瑜伽与教育对慢性下腰痛退伍军人的影响：一项随机对照试验。
Yoga Versus Education for Veterans with Chronic Low Back Pain: a Randomized Controlled Trial.
机构信息
Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston University Medical Campus, 801 Massachusetts Ave, Second Floor, Boston, MA, 02131, USA.
Department of Physical Medicine and Rehabilitation and New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA.
出版信息
J Gen Intern Med. 2023 Jul;38(9):2113-2122. doi: 10.1007/s11606-023-08037-2. Epub 2023 Jan 17.
BACKGROUND
Yoga is effective for chronic low back pain (cLBP) in civilians but understudied among Veterans.
OBJECTIVE
Determine whether yoga is more effective than an educational book for improving disability and pain among Veterans with cLBP.
DESIGN, SETTING, AND PARTICIPANTS: Veterans diagnosed with cLBP at a VA medical center enrolled in a randomized controlled trial from March to December of 2015.
INTERVENTIONS
Twelve weekly hatha yoga classes or education using The Back Pain Helpbook.
MEASURES
Co-primary outcomes were changes from baseline at 12 weeks in back-related disability on the modified Roland Morris Disability Questionnaire and pain on the Defense & Veterans Pain Rating Scale. Secondary outcomes were global improvement, patient satisfaction, pain medication use, and post-traumatic stress symptoms. An intention-to-treat approach was used in primary analyses.
RESULTS
One hundred twenty Veterans (mean age, 55.5 [SD = 16.9]; 11 [9%] women; mean number of chronic conditions, 5.5) were randomized to yoga (n = 62) and education (n = 58). At 12 weeks, reductions in back-related disability in yoga (mean difference [MD] = - 3.50, 95% CI: - 5.03, - 1.97) were not significantly different than education (MD = - 2.55, 95% CI: - 4.10, - 0.99; between-group difference: - 0.95 [95% CI: - 3.14, 1.23], p = 0.39). For pain, there was no significant difference between yoga (MD = - 1.01, 95% CI: - 1.67, - 0.35) and education (MD = - 0.81, 95% CI: - 1.36, - 0.27; between-group difference: - 0.20, 95% CI: - 1.06, 0.66, p = 0.65). More yoga than education participants reported being very much or extremely improved (39% vs 19%, OR = 3.71, 95% CI: 1.37, 10.02, p = 0.01) and very satisfied with treatment (60% vs 31%, OR = 4.28, 95% CI: 1.70, 10.77, p = 0.002). No differences in pain medication use or post-traumatic stress symptoms were observed at 12 weeks. No serious adverse events were reported in either group.
CONCLUSION
Twelve weekly yoga classes were not more effective than an education intervention for improving pain or disability outcomes among mostly older male Veterans with cLBP and multiple comorbid health conditions.
GOV IDENTIFIER
NCT02224183.
背景
瑜伽对平民的慢性下腰痛（cLBP）有效，但退伍军人中的研究较少。
目的
确定瑜伽是否比教育书籍更能改善患有 cLBP 的退伍军人的残疾和疼痛。
设计、地点和参与者：2015 年 3 月至 12 月期间，在退伍军人事务部医疗中心被诊断患有 cLBP 的退伍军人参加了一项随机对照试验。
干预措施
每周 12 节哈他瑜伽课或使用《背部疼痛自助手册》进行教育。
测量
主要结局是从基线到 12 周时，改良 Roland Morris 残疾问卷（Roland Morris Disability Questionnaire）上与背部相关的残疾和防御与退伍军人疼痛评定量表（Defense & Veterans Pain Rating Scale）上的疼痛的变化。次要结局是整体改善、患者满意度、疼痛药物使用和创伤后应激症状。主要分析采用意向治疗方法。
结果
120 名退伍军人（平均年龄 55.5 [SD = 16.9]；11 [9%] 名女性；平均慢性疾病数量 5.5）被随机分配至瑜伽组（n = 62）和教育组（n = 58）。在 12 周时，瑜伽组的与背部相关的残疾减少（平均差异 [MD] = - 3.50，95% CI：- 5.03，- 1.97）与教育组无显著差异（MD = - 2.55，95% CI：- 4.10，- 0.99；组间差异：- 0.95 [95% CI：- 3.14，1.23]，p = 0.39）。对于疼痛，瑜伽组（MD = - 1.01，95% CI：- 1.67，- 0.35）与教育组（MD = - 0.81，95% CI：- 1.36，- 0.27；组间差异：- 0.20，95% CI：- 1.06，0.66，p = 0.65）之间无显著差异。与教育组相比，更多的瑜伽组参与者报告说他们的病情有很大或极大的改善（39% vs 19%，OR = 3.71，95% CI：1.37，10.02，p = 0.01），对治疗非常满意（60% vs 31%，OR = 4.28，95% CI：1.70，10.77，p = 0.002）。在 12 周时，疼痛药物使用或创伤后应激症状均未见差异。两组均未报告严重不良事件。
结论
对于大多数年龄较大的男性退伍军人来说，每周 12 节瑜伽课并不比教育干预更能改善患有慢性下腰痛和多种合并健康状况的退伍军人的疼痛或残疾结局。
政府标识符
NCT02224183。
Zotero 插件