Saper Robert B, Sherman Karen J, Cullum-Dugan Diana, Davis Roger B, Phillips Russell S, Culpepper Larry
Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Massachusetts, USA.
Altern Ther Health Med. 2009 Nov-Dec;15(6):18-27.
Several studies suggest yoga may be effective for chronic low back pain; however, trials targeting minorities have not been conducted. PRIMARY STUDY OBJECTIVES: Assess the feasibility of studying yoga in a predominantly minority population with chronic low back pain. Collect preliminary data to plan a larger powered study.
Pilot randomized controlled trial.
Two community health centers in a racially diverse neighborhood of Boston, Massachusetts.
Thirty English-speaking adults (mean age 44 years, 83% female, 83% racial/ethnic minorities; 48% with incomes < or = $30,000) with moderate-to-severe chronic low back pain.
Standardized series of weekly hatha yoga classes for 12 weeks compared to a waitlist usual care control.
Feasibility measured by time to complete enrollment, proportion of racial/ethnic minorities enrolled, retention rates, and adverse events. Primary efficacy outcomes were changes from baseline to 12 weeks in pain score (0=no pain to 10=worst possible pain) and back-related function using the modified Roland-Morris Disability Questionnaire (0-23 point scale, higher scores reflect poorer function). Secondary efficacy outcomes were analgesic use, global improvement, and quality of life (SF-36).
Recruitment took 2 months. Retention rates were 97% at 12 weeks and 77% at 26 weeks. Mean pain scores for yoga decreased from baseline to 12 weeks (6.7 to 4.4) compared to usual care, which decreased from 7.5 to 7.1 (P=.02). Mean Roland scores for yoga decreased from 14.5 to 8.2 compared to usual care, which decreased from 16.1 to 12.5 (P=.28). At 12 weeks, yoga compared to usual care participants reported less analgesic use (13% vs 73%, P=.003), less opiate use (0% vs 33%, P=.04), and greater overall improvement (73% vs 27%, P=.03). There were no differences in SF-36 scores and no serious adverse events.
A yoga study intervention in a predominantly minority population with chronic low back pain was moderately feasible and may be more effective than usual care for reducing pain and pain medication use.
多项研究表明瑜伽可能对慢性下腰痛有效；然而，尚未开展针对少数族裔的试验。主要研究目标：评估在以少数族裔为主的慢性下腰痛人群中开展瑜伽研究的可行性。收集初步数据以规划一项更大规模的有充分统计学效力的研究。
试点随机对照试验。
马萨诸塞州波士顿一个种族多元化社区的两家社区卫生中心。
30名讲英语的成年人（平均年龄44岁，83%为女性，83%为少数种族/族裔；48%的人收入≤30,000美元），患有中度至重度慢性下腰痛。
与等待名单上的常规护理对照组相比，进行为期12周的标准化每周哈他瑜伽课程系列。
通过完成入组的时间、入组的少数种族/族裔比例、保留率和不良事件来衡量可行性。主要疗效指标是使用改良罗兰-莫里斯残疾问卷（0 - 23分制，分数越高功能越差），从基线到12周疼痛评分（0 = 无疼痛至10 = 可能的最严重疼痛）和与背部相关功能的变化。次要疗效指标是镇痛药使用情况、总体改善情况和生活质量（SF - 36）。
招募工作耗时2个月。12周时保留率为97%，26周时为77%。与常规护理相比，瑜伽组的平均疼痛评分从基线到12周有所下降（从6.7降至4.4），常规护理组从7.5降至7.1（P = 0.02）。与常规护理相比，瑜伽组的平均罗兰评分从14.5降至8.2，常规护理组从16.1降至12.5（P = 0.28）。在12周时，与常规护理参与者相比，瑜伽组报告使用镇痛药的情况较少（13%对73%，P = 0.003），使用阿片类药物的情况较少（0%对33%，P = 0.04），总体改善情况更好（73%对27%，P = 0.03）。SF - 36评分无差异，也没有严重不良事件。
在以少数族裔为主的慢性下腰痛人群中进行的瑜伽研究干预具有一定可行性，在减轻疼痛和减少止痛药物使用方面可能比常规护理更有效。
