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Randomized Controlled Trial
. 2017 Nov;53(5):599-608.
doi: 10.1016/j.amepre.2017.05.019. Epub 2017 Jul 20.

Yoga for Military Veterans with Chronic Low Back Pain: A Randomized Clinical Trial

Erik J Groessl  1 , Lin Liu  2 , Douglas G Chang  3 , Julie L Wetherell  4 , Jill E Bormann  5 , J Hamp Atkinson  4 , Sunita Baxi  6 , Laura Schmalzl  7
Affiliations
Randomized Controlled Trial

Yoga for Military Veterans with Chronic Low Back Pain: A Randomized Clinical Trial

Erik J Groessl et al. Am J Prev Med. 2017 Nov.

Abstract

Introduction: Chronic low back pain (cLBP) is prevalent, especially among military veterans. Many cLBP treatment options have limited benefits and are accompanied by side effects. Major efforts to reduce opioid use and embrace nonpharmacological pain treatments have resulted. Research with community cLBP patients indicates that yoga can improve health outcomes and has few side effects. The benefits of yoga among military veterans were examined.

Design: Participants were randomized to either yoga or delayed yoga treatment in 2013-2015. Outcomes were assessed at baseline, 6 weeks, 12 weeks, and 6 months. Intention-to-treat analyses occurred in 2016.

Setting/participants: One hundred and fifty military veterans with cLBP were recruited from a major Veterans Affairs Medical Center in California.

Intervention: Yoga classes (with home practice) were led by a certified instructor twice weekly for 12 weeks, and consisted primarily of physical postures, movement, and breathing techniques.

Main outcome measures: The primary outcome was Roland-Morris Disability Questionnaire scores after 12 weeks. Pain intensity was identified as an important secondary outcome.

Results: Participant characteristics were mean age 53 years, 26% were female, 35% were unemployed or disabled, and mean back pain duration was 15 years. Improvements in Roland-Morris Disability Questionnaire scores did not differ between the two groups at 12 weeks, but yoga participants had greater reductions in Roland-Morris Disability Questionnaire scores than delayed treatment participants at 6 months -2.48 (95% CI= -4.08, -0.87). Yoga participants improved more on pain intensity at 12 weeks and at 6 months. Opioid medication use declined among all participants, but group differences were not found.

Conclusions: Yoga improved health outcomes among veterans despite evidence they had fewer resources, worse health, and more challenges attending yoga sessions than community samples studied previously. The magnitude of pain intensity decline was small, but occurred in the context of reduced opioid use. The findings support wider implementation of yoga programs for veterans.

Trial registration: This study is registered at www.clinicaltrials.gov NCT02524158.

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Figures

Figure 1.
Figure 1.
Flowchart of study participants. ITT, intention to treat.
Figure 2.
Figure 2.
(A) Mean change in RMDQ scores; (B) mean change in pain-intensity scores. RMDQ, Roland–Morris Disability Questionnaire; DT, delayed treatment.
See this image and copyright information in PMC

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References

    1. Koes BW, van Tulder M, Lin CW, Macedo LG, McAuley J, Maher C.An updated overview of clinical guidelines for the management of nonspecific low back pain in primary care. Eur Spine J. 2010;19(12):2075–2094. 10.1007/s00586-010-1502-y. - DOI - PMC - PubMed
    1. Von Korff M, Saunders K. The course of back pain in primary care. Spine (Phila Pa 1976). 1996;21(24):2833–2837. 10.1097/00007632-199612150-00004. - DOI - PubMed
    1. Goulet JL, Kerns RD, Bair M, et al. The musculoskeletal diagnosis cohort: examining pain and pain care among veterans. Pain. 2016;157 (8):1696–1703. 10.1097/j.pain.0000000000000567. - DOI - PMC - PubMed
    1. Kerns RD, Otis J, Rosenberg R, Reid MC. Veterans’ reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system. J Rehab R D. 2003;40(5):371–379. 10.1682/JRRD.2003.09.0371. - DOI - PubMed
    1. Knox J, Orchowski J, Scher DL, Owens BD, Burks R, Belmont PJ. The incidence of low back pain in active duty United States military service members. Spine (Phila Pa 1976). 2011;36(18):1492–1500. 10.1097/BRS.0b013e3181f40ddd. - DOI - PubMed

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