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瑜伽、艺术体操疗法和标准物理疗法(YES 试验)治疗慢性非特异性下腰痛患者:一项三臂随机对照试验。

Yoga, Eurythmy Therapy and Standard Physiotherapy (YES-Trial) for Patients With Chronic Non-specific Low Back Pain: A Three-Armed Randomized Controlled Trial.

机构信息

Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Germany.

Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Germany.

出版信息

J Pain. 2021 Oct;22(10):1233-1245. doi: 10.1016/j.jpain.2021.03.154. Epub 2021 Apr 20.

Abstract

We aimed to evaluate the effects of yoga and eurythmy therapy compared to conventional physiotherapy exercises in patients with chronic low back pain. In a three-armed, multicentre, randomized controlled trial, patients with chronic low back pain were treated for 8 weeks in group sessions (75 minutes once per week). Primary outcome was patients' physical disability (measured by RMDQ) from baseline to week 8. Secondary outcome variables were pain intensity and pain-related bothersomeness (VAS), health-related quality of life (SF-12) and life satisfaction (BMLSS). Outcomes were assessed at baseline, after the intervention at 8 weeks and at a 16-week follow up. Data of 274 participants were used for statistical analyses. There were no significant differences between the three groups for the primary and all secondary outcomes. In all groups, RMDQ decreased comparably at 8 weeks, but did not reach clinical meaningfulness. Pain intensity and pain-related bothersomeness decreased, while quality of life increased in all 3 groups. In explorative general linear models for the SF-12's mental health component participants in the eurythmy arm benefitted significantly more compared to physiotherapy and yoga. Furthermore, within-group analyses showed improvements of SF-12 mental score for yoga and eurythmy therapy only. All interventions were safe. Clinical Trials Register: DRKS-ID: DRKS00004651 Perspective: This article presents the results of a multicentre three-armed randomized controlled trial on the clinical effects of three 8-week programs in patients with chronic low back pain. Compared to the 'gold standard' of conventional physiotherapeutic exercises, eurythmy therapy and yoga therapy lead to comparable symptomatic improvements in patients with chronic low back pain. However, the within-group effect sizes were small to moderate and did not reach clinical meaningfulness on patients' physical disability (RMDQ).

摘要

我们旨在评估瑜伽和 eurhythmy 疗法与常规物理治疗运动相比在慢性下腰痛患者中的效果。在一项三臂、多中心、随机对照试验中,慢性下腰痛患者在小组治疗中接受了 8 周的治疗(每周一次,每次 75 分钟)。主要结局是从基线到第 8 周患者的身体残疾(用 RMDQ 衡量)。次要结局变量是疼痛强度和与疼痛相关的困扰(VAS)、健康相关生活质量(SF-12)和生活满意度(BMLSS)。在基线、8 周干预后和 16 周随访时进行评估。共 274 名参与者的数据用于统计分析。三组在主要和所有次要结局上均无显著差异。在所有组中,RMDQ 在 8 周时均显著降低,但未达到临床有意义的程度。三组的疼痛强度和与疼痛相关的困扰均降低,而生活质量均提高。在 SF-12 心理健康成分的探索性一般线性模型中,eurhythmy 组的参与者明显优于物理治疗和瑜伽组。此外,组内分析显示,瑜伽和 eurhythmy 疗法仅能改善 SF-12 心理评分。所有干预均安全。临床试验注册:DRKS-ID:DRKS00004651 视角:本文介绍了一项多中心三臂随机对照试验的结果,该试验研究了三种 8 周方案在慢性下腰痛患者中的临床效果。与常规物理治疗运动的“金标准”相比, eurhythmy 疗法和瑜伽疗法可使慢性下腰痛患者的症状得到类似的改善。然而,组内效应大小较小,对患者身体残疾(RMDQ)的影响未达到临床有意义的程度。

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