Colgrove Yvonne M, Gravino-Dunn Nicole S, Dinyer Sarah C, Sis Emily A, Heier Alexa C, Sharma Neena K
Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Missouri, USA.
Int J Yoga. 2019 Sep-Dec;12(3):252-264. doi: 10.4103/ijoy.IJOY_78_18.
Yoga has been shown useful in reducing chronic low back pain (CLBP) through largely unknown mechanisms. The aim of this pilot study is to investigate the feasibility of providing yoga intervention to a predominantly underserved population and explore the potential mechanisms underlying yoga intervention in improving CLBP pain.
The quasi-experimental within-subject wait-listed crossover design targeted the recruitment of low-income participants who received twice-weekly group yoga for 12 weeks, following 6-12 weeks of no intervention. Outcome measures were taken at baseline, preintervention (6-12 weeks following baseline), and then postintervention. Outcome measures included pain, disability, core strength, flexibility, and plasma tumor necrosis factor (TNF)-α protein levels. Outcomes measures were analyzed by one-way ANOVA and paired one-tailed -tests.
Eight patients completed the intervention. Significant improvements in pain scores measured over time were supported by the significant improvement in pre- and post-yoga session pain scores. Significant improvements were also seen in the Oswestry Disability Questionnaire scores, spinal and hip flexor flexibility, and strength of core muscles following yoga. Six participants saw a 28.6%-100% reduction of TNF-α plasma protein levels after yoga, while one showed an 82.4% increase. Two participants had no detectable levels to begin with. Brain imaging analysis shows interesting increases in N-acetylaspartate in the dorsolateral prefrontal cortex and thalamus.
Yoga appears effective in reducing pain and disability in a low-income CLBP population and in part works by increasing flexibility and core strength. Changes in TNF-α protein levels should be further investigated for its influence on pain pathways.
瑜伽已被证明在减轻慢性下腰痛（CLBP）方面有用，但其作用机制大多尚不明确。这项初步研究的目的是调查向主要为服务不足人群提供瑜伽干预的可行性，并探索瑜伽干预改善CLBP疼痛的潜在机制。
采用准实验性受试者内等待名单交叉设计，招募低收入参与者，他们在6 - 12周无干预后，接受为期12周的每周两次的团体瑜伽课程。在基线、干预前（基线后6 - 12周）和干预后进行结果测量。结果测量包括疼痛、功能障碍、核心力量、柔韧性和血浆肿瘤坏死因子（TNF）-α蛋白水平。通过单因素方差分析和配对单尾检验分析结果测量。
8名患者完成了干预。随着时间推移疼痛评分的显著改善得到了瑜伽课程前后疼痛评分显著改善的支持。瑜伽后，Oswestry功能障碍问卷评分、脊柱和髋部屈肌柔韧性以及核心肌肉力量也有显著改善。6名参与者在瑜伽后TNF-α血浆蛋白水平降低了28.6% - 100%，而1名参与者增加了82.4%。2名参与者一开始就检测不到该水平。脑成像分析显示背外侧前额叶皮质和丘脑的N - 乙酰天门冬氨酸有有趣的增加。
瑜伽似乎对减轻低收入CLBP人群的疼痛和功能障碍有效，部分作用机制是通过增加柔韧性和核心力量。TNF-α蛋白水平的变化对疼痛通路的影响应进一步研究。
