63-72.
15. 王丹, 翟俊霞, 牟振云, 等. Meta分析中的異質性及其處理方法. 中國循證醫學雜志, 2009, 9(10): 1115-1118.
16. 王雪冰, 馮連世. 健身氣功五禽戲對成年人血脂影響的Meta分析. 中國運動醫學雜志, 2017, 36(2): 156-163, 182.
17. 劉鳴. 系統評價、Meta-分析設計與實施方法. 北京: 人民衛生出版社, 2011: 87-90.
18. 劉關鍵, 吳泰相, 康德英. Meta-分析中的統計學過程. 中國臨床康復, 2003, 7(4): 538-539.
19. Sherman KJ, Cherkin DC, Wellman RD, et al. A randomized trial comparing yoga, stretching, and a self-care book for chronic low back pain. Arch Intern Med, 2011, 171(22): 2019-2026.
20. Wattamwar RB, Nadkarni K. Effect of conventional occupational therapy and yoga in chronic low back Pain. Indian J Occup Therap, 2012, 44(2): 1-8.
21. Standaert CJ. Is yoga an effective therapy for chronic low back pain? Clin J Sport Med, 2007, 17(1): 83-84.
22. Grotle M, Hagen KB. Yoga classes may be an alternative to physiotherapy for people with chronic nonspecific low back pain [synopsis]. J Physioth, 2018, 64(1): 57.
23. Ostrovsky DA. Yoga may be noninferior to physical therapy for disability and pain at 12 weeks and both might improve function more than education in low resource adults with chronic nonspecific low back pain. Explore (NY), 2017, 13(6): 424-426.
24. Saper R, Herman P, Roseen E, et al. Yoga versus physical therapy versus education for chronic low back pain: a randomized non-inferiority trial in an underserved community-based population. Spine J, 2016, 16(10): S291.
25. Tilbrook HE, Hewitt CE, Aplin JD, et al. Compliance effects in a randomised controlled trial of yoga for chronic low back pain: a methodological study. Physiotherapy, 2014, 100(3): 256-262.
26. Highland KB, Schoomaker A, Rojas W, et al. Benefits of the restorative exercise and strength training for operational resilience and excellence yoga program for chronic low back pain in service members: a pilot randomized controlled trial. Arch Phys Med Rehabil, 2018, 99(1): 91-98.
27. Cox H, Tilbrook H, Aplin J, et al. A randomised controlled trial of yoga for the treatment of chronic low back pain: results of a pilot study. Complement Ther Clin Pract, 2010, 16(4): 187-193.
28. Tilbrook HE, Cox H, Hewitt CE, et al. Yoga for chronic low back pain: a randomized trial. Ann Intern Med, 2011, 155(9): 569-578.
29. Monro R, Bhardwaj AK, Gupta RK, et al. Disc extrusions and bulges in nonspecific low back pain and sciatica: Exploratory randomised controlled trial comparing yoga therapy and normal medical treatment. J Back Musculoskelet Rehabil, 2015, 28(2): 383-392.
30. 張明軍. 瑜伽運動對女性慢性下背痛康復效果的分析. 體育成人教育學刊, 2012, 28(3): 61-62.
31. 江領群, 祁俊菊. 瑜伽在慢性腰背疼痛患者中的應用研究. 重慶醫學, 2017, 46(24): 3402-3404.
32. 李海, 尚艷華, 鐘惠雅, 等. 瑜伽姿勢訓練在腰椎間盤突出癥綜合康復治療中的應用觀察. 新醫學, 2010, 41(6): 397-399, 411.
33. 祁俊菊, 王仙園, 杜秋華. 瑜伽對慢性腰背痛患者康復的生物力學機制分析. 中國醫學物理學雜志, 2017, 34(7): 748-752.
34. Cramer H, Lauche R, Haller H, et al. A systematic review and meta-analysis of yoga for low back pain. Clin J Pain, 2013, 29(5): 450-460.
35. De Giorgio A, Padulo J, Kuva?i? G. Effectiveness of yoga combined with back school program on anxiety, kinesiophobia and pain in people with non-specific chronic low back pain: a prospective randomized trial. MLTJ, 2018, 8(1): 104-112.
36. Hayashino Y, Noguchi Y, Fukui T. Systematic evaluation and comparison of statistical tests for publication bias. J Epidemiol, 2005, 15(6): 235-243.

Chinese Journal of Evidence-Based Medicine

Efficacy of yoga intervention for low back pain: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content